Kev pab kho tus mob cancer prostate

Kev kho qog noj ntshav rau qog nqaij hlav cancer siv kev phais lossis tshuaj kom txo qis ntawm cov txiv neej kev sib deev hauv txivneej lub cev. Qhov no yuav pab kom qhov kev loj hlob sai ntawm prostate.

Androgens yog txiv neej cov tshuaj hormones. Testosterone yog ib hom loj ntawm androgen. Feem ntau cov testosterone ua los ntawm cov noob qes. Cov qog adrenal kuj ua rau me me.

Androgens ua rau cov qog ntshav mob qog nqaij hlav tuaj. Kev kho qog rau prostate cancer ua qis dua cov nyhuv theem ntawm androgens hauv lub cev. Nws tuaj yeem ua qhov no los ntawm:

• Txhawm rau cov noob qes los ntawm kev ua androgens siv phais lossis siv tshuaj
• Kev txwv cov kev ua ntawm androgens hauv lub cev
• Cheem lub cev los ntawm kev tsim androgens

Kev kho tus kheej yuav luag tsis tau siv rau cov neeg Mob Qog I lossis Theem II prostate cancer.

Nws yog tsuas yog siv rau:

• Mob kheesxaws siab heev uas tau kis tshaj li lub qog prostate
• Kab mob qog noj hlav uas tsis tuaj yeem ua tiav rau kev phais lossis hluav taws xob
• Mob khees xaws uas muaj dua

Nws kuj tseem siv tau:

• Ua ntej hluav taws xob lossis phais los pab ua kom lub qog
• Nrog rau kev xoo hluav taws xob rau kev kho mob qog nqaij hlav uas yuav rov muaj dua

Txoj kev kho mob feem ntau yog noj tshuaj uas txo qis ntawm androgens ua los ntawm cov noob qes. Lawv hu ua luteinizing cov tshuaj hormones tso tawm (LH-RH) cov tshuaj tiv thaiv (kev txhaj tshuaj) thiab anti-androgens (ntsiav tshuaj ntawm qhov ncauj). Cov tshuaj no qis thiab androgen theem tib yam nkaus li kev phais ib qho. Hom kev kho no qee zaum hu ua "chemical castration."

Cov txiv neej uas tau txais kev kho mob androgen deprivation yuav tsum tau soj ntsuam nrog tus kws kho mob sau cov tshuaj:

• Hauv 3 rau 6 lub hlis tom qab pib kho
• Tsawg kawg ib xyoos ib zaug, soj ntsuam ntshav siab thiab ua cov ntshav qab zib (piam thaj) thiab kuaj cov roj (cholesterol)
• Txhawm rau kuaj PSA cov ntshav ntsuas seb txoj kev kho ua haujlwm tau zoo npaum li cas

LH-RH cov lus tso tawm tau muab raws li kev txhaj tshuaj lossis tshuaj pleev ib qho me me tso rau hauv qab daim tawv. Lawv raug muab rau txhua qhov chaw ib hlis ib zaug mus rau ib xyoos ib zaug. Cov tshuaj no suav nrog:

• Leuprolide (Lupron, Eligard)
• Goserelin (Zoladex)
• Triptorelin (Trelstar)
• Keebkwm (Vantas)

Lwm cov tshuaj, degarelix (Firmagon), yog LH-RH antagonist. Nws txo cov androgen theem nrawm dua thiab muaj cov kev cuam tshuam tsawg dua. Nws yog siv rau cov txiv neej muaj mob qog nqaij hlav siab tshaj.

Qee tus kws kho mob pom zoo kom tsum thiab thim rov qab kho (kho ntu nruab nrab). Kauj no tshwm los pab txo cov tshuaj phiv tawm tsam kev cuam tshuam. Txawm li cas los xij, nws tsis paub meej yog tias sib quas ntus kho ua haujlwm nrog rau kev kho tas mus li. Qee qhov kev tshawb fawb qhia tau hais tias kev kho mob tas mus li kom muaj txiaj ntsig zoo dua lossis kev kho mob tsis tu ncua yuav tsum siv rau kev xaiv hom mob qog nqaij hlav cancer.

Kev phais kom tshem tawm cov noob qes (tawm haujlwm) nres qhov kev tsim tawm ntawm feem ntau androgens hauv lub cev. Qhov no tseem ua kom qis lossis mob prostate cancer los ntawm kev loj hlob. Thaum ua tau zoo, feem ntau cov txiv neej tsis xaiv qhov kev xaiv no.

Qee cov tshuaj uas ua haujlwm los ntawm kev thaiv cov nyhuv ntawm androgen rau lub qog ntshav qog ntshav. Lawv hu ua anti-androgens. Cov tshuaj no yog siv tshuaj. Lawv feem ntau siv thaum cov tshuaj txo qis androgen theem tsis ua haujlwm zoo li.

