Ukuqapha i-Melanoma: Ukuchazwa kwesiteji
-Delile
- Odokotela basihlola kanjani isigaba se-melanoma?
- Luyini uhlelo lwe-TNM Stage?
- Ziyini izigaba ze-melanoma nezindlela zokwelashwa ezinconywayo?
- Izeluleko zokuvimbela i-melanoma
I-melanoma yesiteji
I-Melanoma uhlobo lomdlavuza wesikhumba ovela lapho amangqamuzana anomdlavuza eqala ukukhula kuma-melanocyte, noma amaseli akhiqiza i-melanin. Lawa ngamangqamuzana anesibopho sokunikeza isikhumba umbala waso. I-Melanoma ingenzeka noma kuphi esikhunjeni, noma emehlweni. Yize lesi simo singavamile, odokotela bathola inani elikhulu labantu abane-melanoma kunanini ngaphambili.
Uma umuntu kutholakala ukuthi une-melanoma, udokotela uzokwenza izivivinyo ukuthola ukuthi i-melanoma isabalale kangakanani nokuthi isimila sikhulu kangakanani. Udokotela uzobe esesebenzisa lolu lwazi ukwabela isigaba sohlobo lomdlavuza. Kunezigaba ezinhlanu eziyinhloko ze-melanoma, kusuka esigabeni 0 kuya esigabeni 4. Uma isibalo siphezulu, umdlavuza uvame kakhulu.
Ngokusebenzisa inqubo yesiteji, odokotela neziguli bakwazi kangcono ukuqonda izinketho zabo zokwelashwa nokubikezela. Isiteji sinikeza iphuzu lesethenjwa elisheshayo lokusiza odokotela ukuxhumana nabanye maqondana nohlelo lokwelashwa komuntu nombono jikelele.
Odokotela basihlola kanjani isigaba se-melanoma?
Odokotela bazoncoma izindlela eziningi zokuhlola ukuthola ukuthi ikhona yini futhi isakazeka i-melanoma. Izibonelo zalezi zindlela zifaka:
- Ukuhlolwa ngokomzimba. I-Melanoma ingakhula noma kuphi emzimbeni. Yingakho odokotela bavame ukuncoma ukuhlolwa kwesikhumba ngokuphelele, kufaka phakathi ekhanda naphakathi kwezinzwani. Udokotela futhi angabuza nganoma yiziphi izinguquko zakamuva esikhunjeni noma kuma-moles akhona.
- Iskena se-CT. Futhi okubizwa ngokuthi yi-CAT scan, i-CT scan ingakha izithombe zomzimba ukukhomba izimpawu ezingaba khona zokusabalala kwesimila nesimila.
- Ukuskena kwe-Magnetic resonance imaging (MRI). Lokhu kuskena kusebenzisa amandla kazibuthe namandla omsakazo ukwenza izithombe. Udokotela angakhipha into enemisebe eyaziwa ngokuthi i-gadolinium egqamisa amangqamuzana omdlavuza.
- Ukuskena kwePositron emission tomography (PET). Lolu olunye uhlobo lokucwaninga ngemidwebo oluhlola lapho umzimba usebenzisa i-glucose (ushukela wegazi) ukuthola amandla. Ngoba izicubu ziyidla kakhulu i-glucose, zivame ukuvela njengezindawo ezikhanyayo ezithombeni.
- Ukuhlolwa kwegazi. Abantu abane-melanoma bangaba namazinga aphezulu kunejwayelekile we-enzyme lactate dehydrogenase (LDH).
- Isidumbu. Udokotela angathatha isampula yesilonda esingaba nomdlavuza kanye nama-lymph node aseduze.
Odokotela bazocubungula imiphumela yalokhu kuhlolwa ngakunye lapho kunqunywa isigaba somdlavuza.
Luyini uhlelo lwe-TNM Stage?
