Ukukhethwa kwonyango lomhlaza wesikhumba kuxhomekeke kulolu hlobo, isigaba , ubungakanani kunye nendawo yesifo, ingaba umhlaza usasazeke (imetastasized) kunye nempilo yakho yonke. Izinyathelo zokwelapha umdlavuza wesikhumba ziquka ukuhlinzwa, unyango lwe-radiation , immunotherapy , kunye / okanye i-chemotherapy.
Iqela loogqirha liya kusebenza kunye nawe ukufumanisa icebo elingcono lomhlaza wesikhumba.
Eli qela lingabandakanya iingcali ezifana ne- oncologist yokugqirha, i- oncologist yezokwelapha, i-radiation oncologist, i-dermatologist (ugqirha ogxile kwizifo zesikhumba) kunye ne-pathologist.
Ukuhlinzwa
Zombini ze-nonmelanoma (i- basal cell kunye ne -cell squamous ) kunye ne-cancer ye- melanoma ye- kansista yonyango ingaphathwa ngokuphumelelayo phantse kuzo zonke iimeko xa zifunyaniswa kwaye ziphathwa xa i-tumor isancinci. Ugqirha ukususa i-tumor yonyango oluqhelekileyo kodwa ezinye iinketho ezininzi zikhoyo. Uhlobo lwenyango yokwelapha ye-nonmelanoma okanye i-melanoma ( isigaba sokuqala okanye isigaba sexesha elide ) iintsholongwane zixhomekeke kwindlela enkulu ngayo i-lesion, apho itholakala emzimbeni kunye noluhlobo oluthile. Ezinye zeendlela eziqhelekileyo zilandelayo:
- Ukugqithwa okulula (ukususwa) kwesihlunu kunye nommandla wesikhumba oqhelekileyo ojikeleze kuyo yonke indawo
- I-Curettage kunye ne-electrodesiccation (ukuchonga kunye ne-cauterizing), esebenzayo kwi-cell basal cell kunye ne-squamous cell cancers
- I-Mohs surger y (utyando oluthathwa ngonyango), ubuchule obukhethekileyo kwi-basal kunye ne-squamous cell carcinoma engabangela ukuba kunqabileyo nje ngezinye iindlela
Emva kokuhlinzwa kwe-melanoma, ugqirha okanye ugqirha we-oncologist unokuphinda ucetyise okuthiwa "adjuvant" unyango olusekelwe kuloluphi ulwazi olufunyenwe ngesifo ngexesha lotyando.
Oku kungabandakanya i-immunotherapy, i-chemotherapy kunye / okanye unyango lwe-radiation. Ukuba i-melanoma isasazeke kwizitho ezikude (isigaba IV) okanye ibuyela (ibuye emva kokunyanga), unyango lunokuphinda lwenziwa kwakhona ukuze luncede ukulawula eso sifo.
Immunotherapy
I-Immunotherapy (ebizwa ngokuba yinjongo okanye i-biologic therapy) inceda umzimba womzimba ukufumana nokuhlaselwa iiseli zomhlaza. Isebenzisa izinto ezenziwa ngumzimba okanye kwibhubhoratri ukukhulisa, ukujolisa okanye ukubuyisela ukusebenza komzimba. I-basal ne-squamous cell carcinoma, i- creamic imiquimod "i-immune response modifier" echazwe ngokuqhelekileyo. I-Immunotherapy isetyenziselwa ukunyanga i-melanoma, ngokukodwa ekunciphiseni umngcipheko wokuba i-melanoma iza kubuya. Izidakamizwa ezimbini eziqhelekileyo ezisetyenziswayo zi-interferon alfa-2b kunye ne-interleukin-2. I-Immunotherapy ingasetyenziselwa ukudibanisa nokuhlinzwa kunye / okanye i-chemotherapy, okanye njengenxalenye yesilingo seklinikhi. Ezinye ezininzi izilwanyana ezijoliswe kuzo zihlolwe ngoku, kuquka nezitulo zokugonya.
Imiphumo emibi yalezi zonyango iyahluka. Zingaquka ukukhathala, ukukhulelwa komkhuhlane, ukubola, intloko yesifo, ubunzima beememori, izicathulo zomsila kunye nentlungu yesikhumba. Ngamanye amaxesha, iziphumo ezivela kwi-immunotherapy zingaquka utshintsho kwixinzelelo lwegazi okanye kubangele ukwanda kwamanzi kwimiphunga.
Kufuneka uxoxe ngezibonelelo kunye nobungozi bokukhetha unyango ngalunye ngogqirha wakho.
