Androgen Deprivation Therapy-tseem hu ua kev kho tshuaj hormone-yog ib txoj hauv kev txo qis qee yam tshuaj ("androgens") hauv txiv neej lub cev los kho mob qog noj ntshav. (Kev kho phais kuj tseem yog ib qho kev xaiv.) Cov kev tshawb fawb tau qhia tias mob qog noj ntshav prostate tuaj yeem nqaim lossis loj hlob ntawm qhov qeeb qeeb thaum cov qib androgen raug txo. Yog li, ntau tus kws kho mob thiab cov neeg mob qog noj ntshav prostate saib rau kev kho kom tsis muaj zog androgen raws li kev kho mob qog noj ntshav prostate tseem ceeb. Los ntawm kev kawm txog nws thiab sab laj nrog koj tus kws kho mob, koj yuav pom tias kev kho tshuaj androgen tsis txaus yog txoj kev kho rau koj.
Cov kauj ruam
Ntu 1 ntawm 3: Tham Nrog Koj Tus Kws Kho Mob
Kauj Ruam 1. Tham nrog koj tus kws kho mob
Tom qab koj thawj zaug kuaj mob qog noj ntshav prostate hauv cov neeg mob qog noj ntshav prostate tsis tau kho yav dhau los, koj yuav muaj sijhawm teem sijhawm teem sijhawm nrog kws kho mob tshwj xeeb oncological. Koj tus kws kho mob yuav tshuaj xyuas koj tus mob thiab xwm txheej thiab tawm tswv yim txog kev kho mob muaj peev xwm.
- Tus kws kho mob yuav sau cov ncauj lus ntxaws txog keeb kwm kev mob nkeeg thiab kuaj lub cev, yog tias lawv tsis tau ua li ntawd.
- Koj tus kws kho mob yuav piav qhia rau koj txog kev kuaj mob, kev kwv yees, thiab kev kho mob muaj peev xwm. Raws li kev kuaj mob, lawv yuav zoo li tham txog koj "qib" lossis qib mob qog noj ntshav prostate. Kev mob qog noj ntshav prostate tau muab qhab nia ntawm qhov ntsuas ntawm 1 txog 10, nrog 5 lossis siab dua qhia txog cov ntaub so ntswg uas tsis txawv txav thiab qhia txog mob qog noj ntshav. Qhov no hu ua Gleason Score siab dua Gleason Score qhov ua rau mob qog noj ntshav ntau dua.
- Nws yog qhov zoo heev uas koj yuav tsum tau sab laj nrog koj tus kws kho mob ob peb zaug ua ntej lawv cog lus rau koj kom kawm txog kev kho cov tshuaj hormones.
Kauj Ruam 2. Xa mus rau kev kuaj mob
Koj tus kws kho mob tshwj xeeb yuav pom zoo kuaj mob uas yuav lees paub koj qhov kev kuaj mob thawj zaug thiab khaws cov ntaub ntawv ntau ntxiv txog koj tus mob. Cov kev kuaj mob no tseem ceeb heev hauv kev pab koj tus kws kho mob kom paub txog lub tswv yim txog kev kho mob yav tom ntej.
- Tus kws kho mob yuav ua haujlwm kuaj ntshav antigen tshwj xeeb prostate. Lawv tuaj yeem ua qhov no ntau zaus.
- Koj tus kws kho mob tshwj xeeb yuav ua qhov transrectal ultrasound.
- Yog tias kev kuaj mob ua ntej qhia tias mob qog noj ntshav prostate, lawv yuav muaj peev xwm ua cov qog nqaij hlav hauv lub cev.
- Muaj ntau yam ntawm lwm qhov kev kuaj mob uas yuav siv tau los saib yog tias mob qog noj ntshav prostate tau nthuav dav dhau ntawm prostate. Cov no suav nrog kuaj pob txha, kuaj CT, MRI, lossis qog ntshav qog ntshav. Cov qog nqaij hlav cancer prostate lig feem ntau kis mus rau lub lumbar qaum nrog mob nraub qaum.