Odokotela bavame ukusebenzisa uhlelo lokuqhafaza olwaziwa ngokuthi yi-American Joint Committee on Cancer (AJCC) TNM system. Uhlamvu ngalunye lohlelo lwe-TNM lubamba iqhaza ekubekeni isimila.
- T yenzelwe isimila. Lapho isimila sikhula ngokwengeziwe, isimila siba sithuthuka kakhulu. Odokotela bazokwabela i-T-score ngokuya ngosayizi we-melanoma. I-T0 ayibubufakazi besimila sokuqala, kuyilapho i-T1 iyi-melanoma eyi-1.0 millimeter obukhulu noma ngaphansi. I-T4 melanoma ingaphezu kwamamilimitha ayi-4.0.
- I-N yenzelwe ama-lymph node. Uma umdlavuza ususabalele kuma-lymph node, kuba kubi kakhulu. I-NX yilapho udokotela engakwazi ukuhlola ama-node wesifunda, kuyilapho i-N0 ilapho udokotela engakwazi ukubona ukuthi umdlavuza ususakazekele kwamanye ama-node. Ukunikezwa kwe-N3 kulapho umdlavuza ususabalalele kuma-lymph node amaningi.
- M yenzelwe imetastasized. Uma umdlavuza ususabalele kwezinye izitho, ukubikezelwa kuvame ukuba mpofu. Ukuqokwa kwe-M0 kulapho kungekho bufakazi bama-metastases. I-M1A yilapho umdlavuza ususetshenziswe emaphashini. Kodwa-ke, i-M1C yilapho umdlavuza ususakaze kwezinye izitho.
Odokotela bazosebenzisa i- “score” kuzo zonke lezi zinto ukuthola isigaba se-melanoma.
Ziyini izigaba ze-melanoma nezindlela zokwelashwa ezinconywayo?
Ithebula elilandelayo lichaza isigaba ngasinye se-melanoma kanye nokwelashwa okujwayelekile ngakunye. Kodwa-ke, lokhu kungahluka ngokuya ngempilo yomuntu wonke, ubudala, kanye nezifiso zabo zokwelashwa.
| 0 | Isimila singene kuphela ku-epidermis, noma ungqimba lwesikhumba olungaphandle. Elinye igama lalokhu i-melanoma in situ. | Udokotela uvame ukususa isimila namanye amaseli azungeze isimila ukuqinisekisa ukuthi umdlavuza ususwe ngokuphelele. Kunconywa ukuvakashelwa okuvamile nokuhlolwa kwesikhumba. |
| 1A | Isimila asikho ngaphezu kwamamilimitha ayi-1 ukushuba futhi asisakazekanga kuma-lymph node noma ezithweni. Isikhumba asibonakali sikhishwe noma siqhekeziwe kusayithi le-melanoma. | Isigaxa sisuswa ngokuhlinzwa. Ukuhlolwa kwesikhumba okujwayelekile kufanele kuqhubeke, kepha ukwelashwa okuqhubekayo akudingi njalo. |
| 1B | Isimila sihlangabezana nenqubo eyodwa kwezimbili. Okokuqala, ingaphansi kwamamilimitha ayi-1 ubukhulu futhi inokubukeka kwesikhumba okuqhekekile, noma okwesibili, ingamamilimitha ayi-1 kuye kwezi-2 ubukhulu ngaphandle kokubukeka okuqhekekile. Akusakazekanga kwamanye ama-lymph node noma izitho. | Ukususwa kokuhlinzwa kwesimila namaseli azungezile imvamisa kuyikho okudingekayo. Ukuhlolwa njalo kokukhula kwesikhumba okusha futhi okuphathelene nakho kunconyiwe. |
| 2A | Isigaxa siyi-1 to 2 millimeters obukhulu futhi sinokubukeka okuqhekekile noma singamamilimitha amabili kuya kwayi-4 ubukhulu futhi siqhekekile. Isimila asisakazelanga kuma-lymph node noma ezithweni ezizungezile. | Kunganconywa ukususwa kokuhlinzwa kwezicubu nezitho ezizungezile kanye nokwelashwa okungahle kube khona, njenge-chemotherapy kanye nemisebe. |
