Kenza, Melanoma Yemeso

Melanoma yeziso kazhinji inokanganisa rukoko rwakati sandara rweziso rako (uvea). Zvikamu zveuvea yeziso rako zvinogona kukura melanoma zvinosanganisira chikamu chine ruvara rweziso rako (iris), tsinga dzemhasuru dziri kutenderera lens yeziso rako (ciliary body), uye rukoko rwema capillaries anovhara kumashure kweziso rako (choroid).

Melanoma rudzi rwerukenza runokura muzera rinogadzira melanin - pigment inoita kuti ganda rako rive neruvara. Maziso ako anewo ma cell anogadzira melanin uye anogona kukura melanoma. Melanoma yeziso inonziwo ocular melanoma.

Mazhinji emelanomas eziso anoumbwa muchikamu cheziso rausingakwanisi kuona kana uchitarisa mugirazi. Izvi zvinoita kuti melanoma yeziso ive yakaoma kuona. Uyezve, melanoma yeziso kazhinji haina zviratidzo kana zviratidzo zvepakutanga.

Kurapwa kuripo kwemelanomas yeziso. Kurapwa kwemamwe melanomas madiki eziso kungasakanganisa kuona kwako. Nekudaro, kurapwa kwemelanomas makuru eziso kazhinji kunokonzera kurasikirwa nekuona.

Melanoma yeziso ingangodaro isina zviratidzo nezvimwe zvinoratidza. Kana zvikaitika, zviratidzo nezvimwe zvinoratidza melanoma yeziso zvinogona kusanganisira:

• Kunzwa kwemagetsi kana mahwendefa eduvi mukuona kwako (floaters)
• Chisimbiso cheduvi chinoonekwa pachena riri kukura pa iris
• Kushanduka kwechitarisiko chechigadziko cheduvi (pupil) pakati pemaziso ako
• Kuona kusina kunaka kana kusapfava kweziso rimwe
• Kurasikirwa nekuona kwepedyo

Enda kunachiremba kana uine zviratidzo zvinokunetsa. Kuchinja kwakapfupi pakuona kwako kunoratidza kuti pane ngozi, saka tsvaga rubatsiro nekukurumidza mumamiriro ezvinhu akadaro.

Hazvina kujeka kuti chii chinokonzera melanoma yemeso.

Vanachiremba vanoziva kuti melanoma yemeso inoitika kana paine zvikanganiso zvinoitika muDNA yesero dzutano dziso. Zvikanganiso zveDNA zvinotaura kumasero kuti akure uye kuwanda zvisina kudzorwa, saka masero akachinja anoenderera mberi achirarama apo angadai akafa. Masero akachinja anoungana mumeso uye anoumba melanoma yemeso.

Melanoma yemeso kazhinji inoitika mumasero erukova rwepakati remetso (uvea). Uvea ine zvikamu zvitatu uye chimwe nechimwe chinogona kukanganiswa nemelanoma yemeso:

• Iris, iyo ndiyo chikamu chine ruvara pamberi pemeso
• Chikamu chechoroid, icho chikamu chemidziyo yeropa ne tishu inobatanidza pakati pesclera neretina kumashure kweuvea
• Ciliary body, iri pamberi peuvea uye inoburitsa mvura yakajeka (aqueous humor) mumeso.

Melanoma yemeso inogonawo kuitika pane rukova rwekupedzisira pamberi pemeso (conjunctiva), mu socket inotenderedza bhora remeso uye pane eyelid, kunyange marudzi aya emelanoma yemeso anokura zvishoma.

Zvinokonzera ngozi yekenza yemelanoma yemeso zvinosanganisira:

• Ruvara rwemeso rwakajeka. Vanhu vane maziso ebhuruu kana maziso egirini vane njodzi yakakura yekenza yemeso.
• Kuva munhu mutsvuku. Vanhu vatsvuku vane njodzi yakakura yekenza yemeso kupfuura vanhu vemhando dzimwe.
• Zera. Njodzi yekenza yemeso inowedzera nezera.
• Zvirwere zve ganda zvakagara nhaka. Chimiro chinonzi dysplastic nevus syndrome, chinoita kuti pave nemavara asinganzwisisike, chinogona kuwedzera njodzi yekuwana melanoma paganda rako uye mumeso ako.