Kauj Ruam 3. Txiav txim siab txog kev kho mob
Tom qab koj tau tham nrog koj tus kws kho mob thiab xa mus rau kev kuaj mob, koj thiab koj tus kws kho mob yuav tuaj yeem txiav txim siab txog yam tshwj xeeb ntawm kev kho tshuaj hormone. Nws yog ib qho tseem ceeb kom ua raws cov lus qhia ntawm koj tus kws kho mob, vim tias lawv muaj kev paub dhau los.
- Yog tias koj xav tias tsis zoo qhia, koj yuav tsum tau txais kev pom zoo thib ob.
- Nyob ntawm koj qhov xwm txheej, koj tus kws kho mob yuav qhia tshwj xeeb txog kev kho tshuaj hormone. Txawm li cas los xij, lawv tuaj yeem muab cov kev xaiv sib txawv rau koj. Siv sijhawm los xav txog qhov zoo thiab qhov tsis zoo ntawm txhua qhov kev xaiv.
- Tham nrog koj tsev neeg txog cov kev xaiv sib txawv uas koj tus kws kho mob tau hais qhia. Tej zaum lawv yuav tuaj yeem muab kev txhawb nqa rau koj lossis lawv yuav muaj qee qhov kev nkag siab uas koj tsis pom. Ib qho ntxiv, qhov kev xaiv uas koj xaiv tuaj yeem cuam tshuam rau koj tsev neeg yav tom ntej.
Ntu 2 ntawm 3: Tau Txais Kev Kho Mob Androgen
Kauj Ruam 1. Siv koj cov tshuaj noj
Ua thawj kauj ruam, koj tus kws kho mob yuav sau ntawv tshuaj noj, xws li GnRH agonist txhawm rau thaiv lub hypothalamus pituitary axis. Cov tshuaj no yuav txo qis lossis ua haujlwm zoo ntawm androgens hauv koj lub cev. Qhov no yog qhov kev xaiv tsis muaj zog, tab sis yuav muab cov txiaj ntsig zoo uas txo cov kev phom sij cuam tshuam nrog cov txheej txheem cuam tshuam ntau dua li kev phais.
- Cov tshuaj noj hauv qhov ncauj tuaj yeem sau tseg rau lub sijhawm luv lossis ntev.
- Nco ntsoov noj koj cov tshuaj raws li koj tus kws kho mob pom zoo.
- Nco ntsoov tias mob qog noj ntshav tuaj yeem tsim kev tiv thaiv androgen kev kho lub sijhawm.
Kauj Ruam 2. Siv tshuaj kho ua ntej lossis ua raws lwm hom kev kho mob
Kev kho tshuaj Hormone-qhov ncauj lossis txhaj tshuaj-feem ntau tau sau ua ntej lossis tom qab phais lossis hluav taws xob. Siv antiandrogens nrog GnRH agonist ua rau muaj kev sib xyaw androgen thaiv.
- Hauv qee kis, tus kws kho mob yuav sau tshuaj kho tshuaj kom txo koj cov qog nqaij hlav hauv kev npaj rau kev phais tshem tawm.
- Lwm lub sij hawm, koj tus kws kho mob yuav sau tshuaj kho cov tshuaj tom qab phais lossis hluav taws xob kom txo qis lossis ua rau muaj mob qog noj ntshav uas tseem tshuav.
- Nov yog ib qho kev xaiv kho mob hnyav tshaj plaws.
Kauj Ruam 3. Muab tshuaj txhaj lossis cog
Koj tus kws kho mob yuav hais qhia tias koj tau txhaj tshuaj rau koj, lossis cog qoob loo. Cov tshuaj no yuav txwv tsis pub lub peev xwm ntawm koj cov noob qes los tsim androgens - txheej txheem hu ua tshuaj lom neeg.
- Kev siv tshuaj lom neeg tuaj yeem thim rov qab thaum cov tshuaj raug tso tseg lossis tshem tawm ntawm lub cev.
- Qhov kev kho no yuav kim heev.
- Ib qho kev phom sij ntawm cov tshuaj lom castration yog cov noob qes ntsws - qee yam uas yuav tsis thim rov qab.
- Cov tshuaj txhaj yuav tsum tau rov ua dua txhua lub hlis.
- Kev cog qoob loo yuav tsum tau hloov txhua xyoo lossis thaum txiav tawm ntawm koj txoj kev kho tshuaj hormone.
