Okudingeka ukwazi nge-Mucosal Melanoma!

Sonke sizwile ngomdlavuza wesikhumba, akunjalo? Kodwa bewazi ukuthi ngezinye izikhathi lomdlavuza ungakhula ngaphakathi emizimbeni yethu, ezindaweni ezingabonakali ngaphandle? Olunye uhlobo lomdlavuza olungavamile kodwa oluyingozi lubizwa ngokuthi i-Mucosal Melanoma. Uma lokhu kuzwakala kungathi sína, ungakhathazeki. Ake sixoxe ngalokhu ngendlela elula ongayiqonda.

Kuyini lokhu okubizwa ngokuthi i-Mucosal Melanoma?

Kalula nje, i-Mucosal Melanoma uhlobo lomdlavuza olungavamile olubizwa ngokuthi i-Melanoma . Luqala ezingxeni zomzimba wethu. Manje ungase uzibuze ukuthi luyini ulwelwesi lwamafinyila. Luyilwelwesi oluncane nolumanzi olumboza izitho zomzimba wethu, njengengaphakathi lekhala, ngaphakathi komlomo, indunu, kanye nesitho sangasese sowesifazane. Cabanga ngalo njengesikhumba esincane nesimanzi ngaphakathi komlomo wethu. Yilapho kutholakala khona lezi zingxeni zamafinyila.

Ngakho-ke, ungayithola le nkinga ebizwa ngokuthi i-mucosal melanoma noma kuphi lapho kukhona khona ulwelwesi lwamafinyila. Kodwa ivame kakhulu ku:

• Ezindaweni zekhanda nentamo: ikakhulukazi ekhaleni, ezindebeni, nangaphakathi emlonyeni.
• Isifunda se-anorectal: Lokhu kusho indawo ezungeze i-anus yakho kanye nendlela okuphuma ngayo indle yakho.
• Isifunda sesitho sangasese sowesifazane: Izingxenye zangaphandle zesitho sangasese sowesifazane nezindawo ezizungezile .

Lesi simo sivame ukuthinta abantu abangaphezu kweminyaka engu-70. Ngeshwa, umdlavuza uvame ukusabalala (ususabalaliswe) kwezinye izingxenye zomzimba ngesikhathi utholakala. Odokotela bangelapha lolu hlobo lwe-mucosal melanoma ngokuhlinzwa. Kodwa-ke, ezimweni eziningi, welashwa yithimba lodokotela elihlanganisa imikhakha eyahlukene elisebenzisana ukusebenzisa izindlela zokwelapha ezahlukahlukene.

Ingabe lesi yisimo esivamile?

Cha, akunjalo ngempela. Akuvamile kakhulu . Cabanga ngakho, i-American Cancer Society ilinganisela ukuthi kuzoba namacala amasha angaba ngu-99,000 e-melanoma ngo-2022. Kodwa lolu hlobo lwe-melanoma, olubizwa ngokuthi i-mucosal melanoma, lubalelwa cishe ku-1% wawo wonke amacala e-melanoma. Labo cishe ngabantu abangu-990. Ngakho ungabona ukuthi lokhu kungavamile kangakanani.

Ziyini izimpawu ze-Mucosal Melanoma?

Yilapho-ke kuba khona ukudideka okuncane. Ngoba izimpawu ze-mucosal melanoma zingaphuthelwa kalula . Lokho kungenxa yokuthi lo mdlavuza ukhula ezindaweni ezifihliwe ngaphakathi emizimbeni yethu esingenakukwazi ukuzihlola njalo. Cabanga ngaphakathi kwekhala lethu noma esikhumbeni esizungeze indunu yethu. Asiziboni njalo izinguquko kulezo zindawo.

Ngaphezu kwalokho, lezi zimpawu ngezinye izikhathi zingafana nezezinye izifo ezingatheni kangako. Ngakho-ke abantu abaningi ababheki lezi zinguquko njengezimpawu zenkinga enkulu. Izimpawu nazo ziyahlukahluka kuye ngokuthi umdlavuza uqala kuphi.

