Melanoma

I-Melanoma uhlobo lwe-kansa yesikhumba ehlala kuma-melanocytes. Ama-Melanocytes amayiseli enza i-pigment enikeza isikhumba umbala. I-pigment ibizwa nge-melanin.

I-Melanoma iqala ngokuvamile esikhumbeni esivame ukuvezwa elangeni. Lokhu kufaka phakathi isikhumba sezingalo, emuva, ebusweni nasezinzweni. I-Melanoma ingakha futhi emehlweni. Ngokungavamile, kungenzeka ngaphakathi komzimba, njengasekhundleni noma egqaleni.

Imbangela eqondile yama-melanomas onke ayicaci. Iningi lama-melanomas libangelwa ukudalulwa ekukhanyeni kwe-ultraviolet. Ukukhanya kwe-ultraviolet, okuthiwa futhi i-UV light, kuvela ekukhanyeni kwelanga noma kuma-tanning lamps nama-beds. Ukulinganisela ukudalulwa ekukhanyeni kwe-UV kungasiza ekuthuthukiseni ingozi ye-melanoma.

Ingozi ye-melanoma ibonakala isanda kubantu abaneminyaka engaphansi kuka-40, ikakhulukazi abesifazane. Ukubona izimpawu ze-kansa yesikhumba kungasiza ekuqinisekiseni ukuthi izinguquko ze-kansa zitholakala futhi zitholwe ngaphambi kokuba i-kansa isakazeke. I-Melanoma ingaphathwa ngempumelelo uma itholakala ngokushesha.

Amabala avame awonakali. Angaba naeenhlanzi noma akhuphuke noma acose. Xoxa nodokotela wakho mayelana nanoma yiluphi ushintsho lombala noma usayizi webala noma uma kukhona ukukhahlela, ubuhlungu, ukuphuza igazi noma ukuvuvukala.

Isilwane sokuqala se-melanoma kuvame ukuba yi-mole eshintsha usayizi, isisindo noma umbala. Le melanoma ibonisa ukuguquguquka kombala kanye nomda ongajwayelekile, kokubili okuyizimpawu zezexwayiso ze-melanoma.

Izimpawu zokuqala ze-melanoma nezibonakaliso zivame ukuba:

• Ukushintsha kwe-mole ekhona.
• Ukuthuthukiswa kokukhula okusha okune-pigmented noma okubukeka okungajwayelekile oluswini.

I-Melanoma ayiqali njalo njenge-mole. Ingase ibe khona nakwisikhumba esinempilo.

Izimpawu ze-melanoma zingaba khona kunoma iyiphi indawo yomzimba. Ama-melanomas avame ukuthuthukiswa ezindaweni eziye zaba nokukhanya kwelanga. Lokhu kuhlanganisa izandla, umhlane, ubuso nezinyawo.

Ama-melanomas angaba khona nezindaweni ezingabonakali kangako elangeni. Lokhu kuhlanganisa izinyawo, izandla nezindawo zezinzipho. I-Melanoma ingaba khona ngaphakathi komzimba. Le melanoma efihliwe ivame kakhulu kubantu abanesikhumba esibomvu noma esimnyama.

Amabala ajwayelekile avame ukuba nombala ofanayo. Angase abonakale ebomvu, e-tan, e-brown noma emnyama. Kubantu abanesikhumba esibomvu nesimnyama, amabala ajwayelekile avame ukuba mnyama noma emnyama. Amabala ajwayelekile anawomda oqondile ohlukanisa ibala ekuswini oluzungezile. Ayiminyene noma ayizungezile futhi avame ukuba mancane kunesiqingatha se-intshi (cishe ama-millimitha ayi-6) ububanzi.

Amabala amaningi aqala ukubonakala ebuntwaneni futhi amabala amasha angase enze kuze kube eminyakeni engama-40. Ngesikhathi sebekhulu, abantu abaningi bane-10 kuya kuma-40 amabala. Amabala angashintsha ukubonakala ngokuhamba kwesikhathi futhi amanye angase ahambe ngokuguga.