Uyezve, vanhu vane pigmentation yeganda isina kujairika inosanganisira maziso nemisungo iri pedyo uye pigmentation yakawedzera pauvea yavo — inozivikanwa se ocular melanocytosis — vane njodzi yakawedzera yekuwana kenza yemeso.

• Kuonekwa kwe ultraviolet (UV) chiedza. Basa rekuonekwa kwe ultraviolet mumasero emelanoma hachizivikanwe. Kune humbowo hunoratidza kuti kuonekwa kwe chiedza che UV, sek chiedza chezuva kana kubva kuma tanning beds, kunogona kuwedzera njodzi yekenza yemeso.
• Kushanduka kwemajini akati wandei. Majini akati wandei anopfuudzwa kubva kuvabereki kuenda kuvana anogona kuwedzera njodzi yekenza yemeso.

Zvirwere zve ganda zvakagara nhaka. Chimiro chinonzi dysplastic nevus syndrome, chinoita kuti pave nemavara asinganzwisisike, chinogona kuwedzera njodzi yekuwana melanoma paganda rako uye mumeso ako.

Uyezve, vanhu vane pigmentation yeganda isina kujairika inosanganisira maziso nemisungo iri pedyo uye pigmentation yakawedzera pauvea yavo — inozivikanwa se ocular melanocytosis — vane njodzi yakawedzera yekuwana kenza yemeso.

Zvinetso zve melanoma yemeso zvinogona kusanganisira:

• Kurasikirwa kwekutarisa. Melanomas huru dziso dzakawanda dzinoita kuti munhu asarasikirwe nekuona kwemeso ane chirwere ichi uye dzinogona kukonzera zvimwe zvinetso, sekubviswa kwe retina, izvo zvinokonzerawo kurasikirwa kwekutarisa.

  Melanomas diki dziso dzinogona kukonzera kurasikirwa kwekutarisa kana dziri munzvimbo dzakakosha dziso. Unogona kunetseka kuona pakati pekuona kwako kana kurutivi. Melanomas huru dziso dzinogona kukonzera kurasikirwa kwekutarisa zvachose.

• Melanoma yemeso inopararira kunze kwemeso. Melanoma yemeso inogona kupararira kunze kwemeso uye kune dzimwe nzvimbo dzemuviri, kusanganisira chiropa, mapapu nemapfupa.

Kurasikirwa kwekutarisa. Melanomas huru dziso dzakawanda dzinoita kuti munhu asarasikirwe nekuona kwemeso ane chirwere ichi uye dzinogona kukonzera zvimwe zvinetso, sekubviswa kwe retina, izvo zvinokonzerawo kurasikirwa kwekutarisa.

Small eye melanomas can cause some vision loss if they occur in critical parts of the eye. You may have difficulty seeing in the center of your vision or on the side. Very advanced eye melanomas can cause complete vision loss.

Kuongorora melanoma yemeso, chiremba wenyu angakurudzira izvi:

• Ultrasound yemeso. Ultrasound yemeso inoshandisa mafungu esound ane simba rakakwirira kubva muchishandiso chinoendeswa nemaoko, chinofanana nehwanda chinonzi transducer kugadzira mifananidzo yemeso enyu. Transducer inoiswa pamusoro peyelid rakazarwa kana pamusoro pemeso enyu.
• Kuongorora kwema veins eropa ari mukati nekumativi kwetumor (angiogram). Panguva yeangiogram yemeso enyu, ruvara rwemavara runoiswa mumutsinga uri muruoko rwenyu. Ruvara runofamba kuenda kuma veins eropa ari mumeso enyu.

Kamera ine mafiritha chaiwo ekutsvaga ruvara inotora mifananidzo ye flash masekondi mashoma kwemaminitsi akati wandei.

