Asizi kakuhle oko kubangela umdlavuza wesikhumba , kodwa izinto ezinobungozi zingabonakalisa ithoni yesikhumba kunye nobuhlanga, ukukhanya kwelanga kunye nokushisa kwelanga, ukuchazwa kweekhemikhali zendalo kunye nezinye izinto, ezinye iimeko zonyango okanye unyango lweengxaki zonyango kunye nokutshaya. Imbali yentsapho yomhlaza wesikhumba, kunye neminye ye-genetic syndromes, inokuphakamisa umngcipheko, kwaye izinto ezibonakalayo zithathwa njengendima ebalulekileyo ekuphuhliseni amaninzi angenayo i-melanoma kunye ne-melanoma ye-skin cancer.
Kwinqanaba elincomekayo, izinto ezinomsoco, ezifana nokutya okunotye kwizityalo nemifuno, kunokunciphisa umngcipheko.
Izinto zobungozi
Izinto ezinobungozi zingabandakanya ukuvezwa okonakalisa ngokukhawuleza ulusu, kubangele utshintsho kwi-DNA (iinguqu zoguquko) ezingakhokelela ekubeni umhlaza uphuhlise. Ezinye izinto, ezifana nokunyanzelwa kwe-immune, kunokunciphisa amandla omzimba ukulungisa iiseli emva kokulimala. Ukubaluleka kwemeko ethile yengozi iyakwazi ukuhluka ngohlobo lwesikhumba, nangaphezulu. Imingcipheko eqhelekileyo yomhlaza wesikhumba iquka:
Ubudala
Ngokuqhelekileyo, i-non-melanoma yesikhumba somhlaza (ezifana ne-basal cell carcinomas kunye ne-squamous cell carcinomas) zanda ngeeminyaka ubudala, nangona i-melanomas idlalwa kubantu abancinci.
I-Skin Tone, ubuhlanga, kunye noBume boMzimba
Itheyibhile yesikhumba ingaba yingozi ebalulekileyo ekuphuhliseni umdlavuza wesikhumba, kunye nabantu abanesikhumba esilungileyo abanomngcipheko omkhulu. Isizathu esilandelayo kukuba i-pigment melanin (ejongene nombala wesikhumba) inikeza ukhuselo oluvela kwi-ultraviolet (UV) imisebe, kunye nabantu abanomphunga omnyama banama-melanin.
Oko kwathiwa, abantu abanombala wesikhumba bangakhula umdlavuza wesikhumba, kwaye nangona umdlavuza wesikhumba udla ngokugqithiseleyo kumhlophe kunabamnyama, abamnyama banokufa kwesi sifo. Kwaye, njengokuba i-melanoma iyanda kumhlophe, yanda ngeLatinos.
Abantu abaneempawu zomzimba ezinxulumene nomngcipheko omkhulu kubandakanya:
- Abantu abaneentsimbi.
- Abo banamathoni eluhlaza.
- Abo bangenalo okanye bangenakudla.
- Abo bashisa ngokulula.
- Abantu abanamehlo akhanyayo, njengamehlo aluhlaza kunye neluhlaza okwesibhakabhaka.
- Abantu abaneenwele ezibomvu okanye ezinobomvu (kunye neenwele ezibomvu ezithwala ingozi ngaphezu koboya be-blonde).
Ukuboniswa kwelanga (i-Natural or Tanning Booths)
Ukutshatyalaliswa kwelanga kuyingozi enkulu yomdlavuza wesikhumba, kodwa ukubaluleka kwayo kuhluka kunye nomhlobo wolomhlaza wesikhumba. I-Squamous cell carcinoma luhlobo lomhlaza wesiko olusondelelene kakhulu ekukhanyeni kwelanga. Umlinganiselo wokukhanya okukhanya kwe-ultraviolet (UV) ukuxhomekeka kumandla kuxhomekeke kumandla okukhanya (anokungafani nekona lelanga), ubude bokungabonakali, kunye nokuba ulusu lugubungelwe ngengubo okanye i-sunscreen.
Ukutshiswa kwelanga ngokusemncinci, nangona oko kwenzeka kuphela kanye, kunokuba ngumngcipheko omkhulu kumashumi eminyaka kamva. I-Sunburns inxulumene kakhulu kakhulu ne-melanoma, kwaye ukushona kwelanga kwi-trunk yomzimba kudibene nomngcipheko omkhulu.
Nangona i-sun exposure idlala indima kuzo zonke iindidi ezinkulu zomdlavuza wesikhumba, uhlobo lomhlaza luyahlukahluka kumzekelo wokutshatyalaliswa. I-squamous cell carcinoma kunye ne-basal cell carcinoma zixhomekeke kakhulu kunye nokutyhila kwexesha elide, kwaye abo bachitha ixesha elingaphezulu ngaphandle komsebenzi okanye ukudlala banomngcipheko ophezulu.