Okuhlobene nekhanda nentamo

Phakathi kuka-31% no-51% wazo zonke izimo ze-mucosal melanoma zenzeka ekhanda nasentanyeni. Kunezinhlobo ezintathu eziyinhloko, ezinezimpawu ezihambisana nazo:

I-melanoma ye-mucosal yomlomo

Lo mdlavuza uthinta ingaphakathi lomlomo wakho, ezindebeni zakho. Izimpawu zingase zihlanganise:

• Iqhubu olimini elingapholi futhi elikhula kancane kancane.
• Isilonda emlonyeni esingeke siphole.
• Ubuhlungu bomlomo.
• Ukopha emlonyeni.
• Amazinyo okufakelwa awalingani kahle. (Uma ugqoka amazinyo okufakelwa)

I-melanoma ye-mucosal ye-Sinonasal

Lona umdlavuza okhula emigudwini yamakhala nasema-sinuses. Izimpawu zingase zihlanganise:

• Ukopha okuqhubekayo okuvela ekhaleni elilodwa (ukopha ekhaleni - `epistaxis`) .
• Umuzwa wokuthi kukhona okubhajwe ngaphakathi ekhaleni (ukuvaleka kwekhala) .
• Ukuchama njalo.
• Ubuhlungu bobuso.

I-melanoma ye-mucosal ye-laryngeal/pharyngeal

Lolu uhlobo olungavamile kakhulu lwe-mucosal melanoma. Luthinta umphimbo wakho. Izimpawu zingafaka:

• Ukuhosha kwezwi.
• Ubunzima bokugwinya ukudla (i-dysphagia) .
• Umphimbo obuhlungu noma ukutheleleka (i-pharyngitis) .
• Kuvela iqhubu noma isimila ngaphandle kwentamo.

Ngaphakathi naseduze kwendunu

I-anorectal mucosal melanoma yenzeka ku-rectum kanye/noma endunu yakho. Ithinta phakathi kuka-17% no-24% wabo bonke iziguli. Izimpawu zingafaka:

• Ubuhlungu e-rectum noma endunu.
• Isigaxa noma isimila esise-rectum noma endunu.
• Ukopha okuvela endunu noma e-rectum.
• Ukuqunjelwa.
• Ukuluma eduze kwendunu (pruritus ani) .

Esithweni sangasese sowesifazane nangaphandle kwesitho sangasese sowesifazane

I-Vulvovaginal mucosal melanoma yenzeka ezindongeni zesitho sangasese sowesifazane kanye nesesitho sangasese sowesifazane kwabesifazane. Ithinta cishe u-18% wabo bonke abaguli. Izimpawu zingafaka:

• Ukopha kwangasese ngesikhathi sokuya esikhathini noma ngemva kokuya esikhathini (okungukuthi, ngemva kokuya esikhathini sekuphele ngokuphelele).
• Ubuhlungu besitho sangasese sowesifazane.
• Kungase kube nokukhishwa okungavamile kwesitho sangasese sowesifazane, ngisho nokukhishwa kwegazi .
• Isigaxa noma ukukhula esithweni sangasese sowesifazane noma endaweni yangaphandle yesitho sangasese sowesifazane.
• Ukuluma esithweni sangasese sowesifazane noma endaweni yangaphandle yesitho sangasese sowesifazane okungathuthuki naphezu kokwelashwa.

Kubaluleke kakhulu: Lezi zimpawu zivame ukubangelwa ezinye izimo zezokwelapha ezivamile. Kodwa-ke, uma uhlangabezana nanoma yiziphi zalezi zimpawu, ikakhulukazi uma ziqhubeka, sicela uxhumane nodokotela . Ukutholwa kusenesikhathi kuhlale kuwusizo olukhulu ekwelashweni okuphumelelayo.

Kungani le melanoma ye-mucosal ikhula? Ziyini izimbangela?

