Ukukhetha ukwelashwa komdlavuza wesikhumba kuncike kunhlobo, isiteji , ubukhulu nendawo yesikhumba , kungakhathaliseki ukuthi umdlavuza usakaze yini (impilo yakho) kanye nempilo yakho yonke. Izinketho zokwelapha umdlavuza wesikhumba ngokuvamile zihlanganisa ukuhlinzwa, ukwelashwa kwemisebe , imithi yokuzivikela , kanye / noma i-chemotherapy.
Ithimba labodokotela lizosebenza nawe ukuze lithole uhlelo olungcono lokwelapha umdlavuza wesikhumba.
Ithimba lingabandakanya ochwepheshe njenge- oncologist yokuhlinza, i- oncologist yezokwelapha, i-oncologist ye-radiation, i-dermatologist (udokotela ogxile ezifweni zesikhumba) kanye nomuntu ohlala esibhedlela.
Ukuhlinzwa
Kokubili i-nonmelanoma (i- basal cell kanye ne- squamous cell ) kanye ne- melanoma isikhumba samanqamu angakwazi ukuphathwa ngempumelelo cishe kuzo zonke izimo uma zitholwa futhi ziphathwa uma isisu sincane kakhulu. Ukwelashwa ukukhipha isisu kuyindlela yokwelashwa ejwayelekile kodwa ezinye izinketho eziningi zitholakala. Uhlobo lwenqubo yokwelashwa ye-nonmelanoma noma i-melanoma ( isigaba sokuqala noma isigaba sekwephuzile ) amagciwane kancike ekutheni i-lesion ikhulu kangakanani, lapho itholakala emzimbeni kanye nohlobo oluthile. Ezinye zezinketho ezivamile ziyi:
- Ukuziqhenya okulula (kokususa) kwe-lesion kanye nendawo yesikhumba esivamile evaliwe kuzo zonke izinkomba
- Ukwelashwa kanye ne-electrodesiccation (ukuhlunga kanye ne-cauterizing), okusebenza kahle kuma- canal angaphansi kwe-basal cell kanye ne-squamous cell cells
- I-Mohs surger y (ukuhlinzwa okuyi- microscopically ukulawulwa), inqubo ekhethekile kakhulu ye-basal ne-squamous cell carcinoma engabangeli ukonakala okuningi njengezinye izindlela
Emva kokuhlinzwa kwe-melanoma, udokotela ohlinzayo noma ochwepheshe bezokwelapha oncologist angase futhi ancoma okuthiwa "i-adjuvant" yokwelashwa ngokusekelwe kulokho ulwazi olwalufundwe ngesifo ngesikhathi sokuhlinzwa.
Lokhu kungabandakanya i-immunotherapy, i-chemotherapy kanye / noma imithi yokwelashwa. Uma i-melanoma isakaze ezithombeni ezikude (isigaba IV) noma i-recurs (ibuye ngemuva kokulashwa), ukuhlinzwa kungenziwa futhi ukusiza ukulawula lesi sifo.
Immunotherapy
I-Immunotherapy (ebizwa ngokuthi i-target target noma i-biologic therapy) isiza isimiso somzimba womzimba ukuthola futhi sihlasela amangqamuzana omdlavuza. Isebenzisa izinto ezenziwe ngumzimba noma ebhokisathri ukuze kukhuliswe, kuhloswe noma kuvuselele ukusebenza komzimba. Ku-basal kanye ne-squamous cell carcinoma, i- creamic imiquimod "i-immune response modifier" ejwayelekile. I-Immunotherapy isetshenziselwa ukwelapha i-melanoma, ikakhulu ekunciphiseni ingozi yokuthi i-melanoma izophinde ibuyele. Izidakamizwa ezimbili ezivame ukusetshenziswa ziyi-interferon alfa-2b ne-interleukin-2. I-Immunotherapy ingasetshenziswa ngokuhlanganiswa nokuhlinzwa kanye / noma i-chemotherapy, noma njengengxenye yesilingo somtholampilo. Ezinye izidakamizwa eziningi ezihlosiwe zivivinywa manje, kuhlanganise nemigomo yokwelapha.
Imiphumela emibi yalezi zokwelapha iyahlukahluka. Zingafaka ukukhathala, umkhuhlane, izikhukhula, izinsizi, ubunzima bememori, ama-muscle aches nokucasula isikhumba. Ngezinye izikhathi, imiphumela emibi evela ku-immunotherapy ingafaka ushintsho egazini legazi noma kubangele ukwanda kwamanzi emaphashini.
Kufanele uxoxe ngezinzuzo nezingozi zokhetho ngalunye kokwelashwa nodokotela wakho.