Ngokwahlukileyo, i-melanoma idibaniswa nokungafihli kwelanga (ingcinga: ukuphuka kwentwasahlobo kwindawo efudumeleyo).
Khemikhali
Ukuboniswa kwamakhemikhali kunye nezinye izinto ekhaya okanye emsebenzini, kunokunyusa ingozi yomhlaza wesikhumba. Izinto ezinxulumene nobungozi obuninzi zibandakanya:
- I-Arsenic: Ukusuka kokungapheliyo emanzini okusela (ingakumbi imithombo yabucala) kwakunye nokunyanzeliswa komsebenzi.
- I-Tar (njengabasebenzi basendleleni).
- Iiparafini (wax): Iiparafini zisetyenziselwa ukuvelisa imoto.
- Iisombululo, ngokukodwa ezinokucoca kunye neklorinated solvents: Ngokomzekelo, kubasebenzi bezinyithi kunye nalabo bavelele ekushicileleni ii-inki, ama-degreasers kunye nemveliso yokucoca.
- I-vinyl chloride (njengamafektri enza iimveliso ze-vinyl).
Ukutshaya
Ukubhema kudibene nomngcipheko okhulayo we-squamous cell carcinomas kwesikhumba, kodwa kungekhona i-basal cell carcinomas. Ucwaningo lwango-2017 lufumene ukuba umngcipheko weengcambu zamaseli ezisezantsi zisezantsi kakhulu kubantu ababhemayo, kodwa bacinga ukuba oku kungenzeka ngenxa yokufunyaniswa kwezinto (abaphandi banokufumana iidrari ezingenakufunyanwa kumntu ongekho kwisifundo). Ngokungafani neentsholongwane ezinjengomdlavuza wamaphaphu, umngcipheko womhlaza wesikhumba kulabo ababefudume ukutshaya bawa phantsi kwabo bangabhemi emva kokuyeka.
Imibandela Yesikhumba okanye unyango lweMeko yeziPhulo
Kukho inani leemeko zesikhumba ezinokunyusa umngcipheko wokwakha umdlavuza wesikhumba, okanye uthathwa njengengqindi. Ukongezelela, iindlela ezithile zonyango zingakhupha umngcipheko womhlaza. Ezinye zeemeko ziquka:
- I-actinic keratosis : I-actinic keratoses (i-keratoses yelanga) ziqhelekileyo izilonda zesikhumba ezibonakala zibuhlungu, i-scaly, i-patch-like patch kwesikhumba esinokubomvu, obomvu, okanye obomvu. Ziqhelekileyo kwiindawo ezibonakalayo zelanga zomzimba. Akunjalo zonke i-actinic keratoses ziya kuqhubela phambili kwi-squamous cell carcinoma yolusu (ininzi ayinayo), kodwa icinga ukuba ama-20 ukuya kuma-40 ekhulwini lamanqamana ekhanda egciniweyo aqala njenge-actinic keratosis. Ukuhlaziywa kwe-2018 kuboniswe ukuba i-actinic keratoses kwezinye iindawo zomzimba ziyakwazi ukuguqulwa kwiikliniki zesikhumba. Ezi ziquka i-keratoses kwiminyango yezandla, iiphambili, imilenze, okanye malunga nomlomo, imilomo, okanye impumlo. I-actinic keratoses ithathwa njengengqungquthela, kwaye, ngokwenene, ezinye iidermatologists zikholelwa ukuba i-actinic keratoses ingaba yindlela yokuqala ye-squamous cell carcinoma yolusu. Abantu abaninzi be-keratoses ye-actinic banakho amathuba okuphuhlisa i-basal cell carcinoma okanye i-melanoma.
- Ukuba ne-moles ezininzi (ngaphezu kwe-50).
- I-Dysplastic moles (ngokungaqhelekanga kubonakala i-moles).
- I-congenital melanocytic nevi: Ezi zikhulu "zi-moles" ezikhoyo xa zizalwa, kwaye i-melanoma ingahlakulela kwi-10 yeepesenti (ikakhulukazi nevi enkulu).
- Imbali yokutshisa okukhulu okanye ukuvuvukala kwesikhumba ngamanye amaxesha kunokubangela umdlavuza wesikhumba.
- I-Psoralens okanye i-ultraviolet (UV) yonyango ye-psoriasis okanye i-eczema inokunyusa umngcipheko wokuphuhlisa umdlavuza ongeyun melanoma.
Imibandela kunye neZonyango
Ezinye iimeko zonyango zidibene nomngcipheko omkhulu wokuba nomhlaza wesikhumba. Ezi ziquka:
- Imbali yakhe yomhlaza wesikhumba. Abo babenomdlavuza wesikhumba esingenayo i-melanoma bangamaxesha angama-10 ngaphezulu kunomlinganiselo wokuphuhlisa enye yale mdlavuza. Abo babe ne-melanoma banamathuba amathathu okuhlakulela umhlaza wengqanda ongeyena melanoma.