Impendulo emfushane iwukuthi abacwaningi bezokwelapha abakayazi imbangela eqondile ye-mucosal melanoma. Njengazo zonke i-melanoma, lolu hlobo lomdlavuza luqala kumaseli abizwa ngokuthi ama-melanocytes . Ama-Melanocytes amaseli akhiqiza i-pigment melanin, enquma umbala wamehlo ethu, izinwele kanye nesikhumba. Le melanin ivikela isikhumba namehlo ethu ekulimaleni okuvela elangeni.

Kodwa ngokumangalisayo, abacwaningi basacwaninga ukuthi kungani la maseli e-melanocyte, avikela elangeni, etholakala ezingxeni zamangqamuzana ezingavamile ukuthola ukukhanya kwelanga.

Kodwa-ke, abacwaningi bathole ukuthi izinguquko ezimbili zofuzo zingaba nomthelela ekuthuthukisweni kwezinye zalezi melanoma ze-mucosal. Lezi zibizwa ngokuthi izinguquko ze-somatic , okusho ukuthi akuyona into esizalwa nayo, kodwa kunalokho izinguquko ezenzeka emaseli ethu phakathi nokuphila kwethu. Izinguquko ku -gene ye-KIT kanye ne-gene ye-BRAF zitholakala kumaphesenti amancane eziguli ezine-melanoma ye-mucosal:

• I-KIT gene: I-KIT gene ilawula ukuthi amanye amangqamuzana, okuhlanganisa nama-melanocyte, akhula ngokushesha kangakanani. Njenge-BRAF gene, i-KIT gene yenza iphrotheni esiza amangqamuzana ukukhula. Lapho i-KIT gene iguquguquka, iphrotheni ye-KIT idukisa amanye amaprotheni, okwenza amangqamuzana ahlukane futhi azalane ngokushesha kunokujwayelekile. Izifundo zibonisa ukuthi izinguquko ze-KIT zitholakala ku-7% kuya ku-17% wazo zonke izimo ze-mucosal melanoma. Zitholakala futhi cishe ku-30% wamacala e-mucosal melanoma yesitho sangasese sowesifazane kanye ne-vulva.

• Izakhi zofuzo ze-BRAF: Izakhi zofuzo ze-BRAF zilawula amaprotheni alawula ukukhula kwama-melanocyte. Lawa maprotheni athola imiyalelo evela ku-BRAF gene mayelana nokuthi amaseli kufanele ahlukane futhi azalane ngokushesha kangakanani. Lapho i-BRAF gene iguquguquka, leyo miyalelo iyashintshwa, okubangela ukuba amaseli azalane ngendlela engalawuleki futhi ekugcineni abe nomdlavuza. Kodwa-ke, izinguquko ze-BRAF zibonakala kuphela ephesenti elincane lamacala, phakathi kuka-3% no-15% wazo zonke izimo ze-mucosal melanoma.

Ukuchayeka elangeni kuyimbangela ye-melanoma yesikhumba. Ingabe kunjalo nange-melanoma ye-mucosal?

Cha, akunjalo. I-mucosal melanoma ikhula ezindaweni ezingavezwanga elangeni, njengangaphakathi kwekhala, ngaphakathi emlonyeni, noma endunu. Ngakho-ke ukukhanya kwelanga akuyona imbangela eqondile.

Odokotela basithola kanjani lesi sifo?

Odokotela basebenzisa izivivinyo ezahlukene ukuxilonga lesi sifo, okuhlanganisa:

• Kungafakwa izivivinyo ezahlukene zokuthwebula izithombe, njenge -CT scans (Computed Tomography scans) kanye ne -MRI scans (Magnetic Resonance Imaging scans) . Lokhu kungabheka izimila emzimbeni, ubukhulu bazo, nokuthi zisakazeke yini.
• Kuyenziwa ukuhlolwa kwe-biopsy . Lokhu kusho ukuthi isampula encane yamangqamuzana noma izicubu ithathwa endaweni esolisayo bese ihlolwa ngaphansi kwe-microscope ngodokotela bezifo. Yilokhu okunquma ngqo ukuthi umdlavuza ungowohlobo luni nokuthi ungowohlobo luni.
• Ukuhlolwa kwezakhi zofuzo kungenziwa futhi ukuhlola izinguquko zezakhi zofuzo.

