Basal Cell Carcinoma

I-carcinoma yase-Basal uhlobo lwe-kansa yesikhumba. I-carcinoma yase-basal iqala kumaseli ase-basal — uhlobo lweseli ngaphakathi kwesikhumba esenza amaseli amasha esikhumba njengoba amadala efa.

I-carcinoma yase-basal ibonakala njengobumba olucacile kancane esikhumbeni, yize ingathatha ezinye izindlela. I-carcinoma yase-basal ivela kakhulu ezindaweni zesikhumba ezidwetshwe ilanga, njengenkaba yakho nemuthi.

Iningi le-carcinoma yase-basal kucatshangwa ukuthi ibangelwa ukudwetshwa isikhathi eside yi-ultraviolet (UV) radiation evela elangeni. Ukugwema ilanga nokusebenzisa i-sunscreen kungasiza ekuvikeleni e-carcinoma yase-basal.

I-basal cell carcinoma ivame ngokuvamile ezingxenyeni zomzimba wakho ezidwetshwe ilanga, ikakhulu ikhanda nemuthi. Ngokungavamile, i-basal cell carcinoma ingathuthuka ezingxenyeni zomzimba wakho ezivikelwe ilanga, njengezitho zangasese.

I-basal cell carcinoma ibonakala njengenguquko oluswini, njengokukhula noma isifo esingahlangi. Lezi zinguquko oluswini (izifo) ngokuvamile ziba nalezi zici ezilandelayo:

• I-bump enhle, enobukhulu boluswini ebonakala, okusho ukuthi ungabona kancane ngaphesheya komphetho. I-bump ingabonakala imhlophe enhle noma pinki oluswini olumhlophe. Oluswini oluphuzi nolumnyama, i-bump ngokuvamile ibonakala iphuzi noma imnyama enhle. Izinsimbi zegazi ezincane zingabonakala, nakuba kungaba nzima ukuzibona oluswini oluphuzi nolumnyama. I-bump ingase iphuze futhi ibe namabala.
• Isifo esiphuzi, esimnyama noma esiluhlaza okwesibhakabhaka — noma isifo esinamabala amnyama — ngomda ophakamileyo, obonakala.
• Isiqephu esiqinile, esiqinile ngomda ophakamileyo. Ngokuhamba kwesikhathi, lezi ziqephu zingakhula kakhulu.
• Isifo esimhlophe, esinamaswidi, esifana nesilonda ngaphandle komda oqondiwe kahle.

Yenza i-aphoyintimenti nodokotela wakho uma ubona izinguquko ekuqaleni kwesikhumba sakho, njengokukhula okusha, ukuguquka kokukhula okwakukhona ngaphambili noma isihlungu esiphindaphindayo.

I-basal cell carcinoma iveza lapho elinye lamaseli e-basal esikhini lithola ukuwohloka kwe-DNA yalo.

Amaseli e-basal atholakala phansi kwe-epidermis—ukuhlanganiswa okuphezulu kwesikhini. Amaseli e-basal akhiqiza amaseli amasha esikhini. Njengoba amaseli amasha esikhini akhiqizwa, acindezela amaseli amadala ukuya ebusweni besikhini, lapho amaseli amadala efa futhi ehlanzwa khona.

Izici ezandisa ingozi yakho yomdlavuza we-basal cell carcinoma zihlanganisa:

• Ukukhanya kwelanga okuqhubekayo. Isikhathi esiningi esichithwe elangeni—noma emakamelweni okubhaka alwimi—sanda ingozi yomdlavuza we-basal cell carcinoma. Usongo mkhulu uma uhlala endaweni elangeni noma ephakeme, kokubili lokhu kukudalula emisebeni eminingi ye-ultraviolet (UV). Ukushisa okukhulu kwelanga futhi kwanda ingozi yakho.
• Ukwelashwa ngomgogodla. Ukwelashwa ngomgogodla ukuze kuphathwe isifo se-acne noma ezinye izimo zesikhumba kungandisa ingozi yomdlavuza we-basal cell carcinoma ezindaweni zokwelashwa ngaphambili esikhumbeni.
• Isikhumba esimhlophe. Ingozi yomdlavuza we-basal cell carcinoma iphakeme kakhulu kubantu abaphuthumayo noma abashaya kalula noma abanesi khumba esilula kakhulu, izinwele ezibomvu noma ezibomvu, noma amehlo alula.
• Ukuthuthuka kweminyaka. Ngoba umdlavuza we-basal cell carcinoma uthatha amashumi eminyaka ukuthuthuka, iningi lomdlavuza we-basal cell carcinoma luvela kubantu abadala. Kodwa futhi lungathinta abantu abadala abancane futhi luyaqala ukwanda kubantu abaseminyakeni yabo engama-20 nama-30.
• Umbhalo womuntu siqu noma womndeni womdlavuza wesikhumba. Uma uke waba nomdlavuza we-basal cell carcinoma kanye noma ngaphezulu, unethuba elihle lokuthuthukisa futhi. Uma unomlando womndeni womdlavuza wesikhumba, ungaba nengozi ephakeme yokuthuthukisa umdlavuza we-basal cell carcinoma.
• Imithi ecindezela amasosha omzimba. Ukuthatha imithi ecindezela amasosha omzimba wakho, njengomuthi wokuphika ukwamukelwa okusetshenziswa ngemuva kokuhlinzwa kokufakelwa, kwanda kakhulu ingozi yomdlavuza wesikhumba.
• Ukudalulwa ku-arsenic. I-Arsenic, ithusi eliyingozi elitholakala kabanzi endaweni, iyandisa ingozi yomdlavuza we-basal cell carcinoma nezinye izifo zomdlavuza. Wonke umuntu unokudalulwa okuthile kwe-arsenic ngoba kwenzeka ngokwemvelo. Kodwa abanye abantu bangaba nokudalulwa okuphezulu uma bephuza amanzi asemathuneni angcolile noma benomsebenzi ohilela ukukhiqiza noma ukusebenzisa i-arsenic.
• I-syndromes ezifuywe ezibangela umdlavuza wesikhumba. Izifo ezithile ezingavamile ze-genetic zingandisa ingozi yomdlavuza we-basal cell carcinoma, kuhlanganise i-nevoid basal cell carcinoma syndrome (i-Gorlin-Goltz syndrome) ne-xeroderma pigmentosum.

Izinkinga ze-basal cell carcinoma zingafaka:

• ingozi yokubuyela. I-basal cell carcinoma ibuyela njalo, ngisho nangemva kokwelashwa okuphumelelayo.
• ingozi eyenyuke yeminye imikhakha yomdlavuza wesikhumba. Umlando we-basal cell carcinoma ungase futhi ukhulise amathuba okukhula kweminye imikhakha yomdlavuza wesikhumba, njenge-squamous cell carcinoma.
• Umdlavuza osakazeka ngaphezu kwesikhumba. Ngokungavamile, i-basal cell carcinoma ingasakazeka (metastasize) ku-lymph nodes eziseduze nakwezinye izingxenye zomzimba, njengemathambo nemiphunga.

Ukuze unciphise ingozi yakho yomdlavuza we-basal cell carcinoma ungenza lokhu:

• Gwema ilanga phakathi nosuku. Emasimini amaningi, imisebe yelanga iqinile phakathi kwama-10 ekuseni kuya kuma-4 ntambama. Hlela imisebenzi yangaphandle ngezinye izikhathi zosuku, ngisho nasebusika noma lapho isibhakabhaka siqengqekile.
• Gqoka i-sunscreen unyaka wonke. Sebenzisa i-sunscreen ebanzi enenombolo ye-SPF okungenani engu-30, ngisho nasezinsukwini ezinamvula. Faka i-sunscreen ngokukhulu, bese uyifaka kabusha njalo emahoreni amabili - noma kaningi uma ugeza noma ukhanyisa.
• Gqoka izingubo ezivikela. Mbopha isikhumba sakho ngezingubo ezimnyama, ezihlanganisiwe ngokukhulu ezihlanganisa izandla zakho nezinyawo zakho, kanye nehethi enkulu, enikeza isivikelo esiningi kunokuthi i-baseball cap noma i-visor. Amanye amabhizinisi athengisa nezingubo ezivikela. I-dermatologist ingakuncoma igama elilungile. Ungakhohlwa izibuko lelanga. Bheka lezo ezivala womabili uhlobo lwemisebe ye-UV - i-ultraviolet A (UVA) ne-ultraviolet B (UVB).
• Gwema imibhede yokubasa. Imibhede yokubasa ikhipha imisebe ye-UV futhi ingakhuphula ingozi yakho yomdlavuza wesikhumba.
• Hlola isikhumba sakho njalo bese ubika izinguquko kudokotela wakho. Hlola isikhumba sakho njalo ngokukhula okusha kwesikhumba noma izinguquko ezimpundu ezikhona, ama-freckles, ama-bumps kanye nama-birthmarks. Ngosizo lwephepha, hlola ubuso bakho, intamo, izindlebe kanye ne-scalp. Hlola isifuba sakho nomzimba kanye nezinhlangothi eziphezulu nezansi zezandla zakho nezinye izandla. Hlola kokubili phambi nangemuva kwezinyawo zakho nezinyawo zakho, kufaka phakathi izinyawo neendawo phakathi kwezinzwane zakho. Hlola futhi indawo yakho yobudoda phakathi kwezinyawo zakho.