Kauj Ruam 4. Nthuav phais kom tshem koj cov noob qes (ob lub orchiectomy)
Tej zaum qhov kev xaiv ntau tshaj plaws ntawm kev kho cov tshuaj hormones yog kom tus kws phais mob tshem koj cov noob qes. Qhov no yuav tshem tawm androgens uas tsim los ntawm cov noob qes.
- Nov yog qhov kev xaiv kho mob tsawg tshaj plaws.
- Qhov no yuav ua rau muaj kev hloov pauv lub cev tas li, zoo li nce phaus thiab nce cov nqaij hauv lub mis, uas nrog qhov txo qis hauv testosterone ntau hauv koj lub cev.
- Qhov kev xaiv no muaj txiaj ntsig vim tias cov noob qes tsim tawm 80% txog 90% ntawm lub cev testosterone.
Ntu 3 ntawm 3: Kawm Txog Kev Kho Mob Androgen Deprivation
Kauj Ruam 1. Paub thaum twg kho cov tshuaj hormones
Koj thawj kauj ruam hauv kev kawm txog kev kho tshuaj hormone yog paub thaum twg - thiab nyob rau qhov xwm txheej twg - kws kho mob sau ntawv nws siv. Thaum kawg, tsis yog txhua tus neeg thiab txhua theem ntawm kev mob qog noj ntshav prostate yuav tsim nyog siv cov tshuaj kho. Kev kho tshuaj Hormone feem ntau siv:
- Thaum mob qog noj ntshav prostate loj dhau los kho los ntawm kev phais lossis hluav taws xob.
- Yog tias mob qog noj ntshav prostate mob tom qab phais lossis hluav taws xob.
- Ua ke nrog lwm yam kev kho mob.
- Raws li tus txheej txheem ua ntej rau lwm tus, cuam tshuam ntau dua, kev kho mob.
Kauj Ruam 2. Nkag siab txog hom kev kho tshuaj hormone sib txawv
Ua ntej txiav txim siab txog kev kho mob, koj yuav tsum nkag siab ntau txoj hauv kev sib txawv ntawm kev ua li ntawd. Thaum kawg, txoj hauv kev sib txawv ntawm kev kho cov tshuaj hormone sib txawv hauv qib ntawm kev cuam tshuam lossis nyob mus ib txhis.
- Kev phais phais, uas tshem tawm cov noob qes - lub cev qhov loj tshaj plaws ntawm androgens.
- Txhaj tshuaj lossis cog tshuaj uas txo cov tshuaj testosterone tsim los ntawm koj cov noob qes.
- Cov tshuaj uas txo cov tshuaj testosterone thiab lwm yam androgens tsim los ntawm koj lub cev.
- Cov tshuaj uas tiv thaiv androgens los ntawm kev ua haujlwm kom raug.
Kauj Ruam 3. Xav txog cov kev mob tshwm sim thiab ua tau zoo ntawm kev kho tshuaj hormone
Zoo li lwm hom kev kho mob qog noj ntshav, kev kho kom tsis muaj zog androgen muaj kev phiv sib txawv thiab qib ntawm kev ua tau zoo.
- Kev ua tau zoo nyob ntawm ntau yam xwm txheej, suav nrog nws siv ua ke nrog lwm yam kev kho mob, mob hnyav ntawm mob qog noj ntshav, thiab hnub nyoog lossis kev noj qab haus huv ntawm tus neeg mob.
- Cov kev mob tshwm sim tuaj yeem suav nrog: kub nyhiab, txo qis kev sib deev, txo qis ntawm cov noob qes, txha txha, pob txha puas, nkees, xeev siab, thiab kev nyuaj siab. Kuj tseem muaj kev cuam tshuam rau lub cev muaj pes tsawg leeg thiab cov metabolism, uas tuaj yeem suav nrog txo qis hauv cov nqaij ntshiv, nce cov rog khaws cia, txo cov leeg muaj zog, ua kom tawv nqaij lossis loj hlob ntawm cov nqaij ntawm lub mis, thiab txo qis insulin rhiab heev.
- Qee qhov kev tshawb fawb qhia tias ADT tuaj yeem ua rau muaj mob thiab tuag taus los ntawm kab mob plawv.