Iyini i-Mucosal Melanoma ebangela umdlavuza?

Odokotela basebenzisa izinhlelo zokulinganisa umdlavuza ukuhlela ukwelashwa nokunquma ukuthi kuzokwenzekani, noma umphumela olindelekile. Ngokuvamile, i-mucosal melanoma yesigaba sokuqala yisimo lapho umdlavuza ungakasabalali khona ngale kwalapho waqala khona.

Kodwa-ke, lokhu kuyinkimbinkimbi kancane. Ngoba uhlobo ngalunye lwe-mucosal melanoma (isib. umlomo, impumulo, i-rectum) lunesistimu yalo yokulinganisa, futhi imininingwane ihlukile kakhulu. Ukulinganisa umdlavuza kungaba nzima ukukuqonda. Uma ungaqiniseki ngalokho okushiwo udokotela wakho, noma uma unemibuzo noma ukukhathazeka, qiniseka ukuthi ubuza udokotela wakho ngolwazi olwengeziwe .

Kuphathwa kanjani lokhu?

Ngenxa yokuthi i-mucosal melanoma iyisifo esiyinkimbinkimbi, ukwelashwa kuvame ukuphathwa yithimba lodokotela abahlukahlukene abavela kochwepheshe abahlukahlukene . Leli qembu lingafaka ochwepheshe be-oncology abahlinzayo, ochwepheshe be-radiation oncology, kanye nochwepheshe be-oncology yezokwelapha. Izinketho zokwelapha zifaka:

• Ukususwa kwezimila ezinomdlavuza kanye nezicubu ezizungezile ngokuhlinzwa . Uhlobo lokuhlinzwa luncike kakhulu endaweni yesimila. Amanye amathumba kunzima kakhulu ukuwasusa ngokuhlinzwa.
• Ukwelashwa ngemisebe kunikezwa njengokwelashwa okusizayo ngemva kokuhlinzwa ukuze kubhujiswe noma yimaphi amangqamuzana omdlavuza asele.

Abacwaningi bezokwelapha okwamanje benza izivivinyo zemitholampilo zokwelapha nge-immunotherapy yomdlavuza kanye nokwelashwa okuqondiwe komdlavuza . Izivivinyo zemitholampilo ziyizifundo ezihlola ukuthi ngabe ukwelashwa okusha kuphephile futhi kuyasebenza yini. Uma une-mucosal melanoma, ungase ufanelekele enye yalezi zivivinyo zemitholampilo.Kuhle ukubuza udokotela wakho.

Yini ongayilindela uma uphila nalesi simo?

I-Mucosal melanoma iyisifo esingasongela impilo . Odokotela basebenzisa ukuhlinzwa kanye nezinye izindlela zokwelapha ukususa izimila zomdlavuza nokubulala amangqamuzana omdlavuza. Kodwa-ke, ama-mucosal melanoma anamathuba amaningi okuphinde abuye (aphinde abuye) . Uma une-mucosal melanoma, ungadinga ukuhlinzwa okwengeziwe noma ezinye izindlela zokwelapha.

Iyini inkomba yokubikezela lesi sifo?

Uma kukhulunywa ngamathuba okululama noma okusinda, kuyahlukahluka kumuntu nomuntu. Kodwa-ke, sekukonke, izifundo zibonisa ukuthi izinga lokusinda kweminyaka emihlanu ngenxa ye-mucosal melanoma licishe libe ngu-25% . Lokhu kungase kubonakale kuphansi, kodwa kuyisilinganiso.