- Amanye amayeza anyukisayo ukukhanya kwelanga (izithombeensitivity), kuquka iincwadana ezincinci zegazi, i-hydrochlorothiazide ye-blood pressure ephezulu kunye namanye amayeza e-chemotherapy.
- Ulwaphulo lwamayeza oludlulileyo kumhlaza. Umngcipheko okhulayo ukhona kuphela kwimimandla apho kwafunyanwa imitha.
- Abantu abanokusilela kwe-immune system, nokuba ngabafa okanye abafumana njenge-HIV / AIDS.
- Usulelo lwe-Human papillomavirus ( HPV ). Ezinye iintlobo ze-HPV zingenza igalelo kumathambo e-genitalia, i-anus, kunye nesikhumba ezungeze iminwe.
Ukutya
Ngoxa singakhange sichaze ukutya okukhethiweyo okuphakamisa umngcipheko womhlaza wesikhumba, sinobungqina bokuba ezinye iindlela zokutya zidibene nomngcipheko ophantsi . Ukutya okuphezulu kwiziqhamo nemifuno kunokunciphisa umngcipheko wokuba nomhlaza wesikhumba .
Genetics
Iimpembelelo ezibonakalayo ekuveliseni umdlavuza wesikhumba ziyahlukahluka ngokuxhomekeke kwintlobo ethile. Kungaba nzima ukuhlukanisa umngcipheko ophathelene nemfuza, kunye neempawu ezinobomi ezifana neeton. Ucwaningo lweewele eziqhelekileyo lubonisa ukuba malunga nesiqingatha somngcipheko womntu we-basal cell kunye ne-squamous cell carcinomas kubangelwa yimfuza. Ngeli xesha i- gene genetic mutations i- akhawunti ye-melanomas, i-2016 iphakanyisiwe ukuba i-58% yengozi ye-melanoma ihambelana nezinto ezizuze ifa.
Asiqinisekanga ukuba unobomi bentsapho yomhlaza wesikhumba luchaphazela njani umngcipheko, nangona umngcipheko we-squamous cell carcinoma eSweden ubonakala ube ngama-2 ukuya kwe-3 amaxesha aphakathi ukuba unesihlobo sokuqala (umzali, umntakwabo, okanye umntwana ) onomdlavuza wesikhumba. Imbali yentsapho ye-nevus syndrome ye-atypical kwandisa umngcipheko we-melanoma.
Kukho ama-syndromes amaninzi azalisekileyo aphakamisa umngcipheko womntu ophucula umdlavuza wesikhumba. Eminye yezinto eziqhelekileyo ziquka:
- I-Basal cell carcinomas: Abantu abane-basal cell nevus syndrome banomngcipheko omkhulu wokuphuhlisa i-basal cell carcinomas (PTCH1 kunye ne-PTCH2 gene changes).
- I-squamous cell carcinomas (SCC): Umngcipheko we-SCC unyuka kulabo abane-xeroderma pigmentosum, i-oculocutaneous albinism, i-epidermolysis bullosa, kunye ne-Fanconi anemia.
- I-Melanoma: Ukungaqhelekanga kwi - CD-N2A i- genetic genetic suppressor gene ixanduva lokufikelela kuma-40 ekhulwini lwe-melanomas.
> Imithombo:
> Dusingize, J., Olsen, C., Pandeva, N. et al. Ukubhema kunye neengozi ze-Basal Cell Carcinoma kunye ne-Squamous Cell Carcinoma. Umbhalo weDermatology yophando . 2017. 137 (8): 1700-1708.
> Mucci, L., Hjelmborg, J., Harris, J. et al. Umngcipheko wobuNtu kunye nokuLungeleka kweCarcer Phakathi kwamawele e-Nordic Countries. JAMA . 315 (1): 68-76.
> INational Cancer Institute. I-Genetics yeCancer Cancer (PDQ) -I-Professional Professional Version. Ukuhlaziywa 02/22/18.
> Ng, C., Yen, H., Hsiao, H., no S. Su. Iiphytochemicals kwiCatal Cancer Prevention and Treatment: Ukuhlaziywa okuhlaziyiweyo. I-International Journal ye-Molecular Sciences . 2018. 19 (4) .pii: E941.
> URichard, M., Amici, J., uBasset-Seguin, uN. et al. Ulawulo lwe-Actinic Keratosis kumaziko aBhunga aBodwa kwiZiGqeba eziPhezulu kwiNgcipheko ephezulu yeCarcinoma izilwanyana: Ukuvunywa kwengcali evela kwi-AKTeam of Expert Clinicians. Umbhalo we-European Academy of Dermatology kunye neVenereology . 2018. 32 (3): 339-346.