Ukuze ahlole noma iyiphi imikhuhlu noma izinguquko ezikhona esikhini sakho, udokotela wakho noma uchwepheshe wezimo zesikhumba (i-dermatologist) uzokwenza umlando wezokwelapha kanye nokuhlolwa.

Udokotela wakho uzokwenza ukuhlolwa komzimba jikelele futhi akubuze imibuzo mayelana nomlando wakho wezokwelapha, izinguquko esikhini sakho, noma ezinye izimpawu noma izimpawu ozibonile.

Imibuzo ingafaka:

Udokotela wakho ngeke ahlole kuphela indawo engathandeki esikhini sakho kodwa futhi wonke umzimba wakho ukuze abone amanye ama-lesion.

Udokotela wakho angenza i-biopsy yesikhumba, okuhilela ukususa isampula encane ye-lesion ukuze ihlolwe elabhoratri. Lokhu kuzoveza ukuthi unekansa yesikhumba, futhi uma kunjalo, uhlobo luni lwekansa yesikhumba. Uhlobo lwe-biopsy yesikhumba oyitholayo luzoxhomeka ohlotsheni nosayizi we-lesion.

• Uqale nini ukubona lokhu kukhula noma i-lesion esikhini?
• Kuguqukile yini kusukela uqale ukuyibona?
• Ingabe lokhu kukhula noma i-lesion kubangela ubuhlungu?
• Ingabe uneminye imikhuhlu noma ama-lesion akukhathazayo?
• Ingabe uke waba nekansa yesikhumba ngaphambili?
• Ingabe kukhona umuntu emndenini wakho obe nekansa yesikhumba? Yiluphi uhlobo?
• Ingabe uthatha izinyathelo zokuphepha elangeni, njengokugwema ilanga emini kanye nokusebenzisa i-sunscreen?
• Ingabe uhlola isikhumba sakho njalo?

Umgomo wokwelapha i-basal cell carcinoma ukususa umdlavuza ngokuphelele. Ukwelashwa okuhle kuwe kuncike ohlotsheni, indawo nobukhulu bomdlavuza wakho, kanye nezifiso zakho nekhono lokwenza izivakashi zokulandelela. Ukukhetha ukwelashwa kungancika futhi ekutheni lokhu kuyi-basal cell carcinoma yokuqala noma ephindaphindayo.

I-basal cell carcinoma ivame ukwelashwa ngokuthi kwenziwe ubuyekezo ukuze kususwe yonke imdlavuza kanye nezinye izicubu eziphilile eziyizungezile.

Amakhetho angafaka:

Ukususa ngokuthi kwenziwe ubuyekezo. Kule nqubo, udokotela wakho uqedela isifo esinamandla kanye nomda ohlangene wesikhumba esinempilo. Umda uhlolwa ngaphansi komkhiqizo ukuqinisekisa ukuthi awekho amaseli omdlavuza.

Ukususa kungase kunconywe kuma-basal cell carcinomas angase aphinde, njengalezo ezakha esifubeni, emuva, ezandleni nasezinyaweni.

Ukuhlinzwa kweMohs. Phakathi kokuthi kwenziwe ubuyekezo lweMohs, udokotela wakho ususa umdlavuza uhlangothi ngehlangothi, ehlola ihlangothi ngalinye ngaphansi komkhiqizo kuze kube yilapho kungasekho amaseli angavamile. Lokhu kuvumela udokotela ukuthi aqiniseke ukuthi ukukhula konke kususiwe futhi kugwenywe ukususa inani elikhulu lesikhumba esinempilo esizungezile.