Chemotherapy
I-Chemotherapy yindlela yokusebenzisa iziyobisi ukubulala amaseli esifo somhlaza. I-chemotherapy echanekileyo ihanjiswa ngegazi, ijolise kumaseli omhlaza kuwo wonke umzimba. Kwi-melanoma, oku kusetyenziswe xa kukho umngcipheko omkhulu ukuba i-melanoma isenokusasaza okanye ukulawula izifo eziphambili, nangona ukunyanga kwe-melanoma esasazekayo. Ukuhlanganiswa kwamakhemikhali athile okwangoku ahlolwe kwiimvavanyo zonyango.
Izidakamizwa eziqhelekileyo ze-chemotherapy ezisetyenziselwa i-melanoma ziquka i-dacarbazine (DTIC), i-carboplatin (i-Paraplatin), i-cisplatin (i-Platinol), i-melphalan (i-Alkeran) ne-temozolamide (i-Temodar).
Amachiza asetyenziswa ukunyanga umdlavuza ahlaziywa rhoqo. Ukuthetha nodokotela wakho ngokuqhelekileyo kuyindlela efanelekileyo yokufunda ngamachiza oye wanyulwa, injongo kunye nemiphumo yabo emibi okanye ukusebenzisana namanye amayeza. Ukongeza kwi-chemotherapy ye-systemic, kukho neendlela ezijolise kumachiza kwindawo ethile. I-perfusion yesigxina esisodwa (i-ILP) kunye nokufakelwa kwesinye isigxina (ILI) yimizekelo yale ndlela.
Imiphumo emibi yechemotherapy ixhomekeke kumntu kunye nomthamo osetyenziswayo kodwa unokuquka ukukhathala, umngcipheko wokusuleleka, isisongela kunye nokuhlanza, umonakalo othile weentlungu obangela ukuguqulwa kwintlungu kunye nokulahleka kweenwele. Ezi ziphumo zihlala ziphela xa unyango luphelile.
Utyando lweyeza
Ulwaphulo lwe-radiation lusetyenziso lwe-X-rays enamandla okanye ezinye iindidi zokubulala amaseli esifo somhlaza. Uhlobo oluqhelekileyo lwonyango lwamayeza lubizwa ngokuba lonyango lwangaphandle lwe-radiation, olwenziwe ngamayeza avela kumatshini ngaphandle komzimba.
Ukunyangwa kwamayeza nge-melanoma kungasetyenziswa ngeendlela ezininzi. Ngokuqhelekileyo isetyenziselwa ukunciphisa iimpawu ezibangelwa yi-melanoma eye yasasazeka, ingakumbi kwingqondo kunye namathambo. Ingasetyenziswa kwakhona xa umdlavuza usasazeke kwi-lymph nodes, emva kwe-lymph node dissection. Ekugqibeleni, uphando luyenziwa ukuvavanya ukusebenza kwe-chemoradiation, ukudibanisa unyango lwe-radiation kunye ne-chemotherapy.
Ukunyanga kwamayeza kunokubangela ukucaphuka kwesikhumba, ukucabangela, ukukhathala nokulahleka kweenwele. Ukuba unyango lwe-radiation lisetyenziswe entloko nasentanyeni, imiphumo emibi, efana nefuthe eguqulelwe kunye nomlomo owomileyo, unokwenzeka. Ezi ziphumo zihlala ziphela xa unyango luphelile. Ukuba i-lymph nodes kufuphi neengalo okanye umlenze zithintekile, umntu unokuba ngumngcipheko ophezulu wokukwakheka kwamanzi kwilungu, umphumo wecala obizwa ngokuba yi-lymphedema.
Isiphelo
Kukho unyango oluninzi lwe-cancer yomhlaza. Kukho ukubanjwa komnye, nangona kunjalo: Isifo kufuneka sitholwe kwangaphambili ukwenzela ukuba unyango luphumelele. Ukuba i-melanoma idibanisa kwizitho ezikude, izinga lokusinda lihla ngokukhawuleza. Ngenxa yalesi sizathu, rhoqo ukuhlolwa kweekhumba kunye nokuphepha kwemingcipheko kunokugcina ubomi bakho.
> Imithombo:
"Izikhokelo zeMelanoma - Treatment for Patients." I-National Comprehensive Cancer Network kunye ne-American Cancer Society.
"Yintoni Okufuneka Uyazi Ngomhlaza Wesikhumba." National Cancer Institute. Julayi 2002.
"Yonke Ngomdlavuza Wesikhumba - iMelanoma." American Cancer Society. Julayi 2008.