Amanqanaba omhlaza wolusu: athetha ntoni?

Umxholo

• Yintoni omele uyazi ngamanqanaba omhlaza
• Basal kunye squamous iiseli zomhlaza wolusu
• Izinketho zonyango
• Amanqanaba e-Melanoma
• Unyango lwe-Melanoma
• Umgca wezantsi

Amanqanaba omhlaza achaza ubungakanani besisu sokuqala kunye nokuba umhlaza sele usasazeke kangakanani ukusuka apho waqala khona. Kukho izikhokelo ezahlukileyo zeentlobo ezahlukeneyo zomhlaza.

Ukubeka indawo kunika isishwankathelo sento onokuyilindela. Ugqirha wakho uya kusebenzisa olu lwazi ukuza nesicwangciso sonyango esingcono kakhulu kuwe.

Kule nqaku, siza kujonga ngokujulile indlela i-basal cell, i-squamous cell, kunye nomhlaza wesikhumba se-melanoma.

Yintoni omele uyazi ngamanqanaba omhlaza

Umhlaza sisifo esiqala kwindawo encinci yomzimba, njengesikhumba. Ukuba ayinyangwa kwangethuba, inokudlulela kwamanye amalungu omzimba.

Oogqirha basebenzisa ulwazi lweqonga ukuqonda:

• ungakanani umhlaza osemzimbeni womntu
• apho umhlaza ukhona
• ingaba umhlaza usasazeke ngaphaya kwaqala kuwo
• unyanga njani umhlaza
• yintoni imbonakalo okanye isifo

Nangona umhlaza uhlala uhlukile kuwo wonke umntu, umhlaza okwinqanaba elifanayo uphathwa ngendlela efanayo kwaye uhlala eneembono ezifanayo.

Oogqirha basebenzisa isixhobo esaziwa ngokuba yinkqubo yokwahlulahlula i-TNM ukwenza iintlobo ezahlukeneyo zomhlaza. Inkqubo yokubeka umhlaza ibandakanya la manqaku mathathu olwazi:

• T:tUbungakanani be-umor kunye nokuba bukhule nzulu kangakanani kulusu
• N: i-lymph nukubandakanyeka kwi-ode
• M:mi-etastasis nokuba umhlaza usasazekile

Umhlaza wolusu uhlelwa ukusuka kwi-0 kuye kwi-4. Njengomgaqo jikelele, isantya esisezantsi senani, kokukhona umhlaza usasazekile.

Umzekelo, inqanaba 0, okanye i-carcinoma in situ, kuthetha iiseli ezingaqhelekanga, ezinokuthi zibe nomhlaza, zikhona. Kodwa ezi seli zihlala kwiiseli apho zaqala khona. Azange zikhule zibe ziithishu ezikufuphi okanye zisasazeke kwezinye iindawo.

Isigaba 4, kwelinye icala, sesona sihamba phambili. Kule nqanaba, umhlaza usasazeke kwamanye amalungu okanye amalungu omzimba.

Basal kunye squamous iiseli zomhlaza wolusu

Ukuhlala ngokwesiqhelo akufuneki kwisifo somhlaza wolusu. Kungenxa yokuba le mihlaza ihlala inyangwa ngaphambi kokuba isasaze kwezinye iindawo.

Umhlaza wesikhumba esine squamous unamathuba aphezulu okusasazeka, nangona umngcipheko usezantsi ngokufanelekileyo.