Ukuhlinzwa kweMohs kungase kunconywe uma i-basal cell carcinoma yakho inengozi enkulu yokubuya, njengokuthi uma inkulu, isondela ngokujulile esikhumbeni noma itholakala ebusweni bakho.

Ngezinye izikhathi ukwelashwa okunye kungase kunconywe ezimweni ezithile, njengokuthi uma ungakwazi ukuhlinzwa noma uma ungafuni ukuhlinzwa.

Ukwelashwa okunye kufaka:

Ukuhlanza nokuqeda ngogesi (C ne-E). Ukwelashwa kokuthi kwenziwe ubuyezo nokuqeda ngogesi (C ne-E) kuhilela ukususa ubuso bomdlavuza wesikhumba ngesixhobo sokuqeda (curet) bese uqeda isisekelo somdlavuza ngenhlanzi yombane.

C ne-E kungaba yindlela yokwelapha ama-basal cell carcinomas amancane angase aphinde, njengalezo ezakha emuva, esifubeni, ezandleni nasezinyaweni.

Ukwelashwa ngomgogodla. Ukwelashwa ngomgogodla kusebenzisa imisebe yamandla aphezulu, njenge-X-rays namaprotoni, ukubulala amaseli omdlavuza.

Ukwelashwa ngomgogodla ngezinye izikhathi kusetshenziswa ngemuva kokuthi kwenziwe ubuyezo uma kunengozi enkulu yokuthi umdlavuza uzobuya. Kungase futhi kusetshenziswe uma ukuhlinzwa kungeyona indlela.

Ukubanda. Lokhu kwelashwa kuhilela ukubanda amaseli omdlavuza ngenitrogeni elukhuni (cryosurgery). Kungaba yindlela yokwelapha izifo zesikhumba ezingaphezulu. Ukubanda kungase kwenziwe ngemuva kokusebenzisa isixhobo sokuqeda (curet) ukususa ubuso bomdlavuza wesikhumba.

I-Cryosurgery ingase icatshangelwe ekwelapheni ama-basal cell carcinomas amancane anamanzi uma ukuhlinzwa kungeyona indlela.

Ukwelashwa kwe-photodynamic. Ukwelashwa kwe-photodynamic kuhlanganisa imithi ye-photosensitizing nokukhanya ukwelapha umdlavuza wesikhumba ongaphezulu. Phakathi kokwelashwa kwe-photodynamic, imithi eyi-liquid eyenza amaseli omdlavuza abe nomuzwa ekukhanyeni ifakwa esikhumbeni. Kamuva, ukukhanya okubhubhisa amaseli omdlavuza wesikhumba kuqondiswa endaweni.

Ukwelashwa kwe-photodynamic kungase kucatshangelwe uma ukuhlinzwa kungeyona indlela.

Kuyincazelo encane kakhulu, i-basal cell carcinoma ingasakazeka (metastasize) kuma-lymph nodes aseduze nezinye izindawo zomzimba. Amakhetho engeziwe okwelapha kule simo afaka:

Ukwelashwa ngemithi ehloliwe. Ukwelashwa ngemithi ehloliwe kugxila ezintweni ezibuthakathaka ezitholakala ngaphakathi kwamaseli omdlavuza. Ngokuvimba lezi zinto ezibuthakathaka, ukwelashwa ngemithi ehloliwe kungabangela amaseli omdlavuza ukuthi afe.

Imithi yokwelapha ehloliwe ye-basal cell carcinoma ivala izibonakaliso ze-molecular ezivumela umdlavuza ukuthi uqhubeke ukukhula. Kungase kucatshangelwe ngemuva kokwelashwa okunye noma uma ukwelashwa okunye kungekho khona.

• Ukususa ngokuthi kwenziwe ubuyezo. Kule nqubo, udokotela wakho uqedela isifo esinamandla kanye nomda ohlangene wesikhumba esinempilo. Umda uhlolwa ngaphansi komkhiqizo ukuqinisekisa ukuthi awekho amaseli omdlavuza.