• Optical coherence tomography. Kuongorora kwemifananidzo kunogadzira mifananidzo yezvikamu zve uveal tract ne retina.
• Kubvisa sampuli yetsinga inokonzera kunetseka kuti iongororwe. Muzviitiko zvimwe, chiremba wenyu angakurudzira nzira yekubvisa sampuli yetsinga (biopsy) kubva mumeso enyu.

Kubvisa sampuli, tsono yakatetepa inoiswa mumeso enyu uye inoshandiswa kubvisa tsinga inokonzera kunetseka. Tsiga inongororwa murabhoritari kuti ione kana ine masero emelanoma yemeso.

Biopsy yemeso kazhinji haina kukosha pakuzivisa melanoma yemeso.

Kuongorora kwemeso. Chiremba wenyu achaongorora kunze kwemeso enyu, achitsvaga ma veins eropa akakura anogona kuratidza tumor iri mukati memso enyu. Zvadaro, achishandisa zviridzwa, chiremba wenyu acha tarisa mukati memso enyu.

Nzira imwe, inonzi binocular indirect ophthalmoscopy, inoshandisa lenses ne chiedza chakajeka chakamiswa pahuma yechiremba wenyu - zvishoma senge mwenje wemugodhi. Nzira imwe, inonzi slit-lamp biomicroscopy, inoshandisa lenses ne microscope inogadzira bhemu rakasimba re chiedza kuti ivheneke mukati memso enyu.

Kuongorora kwema veins eropa ari mukati nekumativi kwetumor (angiogram). Panguva yeangiogram yemeso enyu, ruvara rwemavara runoiswa mumutsinga uri muruoko rwenyu. Ruvara runofamba kuenda kuma veins eropa ari mumeso enyu.

Kamera ine mafiritha chaiwo ekutsvaga ruvara inotora mifananidzo ye flash masekondi mashoma kwemaminitsi akati wandei.

Kubvisa sampuli yetsinga inokonzera kunetseka kuti iongororwe. Muzviitiko zvimwe, chiremba wenyu angakurudzira nzira yekubvisa sampuli yetsinga (biopsy) kubva mumeso enyu.

Kubvisa sampuli, tsono yakatetepa inoiswa mumeso enyu uye inoshandiswa kubvisa tsinga inokonzera kunetseka. Tsiga inongororwa murabhoritari kuti ione kana ine masero emelanoma yemeso.

Biopsy yemeso kazhinji haina kukosha pakuzivisa melanoma yemeso.

Chiremba wenyu angakurudzira bvunzo nedzimwe nzira dzekuongorora kuti aone kana melanoma yakapararira (metastasized) kune dzimwe nhengo dzemuviri wenyu. Bvunzo dzinogona kusanganisira:

• Bvunzo dzeropa dzekuyera basa rechiropa
• Chest X-ray
• Computerized tomography (CT) scan
• Magnetic resonance imaging (MRI) scan
• Abdominal ultrasound
• Positron emission tomography (PET) scan

Sarudzo dzekurapa melanoma yemeso dzichaenderana nekwakagara uye saizi yemelanoma yemeso, pamwe nehutano hwako hwese nezvaunoda.

Melanoma diki yemeso ingangoda kurapwa nekukurumidza. Kana melanoma iri diki uye isiri kukura, iwe nachiremba wenyu mungasarudza kumirira uye kutarisa zviratidzo zvekukura.

Kana melanoma ikakura kana ikakonzera matambudziko, unogona kusarudza kurapwa panguva iyoyo.

Kurapa kwemwaranzi kunoshandisa simba rakasimba, sekupfapfaidza kana gamma rays, kuuraya masero ekenza. Kurapa kwemwaranzi kunowanzo shandiswa kune melanomas diki kusvika pakati.