| 2B | Isimila siwugqinsi lwamamilimitha amabili kuya kwayi-4 futhi siqhekekile noma singaphezu kwamamilimitha amane ukushuba futhi asiqhekekile ngokubukeka. Isimila asisakazelanga kwezinye izitho. | Ukususwa kokuhlinzwa kwesimila nezinye izicubu ezizungezile kungadingeka. Ukwelashwa kungafaka futhi i-chemotherapy kanye ne-radiation njengoba kudingeka. |
| 2C | Isimila singaphezu kwamamilimitha amane ukujiya futhi sibukeka siqhekekile. Lezi zicubu kungenzeka zisabalale ngokushesha. | Udokotela uzosusa isimila ngokuhlinzwa. Ukwelashwa okungeziwe kungafaka i-chemotherapy kanye / noma imisebe. |
| 3A3B, 3C | I-tumor ingaba yinoma yikuphi ukujiya. Kodwa-ke, amaseli anomdlavuza asabalalele kuma-lymph node noma kwezinye izicubu ezingaphandle kwesimila. | Kunconywa ukususwa kokuhlinzwa kwama-lymph node. Ukwelashwa okungeziwe kungafaka ama-immunotherapies Yervoy noma i-Imylgic. Lezi izindlela zokwelashwa ezivunyelwe yi-FDA zesigaba 3 se-melanoma. |
| 4 | Amangqamuzana anomdlavuza asakaze noma afaka imastasas kude kakhulu kwesimila sokuqala. Kungenzeka babe kuma-lymph node, ezinye izitho, noma izicubu ezikude. | Kunconywa ukususwa kokuhlinzwa kwe-tumor ne-lymph node. Ukwelashwa okungeziwe kungabandakanya imishanguzo ye-immunotherapy, ukwelashwa okubhekiswe kwi-melanoma, noma ukubamba iqhaza ezivivinyweni zokwelashwa. |
Izeluleko zokuvimbela i-melanoma
Njengoba kushiwo ngaphambili, i-melanoma iyindlela engajwayelekile yomdlavuza wesikhumba. Kwesinye isikhathi umuntu angahle angabi nawo umlando obalulekile wokushiswa yilanga kodwa abe esethola i-melanoma. Lokhu kungabangelwa umlando womndeni walesi simo. Kodwa-ke, kunezinyathelo ezithile ongazithatha ukunciphisa ubungozi be-melanoma:
- Gwema ukuvezwa yilanga ngokweqile futhi uhlale emthunzini lapho kungenzeka khona ukugwema imisebe yelanga.
- Gwema ukusebenzisa imibhede yokushuka noma izibani zelanga ukuzama ukushuka. Ngokusho kwe-American Cancer Society, labo abasebenzisa imibhede yokushuka basengozini enkulu ye-melanoma.
- Sebenzisa idivayisi yokubamba ngekhanda “Slip! Slop! Ngempama… bese uyigoqa! ” ukukhumbula ukushibilika ehembeni, slop esikrinini selanga, ukushaya isigqoko, nokugoqa izibuko zelanga ukuvikela amehlo akho emisebeni yelanga.
- Yenza ukuhlolwa kwesikhumba njalo ukubheka izimpawu zokushintsha kwezimvukuzane. Abanye abantu bangathatha izithombe zesikhumba sabo futhi baziqhathanise njalo ngenyanga ukuthola ukuthi ngabe kukhona yini ushintsho olwenzekile.
Noma nini lapho umuntu ebheka imvukuzane eguqukayo noma indawo yesikhumba ebonakala iklanyelwe, iqhekeziwe, noma inezilonda ngenye indlela ngokubukeka kufanele ifune udokotela wesikhumba ukuze ahlole ukuthi kungenzeka yini ukuthi unesifo somdlavuza.
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