I-Melanoma

Iyini i-melanoma?

I-melanoma ivela kumaseli (melanocyte) akha i-melanin, i-pigment eyenza isikhumba sakho sibe nombala. Iwuhlobo oluyingozi kakhulu lomdlavuza wesikhumba. I-melanoma ingakhula emehlweni futhi, ezimweni ezingavamile, ngaphakathi komzimba, njengekhala noma umphimbo.

Nakuba i-etiology ethize yawo wonke ama-melanoma ingaziwa, imisebe ye-ultraviolet (UV) evela elangeni, izibani ezishisayo, nemibhede yandisa ingozi yokuthola i-melanoma. Ingozi ye-melanoma ingancishiswa ngokunciphisa ukuchayeka kwakho ekukhanyeni kwe-UV.

Ingozi ye-melanoma ibonakala ikhuphuka kulabo abangaphansi kweminyaka engama-40, ikakhulukazi kwabesifazane. Ukwazi izimpawu nezimpawu zomdlavuza wesikhumba kuzosiza isiqiniseko sokuthi izinguquko eziyingozi ziyatholakala futhi zelashwe ngaphambi kokuba isifo sibhebhetheke. I-melanoma ingelashwa ngempumelelo uma ibanjwe kusenesikhathi.

Isitho esikhulu kunazo zonke emzimbeni yisikhumba. Kukuvikela elangeni, ekushiseni, ekulimaleni nasekungenweni izifo. Amanzi, amafutha, kanye novithamini D konke kugcinwa esikhumbeni, esisebenza futhi ukulawula izinga lokushisa lomzimba. I-epidermis (ungqimba olungaphezulu noma lwangaphandle) kanye ne-dermis (ungqimba lwangaphakathi) yizingqimba ezimbili eziyinhloko zesikhumba (ungqimba olungezansi noma lwangaphakathi). I-epidermis, eyakhiwe izinhlobo ezintathu zamangqamuzana, yilapho umdlavuza wesikhumba ukhula khona.

Amaseli e-squamous angamaseli amancane, asicaba akha ungqimba olungaphezulu lwe-epidermis. Ama-basal cell angamaseli ayindilinga alele ngaphansi kwamaseli e-squamous. Ama-melanocyte amangqamuzana akhiqiza i-melanin futhi akhona engxenyeni engezansi ye-epidermis. I-melanin iwumbala obangela umbala wemvelo wesikhumba. Ama-melanocyte akhiqiza umbala owengeziwe futhi enze isikhumba sibe mnyama lapho sichayeka elangeni noma ekukhanyeni okwenziwa.

Kule minyaka engu-30 edlule, inani leziguli ezintsha ze-melanoma liye lenyuka. I-melanoma ivame ukutholakala kubantu abadala, kodwa ingase yenzeke nasezinganeni nasentsheni. 

Izinhlobo ze-melanoma

I-melanoma ne-nonmelanoma yizinhlobo ezimbili ezivame kakhulu zomdlavuza wesikhumba.

I-melanoma wuhlobo lomdlavuza wesikhumba oluyivelakancane kakhulu. Kungenzeka kakhulu kunezinye izinhlobo zomdlavuza wesikhumba ukuba uhlasele izicubu ezizungezile futhi usakaze kwezinye izingxenye zomzimba. I-melanoma eqala esikhumbeni yaziwa ngokuthi i-cutaneous melanoma. I-melanoma ingakhula nasolwelwesini lwamafinyila (izingqimba ezincane, ezimanzi zezicubu ezimboza indawo efana nezindebe). Le PDQ ihlanganisa i-cutaneous (skin) melanoma kanye ne-melanoma yolwelwesi lwamafinyila.

I-basal cell carcinoma kanye ne-squamous cell carcinoma yizinhlobo ezimbili ezivame kakhulu zomdlavuza wesikhumba. Izimila zesikhumba ezingeyona i-melanoma. Izimila zesikhumba ezingeyona i-melanoma azivami ukusabalala ziye kwezinye izingxenye zomzimba. (Ukuthola eminye imininingwane nge-basal cell kanye nomdlavuza wesikhumba we-squamous cell.

I-melanoma ivame ukutholakala esiqwini (indawo ephakathi kwamahlombe nezinqulu) noma ikhanda nentamo emadodeni. I-melanoma ivame ukuvela ezingalweni nasemilenzeni kwabesifazane.

I-intraocular noma i-ocular melanoma yi-melanoma eqala esweni. 

Izimpawu ze-melanoma

I-melanoma ingavela kunoma iyiphi ingxenye yomzimba. Zivame ukuvela ezifundeni zomzimba ezichayeke elangeni, njengomhlane, imilenze, izingalo nobuso.

I-melanoma ingase futhi ikhule ezindaweni lapho kungekho khona ilanga, njengamathe ezinyawo zakho, izintende zezandla zakho, kanye nemibhede yezipho zakho. Abantu abanesikhumba esimnyama kunamathuba amaningi okuthi babe ne-melanomas efihliwe.

Okulandelayo yizimpawu nezimpawu ezijwayelekile ze-melanoma:

1. Ukuguqulwa kwemvukuzane osekuvele kukhona.
2. Ukukhula okusha okunemibala noma okubukeka okungajwayelekile kuvela esikhumbeni sakho.
3. I-melanoma ayisiwo umphumela wemvukuzane. Ingavela nasesikhumbeni esibonakala sijwayelekile.