Amanye amabala awajwayelekile. Angaba nezici ezithile ezibonisa ama-melanomas noma ezinye izifo zekhanda. Izici zingafaka:

• Isisindo esingajwayelekile. Bheka amabala anemisindo engajwayelekile, njengengxenye ezimbili ezibukeka ezihlukile kakhulu.
• Ukushintsha kombala. Bheka ukukhula okunemibala eminingi noma izindlela zombala ezingajwayelekile.
• Ukushintsha kosayizi. Bheka ukukhula okusha kwibala elikhulu kunesiqingatha se-intshi (cishe ama-millimitha ayi-6).
• Ukushintsha kwezimpawu. Bheka ukushintsha kwezimpawu, njengokukhahlela okusha noma ukuphuza igazi.
• Umda ongajwayelekile. Bheka amabala anemipaka engajwayelekile, enezinsimbi noma eziqoshiwe.

Amabala abe yizifo zingase zibukeke ngezindlela ezihlukene kakhulu. Amanye angase abonise zonke izinguquko ezibalwe ngenhla, kuyilapho amanye angaba nezimpawu ezimbili noma ezimbili ezingajwayelekile.

Ama-melanomas angathuthukiswa nezindaweni zomzimba ezinokukhanya okuncane noma okungekho khona kwelanga. Lezi zindawo zingafaka izikhala phakathi kwezinzwane nasezandleni, izinyawo, ikhanda noma izitho zangasese. Lezi ngezinye izikhathi zibizwa ngokuthi yi-melanomas efihliwe ngoba zenzeka ezindaweni abantu abaningi abangacabangi ukuhlola. Uma i-melanoma ivela kubantu abanesikhumba esibomvu noma esimnyama, kungenzeka kakhulu ukuthi ivela endaweni efihliwe.

Ama-melanomas afihliwe afaka:

• I-Melanoma ngaphakathi komzimba. I-mucosal melanoma ithuthukiswa e-mucous membrane. Le tissue ihlanganisa khona impumulo, umlomo, i-esophagus, i-anus, i-urinary tract ne-vagina. Ama-mucosal melanomas anzima kakhulu ukuthola ngoba angase aphambuke kalula kwezinye izimo ezivame kakhulu.
• I-Melanoma eluhlaza. I-Eye melanoma ibizwa nangokuthi yi-ocular melanoma. Ivamise kakhulu ukwenzeka ebukhulu be-tissue ngaphansi kwe-white yamehlo. Le layer ibizwa ngokuthi yi-uvea. I-eye melanoma ingase ibe nomphumela ekuqondeni futhi ingase itholakale ngesikhathi sokuhlolwa kwamehlo.
• I-Melanoma ngaphansi kwezinzipho. I-Acral-lentiginous melanoma uhlobo oluyimfihlo lwe-melanoma olutholakala ngaphansi kwezinzipho noma ezinzwane. Ingatholakala nezandleni noma ezinyaweni. I-Acral-lentiginous melanoma ivame ukuba mnyama kakhulu, ihlale phansi futhi ibe nemipaka engajwayelekile. Ivame kakhulu kubantu base-Asia nabantu abanesikhumba esibomvu noma esimnyama.

Yenza i-aphoyintimenti nodokotela wakho noma omunye ochwepheshe wezempilo uma ubona noma yiziphi izinguquko zesikhumba ezikukhathazayo.

Ukuqala komdlavuza wesikhumba kuqala ezicellulweni ezenza ilayi eliphambi kwesikhumba, elibizwa ngokuthi i-epidermis. Uhlobo olulodwa lomdlavuza wesikhumba oluthi i-basal cell carcinoma luqala ezicellulweni ze-basal. Izicelluli ze-basal zenze izicelluli zesikhumba eziqhubeka nokusunduzela izicelluli ezindala ekuphumeni. Njengoba izicelluli ezintsha ziqhubeka nokukhuphuka, ziyaba izicelluli ze-squamous. Umdlavuza wesikhumba oqala ezicellulweni ze-squamous ubizwa ngokuthi i-squamous cell carcinoma yesikhumba. I-Melanoma, olunye uhlobo lomdlavuza wesikhumba, ivela ezicellulweni ze-pigment, ebizwa ngokuthi yi-melanocytes.