I-Chemotherapy
I-Chemotherapy isebenzisa izidakamizwa ukubulala amangqamuzana omdlavuza. I-chemotherapy enokwemvelo ihlinzekwa ngegazi, eqondisa umdlavuza wamangqamuzana kuwo wonke umzimba. Nge-melanoma, lokhu kuvame ukusetshenziswa lapho kunengozi enkulu yokuthi i-melanoma ingasakazeka noma ilawule izifo ezithuthukisiwe, nakuba ukwelashwa kwe-melanoma okusabalalisa kungavamile. Izinhlanganisela eziningana ze-chemotherapy zivivinywa okwamanje ezivivinyweni zomtholampilo.
Izidakamizwa ezivamile zamakhemikhali asebenzisa i-melanoma zihlanganisa i-dacarbazine (DTIC), i-carboplatin (i-Paraplatin), i-cisplatin (i-Platinol), i-melphalan (i-Alkeran) ne-temozolamide (i-Temodar).
Imishanguzo yokwelapha isifo somdlavuza iyahlolwa njalo. Ukukhuluma nodokotela wakho ngokuvamile kuyindlela engcono kakhulu yokufunda ngemithi oyibeke yona, injongo yabo nemiphumela emibi yabo noma ukusebenzisana neminye imithi. Ngaphandle kwe-chemotherapy ye-systemic, kunezindlela zokugcizelela izidakamizwa esifundeni esithile. I-perfusion yomlenze we-isolation (i-ILP) ne-infusion yangemuva yangaphandle (i-ILI) yizibonelo zalendlela.
Imiphumela emibi ye-chemotherapy ixhomeke kulowo muntu kanye nomthamo osetshenzisiwe kodwa ungafaka ukukhathala, ingozi yokutheleleka, isisindo sokuhlanza nokuhlanza, umonakalo othile wezinzwa obangelwa ukuguqulwa kokuzwa nokushaywa izinwele. Lemiphumela emibi ivame ukuhamba lapho ukwelashwa sekuphelile.
I-Radiation Therapy
Ukwelashwa kwezidakamizwa kusetshenziswa ama-X-rays ane-high-energy noma ezinye izinhlayiya zokubulala amangqamuzana omdlavuza. Uhlobo oluvame kakhulu ukwelashwa kwemisebe lubizwa ngokuthi yi-external-beam radiation therapy, okuyinto imisebe enikezwa emshini ngaphandle komzimba.
Ukwelashwa kwezidakamizwa ze-melanoma kungasetshenziswa ngezindlela eziningana. Kuvame ukusetshenziselwa ukunciphisa izimpawu ezibangelwa i-melanoma eye yasakazeka, ikakhulukazi ebuchosheni nasemathambo. Kungase futhi isetshenziswe uma umdlavuza usakaze emakhanini omzimba, ngemuva kokusakaza i-lymph node. Okokugcina, ucwaningo lwenziwe ukuhlola ukusebenza kwe-chemoradiation, inhlanganisela ye-radiation therapy kanye ne-chemotherapy.
Ukwelashwa kwezidakamizwa kungabangela ukucasula isikhumba, isicasuli, ukukhathala nokushona kwezinwele. Uma ukwelapha imishanguzo kusetshenziswa ekhanda nasentanyeni, imiphumela emibi, njengokunambitheka okuguquliwe nomlomo omile, kungenzeka. Lemiphumela emibi ivame ukuhamba lapho ukwelashwa sekuphelile. Uma i-lymph nodes eduze kwesandla noma umlenze ishintshiwe, lo muntu angase abe engozini ephakeme yokwakha oketshezi kulelo lungu, umphumela ohlangothini obizwa nge-lymphedema.
Isiphetho
Kuningi ukwelashwa okuphumelelayo ngomdlavuza wesikhumba. Kukhona ukudoba okulodwa, kodwa: Lesi sifo kufanele sitholakale kusenesikhathi ukuze imithi iphumelele. Uma i-melanoma igxilisa ezithombeni ezikude, izinga lokusinda liyehla ngokushesha. Ngenxa yalesi sizathu, ukuzivivinya isikhumba njalo nokugwema izinto eziyingozi kungasindisa impilo yakho.
> Imithombo:
"I-Melanoma - Izinkombandlela zokwelapha zeziguli." I-National Comprehensive Cancer Network ne-American Cancer Society.
"Okudingeka Ukwazi Ngekhanda Lesikhumba." I-National Cancer Institute. July 2002.
"Konke NgoKhukhu Lesikhumba - I-Melanoma." I-American Cancer Society. Julayi 2008.