Lezi zilinganiso zokusinda ziyahlukahluka kuye ngohlobo lwe-mucosal melanoma:

• Ikhanda nentamo: Ngokuvamile, izifundo zibonisa ukuthi abantu abangaphansi kuka-30% baphila eminyakeni emihlanu ngemva kokuxilongwa. (Amazinga okusinda asukela ku-14% kuya ku-48%).
• Isitho sangasese sowesifazane kanye nesitho sangasese sowesifazane: Cishe abantu abangu-36% abanalesi simo baphila iminyaka emihlanu ngemva kokuxilongwa.
• Umdlavuza we-rectal kanye ne-anal: Cishe abantu abangu-20% abanalesi simo baphila iminyaka emihlanu ngemva kokuxilongwa.

Ungakhathazeki ngalezi zibalo. Lezi zimane nje ziyizilinganiso ezisekelwe kokuhlangenwe nakho kweqembu labantu abanesimo esithile. Okuyiqiniso kubo kungase kungabi yiqiniso kuwe. Uma unemibuzo mayelana nalezi zilinganiso zokusinda, cela udokotela wakho akuchazele ukuthi yini ongayilindela ngokusekelwe esimweni sakho.

Kufanele ngiyinakekele kanjani impilo yami?

I-Mucosal melanoma yisifo esisongela ukuphila esingaphinde sibuye ngisho nangemva kokwelashwa. Uma unesifo esiphindaphindayo, ungase uthande ukucabangela ukunakekelwa kokunciphisa ubuhlungu ukuze kusize ekulawuleni izimpawu nemiphumela emibi yokwelashwa. Ukunakekelwa kokunciphisa ubuhlungu kuwukunakekelwa okuhlose ukuthuthukisa ikhwalithi yokuphila kwesiguli nokunciphisa ubuhlungu, kunokwelapha lesi sifo.

Kufanele ngimbone nini udokotela?

Nakuba kunezinhlobo eziningana ze-mucosal melanoma, zonke izinhlobo zingabuya ngemva kokwelashwa. Kuye ngesimo sakho, udokotela wakho uzohlela ukuhlolwa njalo ukuze aqaphe impilo yakho iyonke futhi ahlole ukuthi ingabe ibuya futhi. Kubaluleke kakhulu ukuya kulezi zikhathi ngaphandle kokuphuthelwa yilutho.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Nazi ezinye imibuzo ongayibuza udokotela wakho:

• Uhlobo luni lwe-mucosal melanoma enginayo?
• Iyini isigaba sesifo sami?
• Yiziphi izindlela zokwelapha enginazo?
• Ukwelashwa kuzongithinta kanjani? (Izinto ezifana nemiphumela emibi)
• Iyini inkomba yesifo sami?

Umlayezo Wokuya Nawe Ekhaya

Kulungile, ngakho-ke ngokwalokho esikuxoxile, ngithemba ukuthi unombono othile nge-Mucosal Melanoma. Khumbula:

• Lolu uhlobo lomdlavuza olungavamile oluvela emangqamuzaneni angaphakathi emizimbeni yethu.
• Izimpawu zingase ziphuthelwe kalula futhi zingafana nezinye izifo ezivamile. Ngakho-ke, funa iseluleko sezokwelapha uma unezimpawu ezingavamile neziqhubekayo emlonyeni, ekhaleni, endunu, noma esithweni sangasese sowesifazane.
• Ngokuvamile, kungenzeka ukuthi isakazeke ngisho nangaphambi kokuba itholakale.
• Ukwelashwa kudinga usizo lwethimba lezokwelapha elingochwepheshe .
• Ukuqapha isikhathi eside kwezokwelapha kubalulekile, njengoba lesi sifo singaphinde sibuye .

Sithemba ukuthi lolu lwazi luwusizo kuwe. Ukuqaphela lolu hlobo lwesifo kuzokusiza ukuthi uthathe isinyathelo ngokushesha uma kudingeka. Njalo nakekela impilo yakho!

I- Mucosal Melanoma, Umdlavuza, I-Melanoma, Umdlavuza we-Mucosal, Izimpawu zomdlavuza, Ukwelashwa komdlavuza, Umdlavuza Ongavamile