I-Melanoma kwenzeka lapho okuthile kushintsha i-melanocytes ephilile ibe yizicelluli zomdlavuza. I-Melanocytes yizicelluli zesikhumba ezenza i-pigment enikeza isikhumba umbala waso. I-pigment ibizwa ngokuthi yi-melanin.

I-Melanoma iqala lapho i-melanocytes ithuthukisa ukushintsha kwe-DNA yayo. I-DNA yeselluli igcina imiyalo eyalela iseli ukuthi yenze ini. Ezicellulweni eziphilile, i-DNA inikeza imiyalo yokukhula nokukhulisa ngesilinganiso esibekiwe. Imiyalo iyalela izicelluli ukuthi zife ngesikhathi esibekiwe. Ezicellulweni zomdlavuza, ukushintsha kwe-DNA kunikeza imiyalo ehlukile. Ukushintsha kutshela izicelluli zomdlavuza ukuba zenze izicelluli eziningi ngokushesha. Izicelluli zomdlavuza zingaphila lapho izicelluli eziphilile zingafa. Lokhu kubangela izicelluli eziningi kakhulu.

Izicelluli zomdlavuza zingakha i-mass ebizwa ngokuthi yi-tumor. I-tumor ingakhula ukuze ihlase ize yonakalise inyama yomzimba ephilile. Ngokuhamba kwesikhathi, izicelluli zomdlavuza zingaphula bese zisakazeka kwenye ingxenye yomzimba. Uma umdlavuza usakazeka, ubizwa ngokuthi umdlavuza we-metastatic.

Akucace ukuthi yini eshintsha i-DNA ezicellulweni zesikhumba nokuthi kuholela kanjani e-melanoma. Cishe kuyindlela yokuxuba izinto, kufaka phakathi izinto zokuzungezile nezinto zofuzo. Noma kunjalo, ochwepheshe bezempilo bakholelwa ukuthi ukukhanya kwe-ultraviolet kuyimbangela ehamba phambili ye-melanoma. Ukukhanya kwe-ultraviolet, okubizwa nangokuthi ukukhanya kwe-UV, kuvela elangeni nakwi-tanning lamps nezinqolobane.

Ukukhanya kwe-UV akubangeli wonke ama-melanomas, ikakhulu lawo avela ezindaweni emzimbeni wakho ongafuni ukukhanya kwelanga. Lokhu kusho ukuthi ezinye izinto zingase zifake isandla engozini yakho ye-melanoma.

Izici ezingase zikhulise ingozi yomdlavuza we-melanoma zihlanganisa:

• Umlando womndeni we-melanoma. Uma ilungu elidume kakhulu lomndeni liye laba ne-melanoma, unethuba elikhulu lokukhula kwe-melanoma, nawe. Amalungu omndeni aseduze angabandakanya umzali, ingane noma umfowabo noma udadewabo.
• Umlando wokushiswa yilanga. Ukushiswa okukodwa noma ngaphezulu okukhulu, okubangela amabhabha, kungakhuphula ingozi yakho ye-melanoma.
• Ukuvezwa ekukhanyeni kwe-UV. Ukukhanya okungabonakali, okubizwa nangokuthi ukukhanya kwe-UV, okuvela elangeni nakwimishini yokubhentsha nokulala, kukhuphula ingozi yomdlavuza wesikhumba, kuhlanganise ne-melanoma.
• Ukuba namabala amaningi noma amabala angavamile. Ukuba namabala angaphezu kwama-50 avamile emzimbeni wakho kubonisa ingozi eyenyuke kakhulu ye-melanoma. Futhi, ukuba nohlobo lwebala elingavamile kukhuphula ingozi ye-melanoma. Okuyaziwa ngokwezokwelapha ngokuthi ama-nevi adysplastic, la mabala avame ukuba makhulu kunamabala avamile. Angaba nemikhawulo engavamile nomxube wemibala.
• Ukuphila eduze ne-equator noma phezulu. Abantu abahlala eduze ne-equator yomhlaba bahlangana nemisebe yelanga eqondile. Ngakho-ke, bahlangana namazinga aphezulu okukhanya kwe-UV elangeni kunabantu abahlala enyakatho noma eningizimu. Futhi, abantu abahlala phezulu bahlangana kakhulu nokukhanya kwe-UV.
• Isikhumba esishiswa kalula yilanga. Noma ubani angathola i-melanoma, kodwa kuvamile kubantu abanesikhumba esimhlophe. Uma unezinwele ezibomvu noma eziphuzi, amehlo amakhanyayo, futhi uqhakaza noma ushiswa kalula yilanga, cishe uzothola i-melanoma.
• Isimilo somzimba esibuthakathaka. Uma isimo somzimba sokulwa nezifo sibuthakathaka ngemithi noma ukugula, kungase kube khona ingozi enkulu ye-melanoma namanye ama-skin cancers. Abantu abanesimilo somzimba esibuthakathaka bahlanganisa labo abasebenzisa imithi yokulawula isimo somzimba, njengoba kunjalo ngemuva kokufakelwa komzimba. Izimo ezithile zezokwelapha, njengokuqabuleka yi-HIV, zingabuthakathaka isimo somzimba.

