Asazi ukuthi yini ebangela umdlavuza wesikhumba , kodwa izici ezingozini zingabandakanya ithoni lesikhumba nobuhlanga, ukushisa kwelanga nokushisa kwelanga, ukutholakala kwamakhemikhali emvelo kanye nezinye izinto, ezinye izimo zezokwelashwa noma ukwelashwa kwezinkinga zezokwelapha nokubhema. Umlando womndeni wesifo somdlavuza wesikhumba, kanye nezinye izifo ezithathelwanayo zofuzo, kungabangela ingozi, futhi kucatshangwa ukuthi izakhi zofuzo zidlala indima ebalulekile ekuthuthukiseni okuningi okungewona i-melanoma kanye ne-melanoma yesikhumba somdlavuza.
Ngenye inothi elihle, izici zokudla okunempilo, njengokudla okunezithelo nemifino, zinganciphisa ingozi.
Izingozi Zezingozi
Izici zengozi zingabandakanya ukuvezwa okulimaza ngqo isikhumba, okwenza ushintsho ku-DNA (izakhi zofuzo) ezingabangela umdlavuza okhula. Ezinye izici, ezifana nokucindezelwa kwe-immune, kunganciphisa ikhono lomzimba ukulungisa amangqamuzana ngemva kokulimala. Ukubaluleka kwezici ezithile eziyimingcipheko kungashintsha ngokususelwa kwesikhumba, nokuningi. Izifo ezivamile ezibangelwa umdlavuza wesikhumba zihlanganisa:
Ubudala
Ngokuvamile, amakhemikhali e-non-melanoma yesikhumba (njenge-basal cell carcinomas kanye ne-squamous cell carcinomas) akhula ngobudala, nakuba ama-melanomas atholakala kubantu abasha.
Isikhumba, Isizwe, kanye Nezici Zomzimba
Ithembo lesikhumba lingaba yingozi ebalulekile ekuthuthukiseni umdlavuza wesikhumba, nabantu abanesikhumba esilungile abanengozi enkulu kakhulu. Isizathu salokhu ukuthi i-pigment melanin (ebhekene nombala wesikhumba) inikeza ukuvikeleka okuvela emisebeni ye-ultraviolet (UV), futhi abantu abanekhanda elimnyama bane-melanin eningi.
Lokho kusho ukuthi abantu abanoma yiluphi umbala wesikhumba bangase bahlakulele umdlavuza wesikhumba, kanti nakuba umdlavuza wesikhumba uvame kakhulu kulabo abamhlophe kunabamnyama, abamnyama bangase bafe ngesifo. Futhi, njengoba nje i-melanoma ikhula kwabamhlophe, yanda naseLatinos futhi.
Abantu abanezici zomzimba ezihlobene nengozi enkulu kunazo zonke zihlanganisa:
- Abantu abanama-freckles.
- Labo abanamathoni esikhumba enhle.
- Labo abangazange baqede noma badonsa kabi.
- Labo abashisa kalula.
- Abantu abanamehlo abuhlaza, njengamehlo aluhlaza neluhlaza okwesibhakabhaka.
- Abantu abanezinwele ezibomvu noma ezibomvu (ezinobomvu obubomvu obhekene nobungozi ngaphezu kwezinwele ze-blonde).
I-Sun Exposure (Ama-Natural or Tanning Booths)
Ukuchayeka kwelanga kuyinhloko enkulu engozini yomdlavuza wesikhumba, kodwa ukubaluleka kwayo kuhluka nohlobo lomdlavuza wesikhumba. I-squamous cell carcinoma uhlobo lomdlavuza wesikhumba olusondelene kakhulu nokushisa kwelanga. Inani lokukhanya okukhanya kwe-ultraviolet (UV) lixhomeke emandleni okukhanya (okungahlukahluka nge-angle yelanga), ubude bokuvezwa, nokuthi ngabe isikhumba sasiboshwe izingubo noma i-sunscreen.
Ukushisa ukushisa kwelanga ngesikhathi esencane, ngisho noma kwenzeka kuphela kanye, kungaba yingozi enkulu ngisho nangamashumi eminyaka kamuva. Ama-sunburns ahlotshaniswa kakhulu nge-melanoma, futhi ukushisa ilanga kwisiqu somzimba kuhlobene nengozi enkulu kakhulu.
Ngesikhathi ukukhanya kwelanga kudlala indima kuzo zonke izinhlobo ezinkulu zomdlavuza wesikhumba, uhlobo lomdlavuza luhluka nephethini lokuchayeka. I-Squamous cell carcinoma ne-basal cell carcinoma zixhunyaniswe kakhulu kakhulu nokuvezwa kwesikhathi eside, futhi labo abachitha isikhathi esiningi ngaphandle komsebenzi noma ukudlala banengozi enkulu.
Ngokuphambene nalokho, i-melanoma ihlotshaniswa nokuchayeka kwelanga okungenakuqhathaniswa kodwa okukhulu (cabanga: ukuphumula kwentwasahlobo endaweni efudumele).