Ngezi ntlobo zomhlaza wolusu, amanqaku athile anokwenza iiseli ezinomhlaza ukuba zisasazeke okanye zibuye ukuba zisusiwe. Ezi zinto zibeka emngciphekweni omkhulu zibandakanya:

• i-carcinoma (iiseli ezinomhlaza) zingaphezulu kwe-2 mm (iimilimitha)
• Ukungena kwimithambo yolusu
• Ukungena kwiindawo ezingaphantsi kwesikhumba
• indawo esemlonyeni okanye endlebeni

Iseli yomhlaza wesisele esine squamous kunye neeseli zeseli zeseli zibekwa ngolu hlobo lulandelayo:

• Inqanaba 0: Iiseli ezinomhlaza zikhona kuphela kwindawo ephezulu yesikhumba (i-epidermis) kwaye azange zisasazeke nzulu kulusu.
• Inqanaba 1: I-tumor i-2 cm (iisentimitha) okanye ngaphantsi, ayizange isasaze kwii-lymph nodes ezikufutshane, kwaye inezinto ezinobungozi obuphezulu.
• Inqanaba 2: I-tumor i-2 ukuya kwi-4 cm, ayizange isasazeka kwii-lymph node ezikufutshane, okanye i-tumor nayiphi na ubukhulu kwaye inezinto ezimbini okanye ngaphezulu ezinobungozi obuphezulu.
• Inqanaba 3: I-tumor ingaphezulu kwe-4 cm, okanye isasazeke kwenye yezi zinto zilandelayo:
  • izicwili ezingaphantsi kwesikhumba, esona sinzulu sinzulu, esingaphakathi kwesikhumba esiquka imithambo yegazi, iziphelo zemithambo-luvo kunye neefollic zeenwele
  • ithambo, apho libangele umonakalo omncinci
  • i-lymph node ekufutshane
• Inqanaba 4: I-tumor ingaba nayiphi na ubukhulu kwaye isasazeka ku:
  • I-lymph node enye okanye ngaphezulu, ezinkulu kune-3 cm
  • ithambo okanye umongo wethambo
  • amanye amalungu omzimba

Izinketho zonyango

Ukuba i-squamous cell okanye i-basal cell cancer ibanjwe kwangoko, iyanyangeka kakhulu. Iindlela ezahlukeneyo zotyando zihlala zisetyenziselwa ukususa iiseli ezinomhlaza.

Ezi nkqubo zotyando zihlala zenziwa kwiofisi kagqirha okanye kwiklinikhi yokunyanga ngaphandle kwe-anesthesia yendawo. Oku kuthetha ukuba uyakuphaphama, kwaye kuphela yindawo ejikeleze umhlaza wolusu oya kuba ndindisholo. Uhlobo lwenkqubo yotyando eyenziweyo luya kuxhomekeka:

• uhlobo lomhlaza wolusu
• ubungakanani bomhlaza
• apho umhlaza ukhona

Ukuba umhlaza usasazeke ngokunzulu kulusu okanye unobungozi obuninzi bokusasazeka, ezinye iindlela zonyango zinokufuneka emva kotyando, njenge-radiation okanye ichemotherapy.

Olunye lolona khetho luqhelekileyo kunyango lwe-basal cell okanye i-squamous cell cancer somhlaza zibandakanya oku kulandelayo:

• Ukuxhamla: Ngokukhawuleza, ugqirha wakho uya kusebenzisa i-razor ebukhali okanye i-scalpel ukususa izicubu zomhlaza kunye nezinye izicubu ezisempilweni ezijikelezileyo. Izicubu ezisusiweyo ziya kuthi emva koko zithunyelwe elebhu ukuba zihlolwe.
• Ulawulo lwe-Electrosurgery: Ikwabizwa ngokuba yi-curettage kunye ne-electrodeiccation, le nkqubo ifaneleke kakhulu kumhlaza wolusu ongaphezulu kwesikhumba. Ugqirha wakho uza kusebenzisa isixhobo esikhethekileyo esibizwa ngokuba yi-curette ukususa umhlaza. Ulusu lutshiswe nge-electrode ukutshabalalisa nawuphi na umhlaza oseleyo. Le nkqubo ihlala iphindaphindwe amaxesha ngexesha lotyelelo olufanayo eofisini ukuqinisekisa ukuba wonke umhlaza uyasuswa.
• Utyando lwe-Mohs: Ngale nkqubo, ugqirha wakho usebenzisa isikhumba sokususa isusu esingaqhelekanga kumaleko athe tyaba kunye nezinye izicwili ezijikelezileyo. Ulusu luvavanywa phantsi kwemicroscope kwakamsinya nje ukuba lususwe. Ukuba iiseli zomhlaza zifunyenwe, olunye uhla lwesikhumba luyasuswa kwangoko de kungabikho maseli omhlaza abhaqwayo.
• Utyando: Nge-cryosurgery, i-nitrogen engamanzi isetyenziselwa ukubandisa kunye nokutshabalalisa izicubu zomhlaza. Olu nyango luphindaphindwe amatyeli aliqela ngexesha lotyelelo olufanayo eofisini ukuqinisekisa ukuba zonke izicwili ezinomhlaza zitshatyalalisiwe.