Unganciphisa ingozi yakho yomdlavuza wesikhumba we-melanoma nezinye izinhlobo zomdlavuza wesikhumba uma wenza lokhu okulandelayo:

• Gwema izibani zokubasa nokubasa emakhameni. Izibani zokubasa nokubasa emakhameni zikhulula ukukhanya okungabonakali, okuthiwa futhi yi-UV light. Ukubhekana nalolu hlobo lokukhanya kungandisa ingozi yakho yomdlavuza wesikhumba.
• Gwema ilanga phakathi nosuku. Kubantu abaningi eNyakatho Melika, imisebe yelanga inamandla kakhulu phakathi kwama-10 ekuseni nama-4 ntambama. Hlela imisebenzi yangaphandle ngezinye izikhathi zosuku, ngisho nasebusika noma lapho isibhakabhaka siqengqelekile.
• Jwayelana nesikhumba sakho ukuze uqaphele izinguquko. Hlola isikhumba sakho njalo ubone ukukhula okusha kwesikhumba. Bheka izinguquko ezinkombeni ezikhona, ama-freckles, ama-bumps nama-birthmarks. Ngosizo zama-mirrors, hlola ubuso bakho, intamo, izindlebe kanye ne-scalp. Bheka isifuba sakho nomzimba wakho kanye nezingxenye eziphezulu nangaphansi zezandla zakho. Hlola kokubili phambi nangemuva kwezinyawo zakho kanye nezinyawo zakho, kufaka phakathi izinyawo nezindawo eziphakathi kwezinzwane zakho. Hlola futhi indawo yakho yobudoda phakathi kwemikhono yakho.
• Gqoka izingubo ezivikela. Uma uya ngaphandle phakathi nosuku, gqoka izingubo ezisiza ekuvikeleni isikhumba sakho emisebeni yelanga. Mbopha isikhumba sakho ngezingubo ezimnyama, ezicwebezelayo ezihlanganisa izandla zakho nezinyawo. Gqoka isigqoko esibanzi, esinikeza isivikelo esiningi kunesigqoko sebhola noma i-visor. Amanye ama-companies athengisa futhi izingubo ezivikela. I-dermatologist ingakuncoma i-brand efanele. Ungakhohlwa izibuko lelanga. Bheka lezo ezivimba womabili uhlobo lokukhanya kwe-UV oluvela elangeni, okuthiwa yi-UVA ne-UVB.
• Sebenzisa i-sunscreen unyaka wonke. Sebenzisa i-sunscreen ebanzi enenombolo ye-SPF okungenani engu-30, ngisho nasezinsukwini ezinamvula. Faka i-sunscreen ngokukhulu. Phinda ufake yonke imizuzu emibili, noma kaningi uma ugeza noma uhlanza. Jwayelana nesikhumba sakho ukuze uqaphele izinguquko. Hlola isikhumba sakho njalo ubone ukukhula okusha kwesikhumba. Bheka izinguquko ezinkombeni ezikhona, ama-freckles, ama-bumps nama-birthmarks. Ngosizo zama-mirrors, hlola ubuso bakho, intamo, izindlebe kanye ne-scalp. Bheka isifuba sakho nomzimba wakho kanye nezingxenye eziphezulu nangaphansi zezandla zakho. Hlola kokubili phambi nangemuva kwezinyawo zakho kanye nezinyawo zakho, kufaka phakathi izinyawo nezindawo eziphakathi kwezinzwane zakho. Hlola futhi indawo yakho yobudoda phakathi kwemikhono yakho. Gqoka izingubo ezivikela. Uma uya ngaphandle phakathi nosuku, gqoka izingubo ezisiza ekuvikeleni isikhumba sakho emisebeni yelanga. Mbopha isikhumba sakho ngezingubo ezimnyama, ezicwebezelayo ezihlanganisa izandla zakho nezinyawo. Gqoka isigqoko esibanzi, esinikeza isivikelo esiningi kunesigqoko sebhola noma i-visor. Amanye ama-companies athengisa futhi izingubo ezivikela. I-dermatologist ingakuncoma i-brand efanele. Ungakhohlwa izibuko lelanga. Bheka lezo ezivimba womabili uhlobo lokukhanya kwe-UV oluvela elangeni, okuthiwa yi-UVA ne-UVB.

