Khansara ya khungu ndiyo mtundu wochuluka kwambiri wa khansa yomwe imapezeka ku United States, ndipo imatha kugwidwa mu khansa yambiri ya khansa, basal cell khansa, ndi khansa ya khansa, komanso khansa zina zochepa. Zizindikiro zingakhale ndi zilonda zomwe sizimachiritsa, malo atsopano pakhungu, kapena mole yomwe ikusintha. Madokotala atakayikira kuti khansara ya khungu pakayesedwa, chidziwitso n'chofunika kuti chidziwitsocho chidziwike.
Njira zothandizira zimadalira mtundu ndi siteji, ndi opaleshoni kuchotsa khansa yowonjezera. Ndi mankhwala a khansa ya khansa komanso zamoyo zam'tsogolo zotchedwa squamous cell carcinomas, mankhwala ena monga immunotherapy, chemotherapy, kapena radiation angafunike. Nthawi imodzi yopezera chitetezo imakhala yofunikira pounds la mankhwala, ndipo pali zinthu zambiri zosavuta zimene anthu angachite kuti achepetse chiopsezo chawo.
Pakali pano, kansa ya khungu imatengedwa ngati mliri ku United States, ndipo khansa ya khungu imawerengera 50 peresenti ya khansa yonse. Pafupifupi 80 peresenti ya anthu amamwalira chifukwa cha khansa ya khansa, ndipo kufufuza kuyang'ana njira zabwino zodziwira ndikuthetsera khansa izi zikupitirirabe.
Kumvetsetsa Khungu
Anthu ambiri samaganiza za khungu ngati chiwalo, koma monga ziwalo zina, zimakhala ndi dongosolo lokhazikika komanso ntchito zambiri zofunika. Popeza njira zothandizira khansa yapakhungu nthawi zambiri imadalira "kuya" kwa khansara, ndizothandiza kumvetsetsa zigawo zitatu za khungu.
Epidermis
Epidermis ndi khungu lapamwamba la khungu ndipo limagwira ntchito zosiyanasiyana, kuphatikizapo kuteteza mkati mwa matupi athu ku chilengedwe. Maselo omwe ali m'kati mwake amachititsa kuti khansa yambiri yodwala: squamous cell carcinoma, basal cell carcinoma, ndi melanoma.
- Maselo a squamous: Maselo amenewa ali pansi pa khungu.
- Maselo osambira; Maselo a basal ali pansi pa mzere wambiri ndipo amapanga maselo atsopano a khungu.
- Melanocytes : Maselo amenewa ali pansi pazomwe zimayambira ndipo amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda.
Madontho
Dermis ndi chigawo chapakati cha khungu lopangidwa ndi collagen ndi elastin, ndipo imakhala ndi minofu ya tsitsi, mafinya opangira mafuta (mitsempha ya sebaceous), mitsempha, ndi mitsempha ya magazi.
Mankhwala osakaniza
Minofu yomwe imagwiritsidwa ntchito pang'onopang'ono imakhala ndi mafuta, timagulu ting'onoting'ono, ndi mitsempha yambiri ya magazi, ndi kuchuluka kwa minofuyi kumasiyana malinga ndi ngati munthu ali woonda kapena wolemera kwambiri.
Mitundu ya Khansara ya Khungu
Pali mitundu itatu ya khansa yapakhungu, yomwe imakhala ndi mitundu yoposa 100 yomwe imapezeka. Pamodzi, basal cell carcinoma ndi squamous cell carcinoma amatchedwa khansa ya khansa yomwe siili ndi khansa.
Basal Cell Carcinoma
Basal cell carcinoma (BCC) ndi khansa yapakhungu yowonongeka, yomwe imawerengera 75 peresenti mpaka 80 peresenti ya khansa iyi. Nthawi yowopsa ya moyo wokhala ndi basal cell carcinoma tsopano ndi pafupifupi 30 peresenti. Ankapezeka kawirikawiri makamaka pakati pa anthu akuluakulu kapena achikulire, koma akupezekabe kwa achinyamata. Ndi khansa yambiri ya khungu pakati pa Hispanics.
Basal cell carcinoma imayamba kumadera omwe dzuwa limakhala, monga nkhope, khosi, ndi manja.
Ndi khansara yopitirira pang'onopang'ono yomwe imafalikira ku ziwalo zina za thupi, koma anthu omwe ali ndi mbiri ya BCC ali pachiopsezo chachikulu chotenga kachiwiri ka BCC. Ngati basal cell carcinoma sichikuchiritsidwa, ikhoza kuwononga minofu yomwe imayandikana nayo, ndipo imayambitsa kutaya thupi ndipo ikhoza kugwera mafupa. Mankhwala amathandiza kwambiri pamene khansa imapezeka ndikupatsidwa mwamsanga.
Squamous Cell Carcinoma
Squamous cell carcinoma (SCC) amaimira 16 peresenti mpaka 20 peresenti ya khansa ya khungu ndipo imapezeka kawiri kawiri mwa amuna monga amayi. Izi ndizo mitundu yambiri ya khansa ya khungu yomwe imapezeka mumdima. Mosiyana ndi basal cell carcinomas, khansa imeneyi ingafalikire (metastasize) ngati ikhale yaikulu.