Anti-androgens suav nrog:

• Flutamide (Eulexin)
• Enzalutamide (Xtandi)
• Abiraterone (Zytiga)
• Bicalutamide (Casodex)
• Nilutamide (Nilandron)

Androgens tuaj yeem tsim nyob rau lwm qhov chaw ntawm lub cev, xws li cov qog adrenal. Qee cov kab mob qog ntshav yuav ua tau androgens. Peb cov tshuaj pab nres lub cev los ntawm kev tsim cov androgens los ntawm cov nqaij mos dua li cov noob qes.

Ob yam tshuaj, ketoconazole (Nizoral) thiab aminoglutethimide (Cytradren), kho lwm yam kab mob tab sis qee zaum siv los kho kev mob qog nqaij hlav prostate. Qhov thib peb, abiraterone (Zytiga) kho cov qog ntshav qog nqaij hlav siab coob uas tau kis mus rau lwm qhov chaw hauv lub cev.

Sij hawm dhau mus, kev mob qog nqaij hlav cancer yuav tiv thaiv kev kho qog. Qhov no txhais tau tias kev mob qog tsuas xav tau androgen theem qis kom loj hlob ntxiv. Thaum qhov no tshwm sim, yuav tau siv tshuaj ntxiv lossis lwm yam kev kho mob ntxiv.

Androgens muaj cov teebmeem thoob plaws lub cev. Yog li, cov kev kho mob uas txo cov tshuaj hormones no tuaj yeem ua rau ntau yam kev mob tshwm sim. Ntev koj noj cov tshuaj no ntev, koj muaj feem yuav muaj kev phiv ntau.

Lawv suav nrog:

• Cov teeb meem tau txais erection thiab tsis xav nrog kev sib deev
• Txi cov noob qes thiab noov
• Kub muag kub
• Nqaij lossis tawg cov pob txha
• Cov leeg me thiab cov leeg tsis muaj zog
• Hloov ntshav siab, xws li roj (cholesterol)
• Hloov ntshav qab zib
• Qhov hnyav nce
• Mus ob peb vas hloov
• Nkees
• Kev loj hlob ntawm cov nqaij mos, ua kom lub mis

Txoj kev kho Androgen deprivation tuaj yeem ua rau muaj kev pheej hmoo rau ntshav qab zib thiab mob plawv.

Kev txiav txim siab txog kev kho tshuaj hormones rau tus mob qog nqaij hlav cancer tuaj yeem yog txoj kev txiav txim siab nyuaj thiab txawm tias nyuaj. Hom kev kho mob twg yuav yog nyob ntawm:

• Koj qhov kev pheej hmoo yuav mob kheesxaws rov qab los
• Npaum li cas koj kev mob qog yuav ntau npaum li cas
• Txawm hais tias lwm txoj kev kho mob tau tso tseg tsis ua haujlwm lawm
• Seb puas yuav kis tau tus mob cancer

Tham nrog koj tus kws kho mob txog koj cov kev xaiv thiab qhov zoo thiab qhov txaus ntshai ntawm txhua qhov kev kho mob tuaj yeem pab koj txiav txim siab zoo tshaj plaws rau koj.

Androgen kev tiv thaiv tsis zoo; ADT; Androgen txwv kev kho mob; Ua ke androgen blockade; Orchiectomy - mob cancer prostate; Castration - mob prostate

• Txiv neej deev aatomy

American Cancer Society lub vev xaib. Kev pab kho tus mob cancer prostate. www.cancer.org/cancer/prostate-cancer/treating/hormone-therapy.html. Hloov kho thaum Lub Kaum Ob Hlis 18, 2019. Nkag mus Lub Peb Hlis 24, 2020.

Lub koom haum Cancer National website. Kev pab kho tus mob cancer prostate. www.cancer.gov/types/prostate/prostate-hormone-therapy-fact-sheet. Hloov kho Lub Ob Hlis 28, 2019. Nkag mus Lub Kaum Ob Hlis 17, 2019.

Lub koom haum Cancer National website. Kev kho mob Prostate cancer (PDQ) - kev tshaj lij kho mob. www.cancer.gov/types/prostate/hp/prostate-treatment-pdq. Hloov kho Lub Ib Hlis 29, 2020. Nkag mus rau Lub Peb Hlis 24, 2020.

Lub Tebchaws National Comprehensive Cancer Network lub vev xaib. NCCN kev soj ntsuam kev coj ua hauv oncology (Cov txheej txheem NCCN): mob prostate. Daim Ntawv 1.2020. www.nccn.org/professionals/physician_gls/pdf/prostate.pdf. Hloov kho thaum Lub Peb Hlis 16, 2020. Nkag mus rau Lub Peb Hlis 24, 2020.

Eggener S. Kev kho qog noj ntshav rau qog ntshav qog nqaij hlav cancer. Hauv: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh UrologyCov. 12th ed. Philadelphia, PA: Elsevier; 2021: chap 161.

• Prostate Cancer