Phakathi ne-excisional biopsy, kukhishwa i-scalpel ukuze kuqoshwe i-lump noma indawo yesikhumba esingajwayelekile kanye nezinye izikhumba eziphilile ezizungezile. Njengomthetho, kuyadingeka izinsuku zokuvala isifo.

Phakathi ne-punch biopsy, ithuluzi lokusika eliqoshiwe lisetshenziswa ukususa izigaba ezijulile zesikhumba ukuze kuvivinywe. Kuya ngosayizi, izinsuku zingadingeka ukuvala isifo.

Izivivinyo nezinqubo ezisetshenziswa ukuthola i-melanoma zihlanganisa:

Uchwepheshe wakho wezokunakekelwa kwezempilo uzobabuza imibuzo mayelana nomlando wakho wezempilo. Lo muntu uzobuye ahlole isikhumba sakho ukuze abuke izimpawu ezingasho i-melanoma.

I-biopsy inqubo yokususa isampula yethishu ukuze kuvivinywe elabhoratri. Uhlobo lwenqubo ye-biopsy olusetshenziswayo luya ngesimo sakho. Ngokuvamile ochwepheshe bezempilo bancoma ukususa ukukhula konke uma kungenzeka.

Enye indlela ibizwa ngokuthi i-excisional biopsy. I-excisional biopsy isebenzisa i-scalpel ukuze isikishe i-mole yonke kanye nezinye izicubu eziphilile ezizungezile.

Uma uthola ukuxilongwa kwe-melanoma, isinyathelo esilandelayo ukunquma ukwanda komdlavuza, okuthiwa isiteji. Ukuze ubeke isiteji ku-melanoma yakho, iqembu lakho lokunakekelwa kwezempilo lizo:

• Kunqume ubukhulu. Ngokuvamile, uma i-melanoma ibukhulu, umdlavuza uba sibi kakhulu. Ubukhulu be-melanoma bunqunywa ngokubuka i-melanoma ngaphansi komkhiqizo bese ulikala ngethuluzi elikhethekile. Ubukhulu be-melanoma lusiza iqembu lakho lokunakekelwa ukunquma uhlelo lokwelashwa.

  I-melanomas ezincinci zingadingeka kuphela ukuhlinzwa ukususa umdlavuza kanye nezinye izicubu eziphilile ezizungezile. Uma i-melanoma ibukhulu, iqembu lakho lokunakekelwa kwezempilo lingase liqondise ezinye izivivinyo ukuze libone ukuthi umdlavuza usakazeke yini ngaphambi kokunquma ngezinketho zakho zokwelashwa.