  Ukususa kungase kunconywe kuma-basal cell carcinomas angase aphinde, njengalezo ezakha esifubeni, emuva, ezandleni nasezinyaweni.

• Ukuhlinzwa kweMohs. Phakathi kokuthi kwenziwe ubuyezo lweMohs, udokotela wakho ususa umdlavuza uhlangothi ngehlangothi, ehlola ihlangothi ngalinye ngaphansi komkhiqizo kuze kube yilapho kungasekho amaseli angavamile. Lokhu kuvumela udokotela ukuthi aqiniseke ukuthi ukukhula konke kususiwe futhi kugwenywe ukususa inani elikhulu lesikhumba esinempilo esizungezile.

  Ukuhlinzwa kweMohs kungase kunconywe uma i-basal cell carcinoma yakho inengozi enkulu yokubuya, njengokuthi uma inkulu, isondela ngokujulile esikhumbeni noma itholakala ebusweni bakho.

• Ukuhlanza nokuqeda ngogesi (C ne-E). Ukwelashwa kokuthi kwenziwe ubuyezo nokuqeda ngogesi (C ne-E) kuhilela ukususa ubuso bomdlavuza wesikhumba ngesixhobo sokuqeda (curet) bese uqeda isisekelo somdlavuza ngenhlanzi yombane.

  C ne-E kungaba yindlela yokwelapha ama-basal cell carcinomas amancane angase aphinde, njengalezo ezakha emuva, esifubeni, ezandleni nasezinyaweni.

• Ukwelashwa ngomgogodla. Ukwelashwa ngomgogodla kusebenzisa imisebe yamandla aphezulu, njenge-X-rays namaprotoni, ukubulala amaseli omdlavuza.

  Ukwelashwa ngomgogodla ngezinye izikhathi kusetshenziswa ngemuva kokuthi kwenziwe ubuyezo uma kunengozi enkulu yokuthi umdlavuza uzobuya. Kungase futhi kusetshenziswe uma ukuhlinzwa kungeyona indlela.

• Ukubanda. Lokhu kwelashwa kuhilela ukubanda amaseli omdlavuza ngenitrogeni elukhuni (cryosurgery). Kungaba yindlela yokwelapha izifo zesikhumba ezingaphezulu. Ukubanda kungase kwenziwe ngemuva kokusebenzisa isixhobo sokuqeda (curet) ukususa ubuso bomdlavuza wesikhumba.

  I-Cryosurgery ingase icatshangelwe ekwelapheni ama-basal cell carcinomas amancane anamanzi uma ukuhlinzwa kungeyona indlela.

• Ukwelashwa okusetshenziswayo. Amakhilimu noma ama-ointments alayishiwe angase acatshangelwe ekwelapheni ama-basal cell carcinomas amancane anamanzi uma ukuhlinzwa kungeyona indlela.

• Ukwelashwa kwe-photodynamic. Ukwelashwa kwe-photodynamic kuhlanganisa imithi ye-photosensitizing nokukhanya ukwelapha umdlavuza wesikhumba ongaphezulu. Phakathi kokwelashwa kwe-photodynamic, imithi eyi-liquid eyenza amaseli omdlavuza abe nomuzwa ekukhanyeni ifakwa esikhumbeni. Kamuva, ukukhanya okubhubhisa amaseli omdlavuza wesikhumba kuqondiswa endaweni.

  Ukwelashwa kwe-photodynamic kungase kucatshangelwe uma ukuhlinzwa kungeyona indlela.

• Ukwelashwa ngemithi ehloliwe. Ukwelashwa ngemithi ehloliwe kugxila ezintweni ezibuthakathaka ezitholakala ngaphakathi kwamaseli omdlavuza. Ngokuvimba lezi zinto ezibuthakathaka, ukwelashwa ngemithi ehloliwe kungabangela amaseli omdlavuza ukuthi afe.

  Imithi yokwelapha ehloliwe ye-basal cell carcinoma ivala izibonakaliso ze-molecular ezivumela umdlavuza ukuthi uqhubeke ukukhula. Kungase kucatshangelwe ngemuva kokwelashwa okunye noma uma ukwelashwa okunye kungekho khona.

• Ukwelashwa nge-chemotherapy. I-chemotherapy isebenzisa imithi enamandla ukubulala amaseli omdlavuza. Kungaba yindlela uma ukwelashwa okunye kungasizanga.