Mwaranzi inowanzoendeswa kutumor nekugadzika plaque ine radioactive pamusoro pemeso ako, zvakananga pamusoro petumor muitiro unonzi brachytherapy. Iyo plaque inobatwa munzvimbo nemisono yenguva pfupi. Iyo plaque inoita kunge chivharo chebhodhoro uye ine mbeu dzakawanda dzinoratidza radioactive. Iyo plaque inoramba iri munzvimbo kwemazuva mana kusvika mashanu usati yabviswa.

Mwaranzi inogonawo kubva muchina unotungamira mwaranzi, senge proton beams, kumeso ako (external beam radiation, kana teletherapy). Rudzi urwu rwekurapa kwemwaranzi runowanzoitwa kwemazuva akawanda.

Kurapa kunoshandisa laser kuuraya masero emelanoma kunogona kuva sarudzo mumamiriro ezvinhu akati. Rudzi rumwe rwekurapa kwe laser, runonzi thermotherapy, runoshandisa infrared laser uye dzimwe nguva runoshandiswa pamwe chete nekurapa kwemwaranzi.

Photodynamic therapy inosanganisa mishonga ine wavelength chaiyo yechiedza. Mishonga inoshandisa masero ekenza kuti ave nyore kune chiedza. Kurapa kunokuvadza midziyo nemasero anoumba melanoma yemeso. Photodynamic therapy inoshandiswa mune zviduku zviduku, sezvo isingashande kune makanser makuru.

Kutonhora kwakanyanya (cryotherapy) kunogona kushandiswa kuparadza masero emelanoma mune mamwe melanomas maduku emeso, asi kurapwa uku hakuwanzo shandiswa.

Mabasa anoshandiswa kurapa melanoma yemeso anosanganisira maitiro ekubvisa chikamu chemeso kana maitiro ekubvisa ziso rose. Maitiro aunozoita anotsamira pakukura nekukura kwemelanoma yemeso. Sarudzo dzinogona kusanganisira:

• Kuvhiya kubvisa melanoma nechepakati chidiki chetsitisi ine hutano. Kuvhiya kubvisa melanoma nebhendi re tsitisi ine hutano rinomukomberedza kunogona kuva sarudzo yekurapa melanomas diki.
• Kuvhiya kubvisa ziso rose (enucleation). Enucleation inowanzo shandiswa kune zvipembenene zvikuru zvemeso. Inogona kushandiswawo kana tumor iri kukonzera kurwadziwa kwemeso.

Mushure mekunge ziso rine melanoma rabviswa, implant inoiswa munzvimbo imwechete, uye minhanho inodzora kufamba kweziso inobatanidzwa ne implant, izvo zvinoita kuti implant ifambe.

Mushure mekunge wava ne nguva yekurapa, ziso rekugadzira (prosthesis) rinoitwa. Pamusoro pe ziso rako idzva richapenyerwa kuti rifane neziso rako riripo.

Kuvhiya kubvisa ziso rose (enucleation). Enucleation inowanzo shandiswa kune zvipembenene zvikuru zvemeso. Inogona kushandiswawo kana tumor iri kukonzera kurwadziwa kwemeso.

Mushure mekunge ziso rine melanoma rabviswa, implant inoiswa munzvimbo imwechete, uye minhanho inodzora kufamba kweziso inobatanidzwa ne implant, izvo zvinoita kuti implant ifambe.

Mushure mekunge wava ne nguva yekurapa, ziso rekugadzira (prosthesis) rinoitwa. Pamusoro pe ziso rako idzva richapenyerwa kuti rifane neziso rako riripo.

Kana kurapwa kwako kwenzara kukonzera kurasikirwa kwakazara kwekuona mune rimwe ziso, sekunge zvinoitika kana ziso rabviswa, zvichiri kuitika kuita zvinhu zvizhinji zvawakakwanisa kuita neziso riri kushanda. Asi zvinogona kutora mwedzi mishoma kugadzirisa kune kuona kwako kutsva.

Kuva neziso rimwe chete kunokanganisa kugona kwako kutonga kure. Uye zvinogona kuoma kuziva zvinhu zvakakukomberedza, kunyanya zvinhu zvinoitika parutivi pasina kuona.