HER2乳癌既兇且惡：適當治療控病效果佳更能保住生活質素

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醫療新知 > HER2乳癌既兇且惡：適當治療控病效果佳更能保住生活質素

HER2乳癌既兇且惡：適當治療控病效果佳更能保住生活質素

05-12-2022

很多女士以為乳癌離自己很遠，但這種女性最常見癌症其實十分普遍，大約每14名女性便有一人會於75歲之前患上乳癌¹，而單在2019年便有超過4700宗新症²。幸而近年乳癌治療不斷有突破，即使是較惡性的HER2乳癌，仍可利用化療及標靶藥等治療，包括抗體複合藥物(ADC) ³，以獲得更理想的控病效果。

臨床上，乳癌不但會按腫瘤範圍及擴散情況分期，也會根據腫瘤特性進行分類，分別是荷爾蒙受體（ER/PR）陽性、HER2陽性及三陰性等三類，當中HER2被視為比較「惡」的乳癌類別，不只生長速度較急，亦容易出現擴散⁴，而且復發時間更早、風險也較高⁵。

擴散乳癌以藥物治療為主

對於較早期的乳癌，通常可透過手術達到根治效果，並可因應復發風險加入藥物作輔助治療，又或先以藥物治療縮小腫瘤，然後才進行手術切除⁶。但若癌細胞已進入較晚期及出現擴散，可能會引起骨痛、氣喘、腹脹，又或是與中風相似的神智混亂及半身無力等情況⁷，這時的治療則與早期乳癌大為不同。

以HER2乳癌為例，如癌細胞已經擴散，傳統做法是以單標靶加化療作治療⁸，惟不少病人都因為化療而出現嘔吐、脫髮及造血功能下降等副作用⁹，故現在治療方案多改以針對性較高的使用⁸。假若病情進一步惡化，則可以採用針對性更高的抗體藥物複合體控制病情⁸。

二合一藥物夾擊腫瘤增療效

盧醫生指出，這類結合標靶藥和化療的抗體複合藥物有助病人維持較為正常及良好的生活質素，病人於治療期間亦可以如常生活，繼續上班及照顧家庭。患上乳癌雖然令人難以接受及感到不安，不過患病並非等於世界末日，現時有很多有效的藥物可用，而且不斷有更具療效的新藥面世，讓病人可以享有數以年計的壽命。

及早察覺乳癌根治機會愈高

早期乳癌的治癒機會較高，故此定期檢查十分重要，尤其是帶有相關遺傳基因的女性¹，更不能掉以輕心。與此同時，我們平日應留意乳房的狀況和變化¹（見附表），發現徵狀應該及早求醫，不宜拖延處理，以免錯失治療的黃金機會。

表：乳癌6大症狀¹⁰

摸到乳房有硬塊
腋下/鎖骨淋巴腫脹
乳房皮膚異常增厚/脫皮
乳房或周圍發炎／紅腫
乳頭變得凹陷
乳頭有分泌物

此文章由香港第一三共和阿斯利康香港支持

HK-8097 30/11/2022

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