Amakhemikhali Emvelo
Ukuvezwa kwamakhemikhali nezinye izinto ekhaya noma emsebenzini, kungandisa ingozi yomdlavuza wesikhumba. Izinto ezihlobene nenengozi eyengeziwe zibandakanya:
- I-Arsenic: Ukungenisa okungapheli emanzini okuphuza (ikakhulukazi emithonjeni yangasese) kanye nokutholakala komsebenzi.
- I-Tar (njengezisebenzi zomgwaqo).
- Amaparafini (wax): Ama-parafini asetshenziselwa ukukhiqizwa kwezimoto.
- Amakhemikhali, ikakhulukazi amakhemikhali anomswakama neklorini: Isibonelo, ezisebenzini zensimbi nalabo abavezwa eminjini yokunyathelisa, ama-degreasers, nemikhiqizo yokuhlanza.
- I-vinyl chloride (njengezimboni ezikhiqiza imikhiqizo ye-vinyl).
Ukubhema
Ukubhema kuhlotshaniswa nengozi eyengeziwe ye-squamous cell carcinomas yesikhumba, kodwa hhayi i-basal cell carcinomas. Ucwaningo olwenziwa ngo-2017 lwathola ukuthi ingozi ye-basal cell cancers empeleni yayingaphansi kakhulu kwabokubhema, kodwa wacabanga ukuthi lokhu kungenzeka ngenxa yokukhishwa kwesibambiso (abacwaningi kungenzeka ukuthi bathole amakhemikhali angenakutholakali kumuntu ongekho esifundweni). Ngokungafani ne-khansa efana nomdlavuza wamaphaphu, ingozi yomdlavuza wesikhumba kulabo ababekade bebhema behla kuya kokungabhemi ngemuva kokuyeka.
Izimo Zesikhumba Noma Ukwelapha Izimo Zesikhumba
Kunezimo eziningi zesikhumba ezingase zandisa ingozi yokuthuthukisa umdlavuza wesikhumba, noma zibhekwe njengesiqhwaga. Ngaphezu kwalokho, izindlela ezithile zokwelapha zingabangela ingozi yomdlavuza. Ezinye zalezi zimo zifaka:
- I-actinic keratosis : I-actinic keratoses (i-keratoses ye-solar) izilonda zesikhumba ezivamile kakhulu ezibonakala njengezinhlanzi, i-scaly, i-patch-like patch esikhumbeni esingabomvu, obomvu noma obomvu. Zivame kakhulu ezindaweni ezivuliwe zelanga zomzimba. Akuwona wonke ama-keratoses we-actinic azoqhubekela phambili e-squamous cell carcinoma yesikhumba (iningi alikho), kodwa ucatshangwa ukuthi amaphesenti angama-20 kuya kwangu-40 e-squamous cell cell cancers aqala njenge-actinic keratosis. Ukubuyekezwa kuka-2018 kwaphawula ukuthi i-actinic keratoses kwezinye izifunda zomzimba kungenzeka ukuthi iguqulwe ezincelweni zomdlavuza wesikhumba. Lokhu kufaka phakathi i-keratoses emhlane, izandla, imilenze, noma ezungeze amehlo, izindebe, noma impumulo. I-actinic keratoses ibhekwa njengeyinqaba, futhi, eqinisweni, ezinye izidakamizwa zikholelwa ukuthi i-actinic keratoses ingaba uhlobo lokuqala lwe-squamous cell carcinoma yesikhumba. Abantu abanama-keratoses amaningi ase-actinic nabo banamathuba amaningi okuthuthukisa i-basal cell carcinoma noma i-melanoma.
- Ukuba nama-moles amaningi (angaphezu kuka-50).
- Ama-molecular Dysplastic (okungavamile ukubonakala ngama-moles).
- I-congenital melanocytic nevi: Lezi zikhulu "ze-moles" ezikhona lapho zizalwa, futhi i-melanoma ingase ikhule ngamaphesenti angama-10 alezi zilonda (ikakhulukazi i-nevi enkulu).
- Umlando wokushisa okukhulu noma ukuvuvukala kwesikhumba ngezinye izikhathi kungaholela emdlalweni wesikhumba.
- I-Psoralens noma i-ultraviolet (UV) yokwelashwa kwe-psoriasis noma i-eczema ingandisa ingozi yokuthuthukisa umdlavuza wesikhumba ongenayo i-melanoma.
Imibandela Nezokwelapha
Ezinye izimo zezokwelapha zihlobene nengozi enkulu yokuthuthukisa umdlavuza wesikhumba. Lezi zingabandakanya:
- Umlando womuntu siqu womdlavuza wesikhumba. Labo abaye banomdlavuza wesikhumba ongewona i-melanoma bangamaphesenti angu-10 ngaphezulu kunomphakathi ukuthuthukisa enye yalezi zomshukela. Labo abane-melanoma bangamathuba amathathu okuthuthukisa umdlavuza wesikhumba ongeyona i-melanoma.