Izimbangela ze-melanoma

I-melanoma iqala lapho kukhona okungahambi kahle kumaseli akhiqiza i-melanin (melanocyte), enikeza isikhumba sakho umbala. Amaseli esikhumba ngokuvamile akhula ngendlela elawulwayo nehlelekile, namaseli amasha anempilo ephushela amaseli amadala phezulu, lapho efa khona futhi awe. Nokho, lapho amangqamuzana athile egcina ukulimala kwe-DNA, amangqamuzana amasha angase ande ngokungalawuleki, agcine eseyinqwaba yamangqamuzana ayingozi.

Akukacaci ukuthi yini edala ukulimala kwe-DNA kumaseli esikhumba nokuthi lokhu kuholela kanjani ku-melanoma. I-melanoma cishe ibangelwa inhlanganisela yezinto, okuhlanganisa izici zemvelo nezofuzo. Naphezu kwalokhu, ochwepheshe bakholelwa ukuthi imisebe ye-UV evela elangeni, izibani ezishisayo, nemibhede iyimbangela evame kakhulu ye-melanoma.

Wonke ama-melanoma awabangelwa ukukhanya kwe-UV, ikakhulukazi lawo avela ezindaweni zomzimba wakho ezingavezwanga elangeni. Lokhu kuphakamisa ukuthi ezinye izici zingadlala indima engozini yakho ye-melanoma.

Ukwelashwa kwe-melanoma

Ukwelashwa okungcono kakhulu kwe-melanoma yakho kuncike kusayizi nesigaba somdlavuza, impilo yakho iyonke, kanye nezinto ozikhethayo.

Ukwelashwa kwe-melanomas encane

Ukwelashwa kwe-melanomas yesigaba sokuqala ngokuvamile kuhlanganisa ukuhlinzwa ukuze kukhishwe i-melanoma. I-melanoma ezacile kakhulu ingase isuswe ngokuphelele ngesikhathi se-biopsy futhi ingadingi ukwelashwa okwengeziwe. Uma kungenjalo, udokotela wakho ohlinzayo uzosusa umdlavuza kanye nomngcele wesikhumba esivamile kanye nongqimba lwezicubu ngaphansi kwesikhumba. Kubantu abanama-melanomas asekuqaleni, lokhu kungase kube ukuphela kokwelashwa okudingekayo.

Ukwelapha i-melanoma esabalele ngale kwesikhumba

Uma i-melanoma isakazeke ngaphezu kwesikhumba, izinketho zokwelashwa zingabandakanya:

• Ukuhlinzwa ukuze kukhishwe ama-lymph nodes athintekile. Uma i-melanoma isakazekele kuma-lymph nodes aseduze, udokotela wakho ohlinzayo angase asuse ama-node athintekile. Ukwelashwa okwengeziwe ngaphambi noma ngemva kokuhlinzwa nakho kungase kunconywe.

• I-Immunotherapy. I-Immunotherapy iwukwelashwa kwezidakamizwa esiza amasosha omzimba wakho ukuthi alwe nomdlavuza. Amasosha omzimba wakho alwa nesifo angase angawuhlaseli umdlavuza ngenxa yokuthi amangqamuzana omdlavuza akhiqiza amaprotheni awasiza ukuba acashe kumaseli amasosha omzimba. I-Immunotherapy isebenza ngokuphazamisa leyo nqubo.

  I-Immunotherapy ivame ukutuswa ngemva kokuhlinzwa kwe-melanoma esabalele kuma-lymph nodes noma kwezinye izindawo zomzimba. Uma i-melanoma ingakwazi ukususwa ngokuphelele ngokuhlinzwa, ukwelashwa kwe-immunotherapy kungase kufakwe ngqo ku-melanoma.

• Ukwelashwa okuhlosiwe. Ukwelashwa kwezidakamizwa okuhlosiwe kugxile ebuthakathakeni obuthile obukhona kumaseli omdlavuza. Ngokuqondisa lobu buthakathaka, ukwelashwa kwezidakamizwa okuhlosiwe kungabangela ukuba amangqamuzana omdlavuza afe. Amaseli e-melanoma yakho angase ahlolwe ukuze kubonakale ukuthi ukwelashwa okuhlosiwe kungenzeka yini kusebenze ngokumelene nomdlavuza wakho.

  Nge-melanoma, ukwelashwa okuhlosiwe kungase kunconywe uma umdlavuza ususabalele kuma-lymph nodes noma kwezinye izindawo zomzimba wakho.

• Ukwelashwa ngemisebe. Lokhu kwelashwa kusebenzisa imishayo yamandla enamandla amakhulu, njengama-X-ray nama-proton, ukubulala amangqamuzana omdlavuza. Ukwelashwa ngemisebe kungase kuqondiswe kuma-lymph nodes uma i-melanoma isakazeke lapho. Ukwelapha ngemisebe nakho kungasetshenziswa ukwelapha i-melanoma engakwazi ukususwa ngokuphelele ngokuhlinzwa.

  Ngemelanoma esabalele kwezinye izindawo zomzimba, ukwelapha ngemisebe kungasiza ekudambiseni izimpawu.

• I-Chemotherapy. I-Chemotherapy isebenzisa izidakamizwa ukubulala amangqamuzana omdlavuza. I-Chemotherapy inganikezwa ngomjovo, ngendlela yephilisi noma kokubili ukuze ihambe kuwo wonke umzimba wakho.

  Ukwelashwa ngamakhemikhali kunganikezwa futhi emthanjeni osengalweni noma emlenzeni wakho ngenqubo ebizwa ngokuthi i-isolated limb perfusion. Phakathi nale nqubo, igazi elingalweni noma emlenzeni wakho alivunyelwe ukuya kwezinye izindawo zomzimba wakho isikhathi esifushane ukuze imithi ye-chemotherapy ihambe ngqo endaweni ezungeze i-melanoma futhi ingaphazamisi ezinye izingxenye zomzimba wakho.