Amanqanaba e-Melanoma

Nangona i-melanoma ingaqhelekanga kune-basal cell okanye i-squamous cell cancer, inamandla ngakumbi. Oku kuthetha ukuba kunokwenzeka ukusasazeka kwizicubu ezikufutshane, ii-lymph node, kunye namanye amalungu omzimba, xa kuthelekiswa nomhlaza wesikhumba we-nonmelanoma.

I-Melanoma ihlelwe ngolu hlobo lulandelayo:

• Inqanaba 0: Iiseli ezinomhlaza zikhona kuphela kumaleko angaphandle kwesikhumba kwaye azange zihlasele izicwili ezikufutshane. Kule nqanaba elingabonakaliyo, umhlaza ungasuswa ngokuhlinzwa kuphela.
• Inqanaba 1A: Ithumba alikho ngaphezulu kwe-1 mm ubukhulu. Inokuthi okanye ingabinasilonda (ikhefu kulusu oluvumela izicwili ezingezantsi zibonise).
• Inqanaba 1B: Ukudumba kwe-tumor yi-1 ukuya kwi-2 mm, kwaye akukho zilonda.
• Inqanaba 2A: Ithumba yi-1 ukuya kwi-2 mm ubukhulu kwaye inezilonda, okanye yi-2 ukuya kwi-4 mm kwaye ayinasisilonda.
• Inqanaba 2B: Ithumba yi-2 ukuya kwi-4 mm ubukhulu kwaye inezilonda, okanye ingaphezulu kwe-4 mm kwaye ayinasisilonda.
• Inqanaba 2C: Ithumba lingaphezulu kwe-4 mm ubukhulu kwaye linezilonda.
• Inqanaba 3A: Ubunzima be-tumor abukho ngaphezu kwe-1 mm kwaye kukho i-ulceration, okanye i-1 ukuya kwi-2 mm kwaye ingabi nezilonda. Umhlaza ufumaneka kwi-1 ukuya kwi-3 ye-sentinel lymph node.
• Inqanaba 3B: I-tumor ifike kwi-2 mm ubukhulu kunye nesilonda, okanye i-2 ukuya kwi-4mm ngaphandle kwesilonda, kunye nomhlaza ukhona kwenye yezi:
  • indawo enye ukuya kwezintathu
  • kumaqela amancinci eeseli zethumba, ezibizwa ngokuba yimicrosatellite tumors, kanye ecaleni kwethumba lokuqala
  • kumaqela amancinci eeseli zethumba ngaphakathi kwe-2 cm yethumba yokuqala, ebizwa ngokuba ngamathumba esathelayithi
  • kwiiseli ezisasazeke kwimikhumbi ye-lymph ekufuphi, eyaziwa njenge-metastases ekuhambeni
• Inqanaba 3C: I-tumor ifike kwi-4 mm ubukhulu kunye nesilonda, okanye i-4 mm okanye enkulu ngaphandle kwesilonda, kunye nomhlaza ukhona kwenye yezi:
  • iindawo ezimbini ukuya kwezintathu
  • Inombolo enye okanye ezingaphezulu, kunye ne-microsatellite tumors, satellite satellite, okanye in-transit metastases
  • iindawo ezine okanye nangaphezulu okanye naliphi na inani leendawo ezidityanisiweyo
• Inqanaba le-3D: Ubunzima be-tumor bungaphezulu kwe-4 mm kwaye unesilonda. Iiseli zomhlaza zifunyenwe kwezi ndawo:
  • ii-lymph node ezine okanye nangaphezulu okanye naliphi na inani leendawo ezidityanisiweyo
  • iindawo ezimbini okanye nangaphezulu okanye naliphi na inani leendawo ezidityanisiweyo, kunye nezidumba ze-microsatellite, izilonda zesathelayithi, okanye i-metastases yokuhamba
• Inqanaba 4: Umhlaza unwenwele kwiindawo ezikude zomzimba. Oku kunokubandakanya ii-lymph node okanye amalungu afana nesibindi, imiphunga, ithambo, ingqondo, okanye indlela yokugaya ukutya.