• Bona ukuthi i-melanoma isakazeke yini kuma-lymph nodes. Uma kunengozi yokuthi umdlavuza usakazeke kuma-lymph nodes aseduze, ungase udinga i-sentinel node biopsy.

  Phakathi ne-sentinel node biopsy, umbala uqoshwa endaweni lapho i-melanoma yakho isusiwe khona. Umbala ugeleza kuma-lymph nodes aseduze. Ama-lymph nodes okuqala ukuthatha umbala asusiwe futhi avivinywe ngezicubu zomdlavuza. La ma-lymph nodes okuqala abizwa ngama-sentinel lymph nodes. Uma engekho umdlavuza, kunenzuzo enhle yokuthi i-melanoma ayisakazekanga.

• Bheka izimpawu zomdlavuza ngaphezu kwesikhumba. Uma kukhona ukukhathazeka ukuthi i-melanoma isakazeke, izivivinyo zokwenza izithombe zingase zisetshenziswe ukubuka izimpawu zomdlavuza kwezinye izindawo zomzimba. Izivivinyo zingase zihlanganise i-X-ray, i-MRI, i-CT ne-positron emission tomography, okuthiwa futhi i-PET scan. Lezi zivivinyo zokwenza izithombe ngokuvamile azisetshenziswa kuma-melanomas amancane anezingozi eziphansi zokusakazeka ngaphezu kwesikhumba.

Kunqume ubukhulu. Ngokuvamile, uma i-melanoma ibukhulu, umdlavuza uba sibi kakhulu. Ubukhulu be-melanoma bunqunywa ngokubuka i-melanoma ngaphansi komkhiqizo bese ulikala ngethuluzi elikhethekile. Ubukhulu be-melanoma lusiza iqembu lakho lokunakekelwa ukunquma uhlelo lokwelashwa.

I-melanomas ezincinci zingadingeka kuphela ukuhlinzwa ukususa umdlavuza kanye nezinye izicubu eziphilile ezizungezile. Uma i-melanoma ibukhulu, iqembu lakho lokunakekelwa kwezempilo lingase liqondise ezinye izivivinyo ukuze libone ukuthi umdlavuza usakazeke yini ngaphambi kokunquma ngezinketho zakho zokwelashwa.

Bona ukuthi i-melanoma isakazeke yini kuma-lymph nodes. Uma kunengozi yokuthi umdlavuza usakazeke kuma-lymph nodes aseduze, ungase udinga i-sentinel node biopsy.

Phakathi ne-sentinel node biopsy, umbala uqoshwa endaweni lapho i-melanoma yakho isusiwe khona. Umbala ugeleza kuma-lymph nodes aseduze. Ama-lymph nodes okuqala ukuthatha umbala asusiwe futhi avivinywe ngezicubu zomdlavuza. La ma-lymph nodes okuqala abizwa ngama-sentinel lymph nodes. Uma engekho umdlavuza, kunenzuzo enhle yokuthi i-melanoma ayisakazekanga.

Ezinye izici zingase zifake ekunqumeni ingozi yokuthi umdlavuza ungasakazeka. Eyodwa yiyona isikhumba phezu kwendawo esakhe isifo esivulekile, okuthiwa i-ulceration. Okunye ukuthi zingaki izicubu zomdlavuza ezihlukanisayo ezitholakala uma ubheka isampula yomdlavuza ngaphansi komkhiqizo. Odokotela bakubiza lokhu ngokuthi i-mitotic rate yomdlavuza.

Iqembu lakho lokunakekelwa kwezempilo lisebenzisa imiphumela yalezi zivivinyo ukuze lifunde isiteji se-melanoma yakho. Iziteji ze-melanoma zisebenzisa izinombolo ezivela ku-0 kuya ku-4. Kwisiteji 0 nesiteji 1, i-melanoma inciphile futhi incinci. Ukwelashwa kungenzeka kube yimpumelelo. Njengoba i-melanoma ikhula ejulile esikhumbeni, iziteji ziyakhuphuka. Ukwelashwa kuba nzima kakhulu. Ngositeji 4, umdlavuza usakazeke ngaphezu kwesikhumba kuya kwezinye izitho, njengemiphunga noma isibindi.