- Imithi ethile ekhulisa ukuzwela kwelanga (izithombeensitivity), kufaka phakathi ama-antibiotic ambalwa, i-high blood pressure hydrochlorothiazide, neminye imikhiqizo ye-chemotherapy.
- Ukwelashwa kwemisebe yangaphambilini yomdlavuza. Ingozi ekhulayo ikhona kuphela ezindaweni lapho kutholakala khona imisebe.
- Abantu abanezinkinga zokuzivikela nge-immune, noma bazuze noma bazuze njenge-HIV / AIDS.
- Ukutheleleka kwe-Human papillomavirus ( HPV ). Ezinye izinkinga ze-HPV zingabangela ukwelapha emathisini ezakhi zofuzo, i-anus, nesikhumba ezungeze iminwe.
Ukudla
Nakuba singakabonakali ukudla okuqondile okuphakamisa ingozi yomdlavuza wesikhumba, sinokuthi imikhuba ethile yokudla ihlotshaniswa nengozi ephansi . Ukudla kakhulu izithelo nemifino kunganciphisa ingozi yokuthuthukisa umdlavuza wesikhumba .
I-Genetics
Ithonya ukuthi izakhi zofuzo zidlala ekuthuthukiseni umdlavuza wesikhumba zingahlukahluka kuye ngokuthi uhlobo oluthile. Kungaba nzima ukuhlukanisa ingozi ehlobene nezakhi zofuzo, kanye nezici ezifa njengezikhumba zesikhumba. Ucwaningo lwe-twin olubonisa ukuthi cishe ingxenye yesigceme somuntu we-basal cell kanye ne-squamous cell carcinomas kubangelwa izici zofuzo. Ngenkathi i- genetic mutations account ezuze njengefa iyingxenye eyodwa kuphela yamaphesenti ama-melanomas, isifundo se-2016 siphakamise ukuthi amaphesenti angama-58 enengozi ye-melanoma ihlobene nezinto ezizuzwe njengefa.
Asiqiniseki kahle ukuthi ukuba nomlando womndeni womdlavuza wesikhumba kuthinta ingozi, nakuba ingozi ye-squamous cell carcinoma eSweden ibonakala ibe izikhathi ezimbili kuya kwezi-3 isilinganiso uma unesihlobo sokuqala (umzali, umntakwethu, noma ingane ) onomdlavuza wesikhumba. Umlando womndeni we-veus syndrome we-atypical ukwandisa ingozi ye-melanoma.
Kunama-syndromes amaningana okuzalwa adala amathuba okuba umuntu ahlakulele umdlavuza wesikhumba. Ezinye ezimbalwa ezivamile zihlanganisa:
- Ama-basal cell carcinomas: Abantu abane-basal cell nevus syndrome banengozi enkulu yokuthuthukisa i-basal cell carcinomas (PTCH1 ne-PTCH2 gene mutations).
- I-squamous cell carcinomas (SCC): Ingozi ye-SCC yanda kulabo abane-xeroderma pigmentosum, i-oculocutaneous albinism, i-epidermolysis bullosa, ne-Fanconi anemia.
- I-Melanoma: Ukungafanakali kwe-genetic anti- inflammatory genetic CDKN2A kunesibopho samaphesenti angama-40 e-melanomas emndenini Okunye okunye ukuguquka kwesakhi sofuzo nakho kuhlotshaniswa ne-melanoma, kuhlanganise ne- BRCA2 ye-gene mutations .
> Imithombo:
> Dusingize, J., Olsen, C., Pandeva, N. et al. Ukubhema Ugwayi kanye Nezingozi Ze-Basal Cell Carcinoma Ne-Squamous Cell Carcinoma. Journal of Dermatology Investigational . 2017. 137 (8): 1700-1708.
> Mucci, L., Hjelmborg, J., Harris, J. et al. Ingozi Ejwayelekile Yokwemdlavuza Phakathi kwamawele emazweni aseNordic. I-JAMA . 315 (1): 68-76.
> National Cancer Institute. I-Genetics of Cancer Cancer (PDQ) -Health Professional Version. Kubuyekezwe 02/22/18.
> Ng, C., Yen, H., Hsiao, H., no S. Su. Amakhemikhali e-Phyto e-Skin Prevention and Treatment: Isibuyekezo Esibuyekeziwe. I-International Journal of Sciences Molecular . 2018. 19 (4) .pii: E941.
> Richard, M., Amici, J., Basset-Seguin, N. et al. Ukuphathwa kwe-Actinic Keratosis emaSikhumeleni aMzimba aKhethekile ezigulini eziNgcintweni eziPhezulu zeCarcinoma Lesions: Ukuvunywa kobuchwepheshe kusuka ku-AKTeam of Expert Clinicians. Journal of the European Academy of Dermatology and Venereology . 2018. 32 (3): 339-346.