Unyango lwe-Melanoma

Kwi-melanoma, unyango luya kuxhomekeka kwinqanaba kunye nendawo yokukhula komhlaza. Nangona kunjalo, ezinye izinto zinokuthi zichonge nokuba loluphi uhlobo lonyango olusetyenziswayo.

• Inqanaba 0 no-1: Ukuba i-melanoma ifunyenwe kwangethuba, ukususwa ngotyando kunye nezicubu ezijikelezileyo kuhlala kuyinto efunekayo. Ukuhlolwa kolusu rhoqo kucetyiswa ukuqinisekisa ukuba akukho mhlaza mtsha uvelayo.
• Inqanaba 2: I-melanoma kunye nezicubu ezijikelezayo ziya kususwa ngotyando.Ugqirha wakho unokuphinda acebise i-sentinel lymph node biopsy ukuqinisekisa ukuba umhlaza awusasazekanga kwii-lymph node ezikufutshane. Ukuba i-lymph node biopsy ifumanisa iiseli zomhlaza, ugqirha wakho unokucebisa ukususwa kotyando lwee-lymph nodes kuloo ndawo. Oku kwaziwa njenge-lymph node dissection.
• Inqanaba 3: I-melanoma iya kususwa ngotyando kunye nenani elikhulu lezicubu ezijikelezileyo. Ngenxa yokuba umhlaza usasazeke kwii-lymph node ngeli nqanaba, unyango luya kubandakanya i-lymph node dissection. Emva kotyando, unyango olongezelelweyo luya kucetyiswa. Banokubandakanya:
  • iziyobisi ze-immunotherapy ezinceda ukukhulisa impendulo yomzimba wakho ngokuchasene nomhlaza
  • amachiza onyango ekujoliswe kuwo athintela iiproteni ezithile, ii-enzymes, kunye nezinye izinto ezinceda umhlaza ukuba ukhule
  • unyango lwemitha olujolise kwiindawo apho ii-lymph node zisuswe khona
  • ichemotherapy eyedwa, ebandakanya ukufakela nje indawo apho wawukhona umhlaza
• Inqanaba 4: Ukususwa kotyando kunye ne-lymph node kuyacetyiswa. Ngenxa yokuba umhlaza usasazeke kwizitho ezikude, unyango olongezelelweyo luya kubandakanya enye okanye ngaphezulu koku kulandelayo:
  • iziyobisi ze-immunotherapy ezaziwa ngokuba zii-inhibitors zokujonga
  • iziyobisi zonyango ekujoliswe kuzo
  • ichemotherapy

Umgca wezantsi

Amanqanaba omhlaza wolusu anokukuxelela okuninzi malunga nokuba isifo sesihambele phambili kangakanani. Ugqirha wakho uyakuthathela ingqalelo uhlobo oluthile lomhlaza wolusu kunye nenqanaba lokumisela unyango olufanelekileyo kuwe.

Ukufumanisa kwangoko kunye nonyango ngokubanzi kubonelela ngeyona mbono intle. Ukuba usemngciphekweni omkhulu womhlaza wolusu okanye uqaphele into engaqhelekanga kulusu lwakho, cwangcisa uvavanyo lomhlaza wolusu ngokukhawuleza.