Nthawi zambiri zimapezeka pamaso, khutu, khosi, milomo, ndi nsana. SCC ingayambenso mkati mwa zilonda kapena zilonda za khungu m'malo ena pamtundu. Mofanana ndi basal cell carcinoma, mankhwala omwe alipo ali othandiza kwambiri ngati chotupacho chikupezeka pamene chiri chochepa komanso chochepa. Squamous cell carcinomas ali ndi mphamvu zogwirizana ndi dzuwa.
Melanoma
Chilonda cha mtundu wa khansa ndi mtundu woopsya kwambiri wa khansara ya khungu ndipo, ngakhale kuti sagwirizana kwambiri ndi basal cell ndi squamous khansa, ndi amene amachititsa anthu ambiri kufa. Mankhwalawa akhoza kutuluka mu khungu lenileni, koma nthawi zambiri amayamba mu mole. Amapezeka kawirikawiri kumbuyo kwa amuna, miyendo ya amayi, ndi manja, manja a mapazi, pansi pa zipilala kapena zida za anthu okhala ndi mitundu yofiira ya khungu. Izi zinati, khansa imeneyi ikhoza kufika paliponse, kuphatikizapo malo a khungu omwe sanadziwonepo dzuwa.
Chiwerengero cha khansa ya khansa yakhala ikukula kwambiri ku United States kwa zaka makumi atatu zapitazi. Ngakhale kuti khansa ya khansa imakhala yochuluka kwambiri kawiri pa azungu, chiwerengero cha melanoma pansi pa misomali chiri chofanana ndi anthu onse a khungu. Kuonjezerapo, kupitirira kwa omwe akupezeka ndi kwakukulu kwa anthu akuda. M'mawu ena, aliyense ayenera kudziwa za matendawa.
Mafupa a khansawa ndi abwino pamene amapezeka msanga, koma amatsika mofulumira pamene akufalikira kumalo ochepa kwambiri a m'mimba kapena ziwalo, monga mafupa, mapapo, chiwindi, ndi ubongo. Mankhwala atsopano, komabe, akuthandizira kuti apulumuke, ndipo ngakhale ma melanomas apamwamba angathe tsopano kulamuliridwa ndi mankhwalawa.
Mitundu Yambiri
Mocheperako, palinso mitundu ina ya khansa yomwe imaonekera pakhungu kapena phungu. Ena mwa awa ndi awa:
- Merkel cell carcinoma: Mankhwala a Merkel cell samapezeka khansa yapakhungu yomwe nthawi zambiri imapezeka m'maso mwa anthu okalamba. Pazifukwa zosadziwika, khansa iyi ikuwonjezeka. Amakonda kukhala achiwawa, ndipo amafalikira mofulumira kumalo ena a thupi.
- Kaposi's sarcoma : Khansara iyi imayambitsidwa ndi Kaposi sarcoma herpesvirus, ndipo kawirikawiri imapezeka mwa anthu omwe ali ndi kachilombo ka HIV / Edzi, kapena omwe amadziwika kuti ali ndi kachilombo ka HIV. Amapereka zazikulu zofiira, zofiira, kapena zofiira kuzungulira thupi komanso kutupa komwe kungakhale koopsa. Mwamwayi, nthawi zambiri amamvera bwino mankhwala a HIV.
- Sebaceous gland carcinoma: Khansa imeneyi imayambira m'matenda osakanikirana, ndipo imachitika kawirikawiri kwa akazi achikulire, kuzungulira diso.
- Protuberance ya Dermatofibrosarcoma: Khansayi imayambira ngati thumba lopweteka lomwe limayambira mu dermis ndi kufalikira mofulumira. Zili zokhudzana ndi gene geneation, zomwe zimapangitsa kuti pulojekitini yodziwika bwino kwambiri ikhale ndi mapuloteni otchedwa platelet-derived growth factor.
Metastases ya Khungu ndi Khansa Zina Zimene Zimapezeka Phungu
Nthawi zina, khansa yomwe imabwera m'madera ena a thupi ikhoza kufalikira ( kuchepetsa mphamvu ) kwa khungu. Khansa zomwe zimagwirizanitsidwa ndi metastases ya khungu zimakhala ndi khansa ya m'mawere, khansara yamtundu, ndi khansara yamapapo. Pamene khansa ina imafalikira pakhungu samatchedwa khansara ya khungu, ndipo ngati muyang'ana maselo pansi pa microscope, mwachitsanzo, ndi mawere a m'mawere, khungu la khungu ndi maselo a khansa, osati maselo a khungu. Iwo angatengedwe ngati khansa ya m'mawere, osati khansara ya khungu.
Mitundu iwiri ya khansara ya m'mawere imakhalanso khungu, ndipo kumayambiriro koyamba angafanane ndi kadzuwa kapena khansara ya khungu. Khansara yotentha ya m'mawere imayamba ndi kufiira ndi kupweteka pa bere. Matenda a Paget ndi mawonekedwe a khansara ya m'mawere yomwe imayamba pa khungu la mavupa. Matenda a T cell lymphoma ndi gulu la matenda (kuphatikizapo mycosis fungoides , Sezary matenda, ndi ena) omwe alidi mitundu ya lymphoma. Maselo a khansa ndi mtundu wa maselo oyera omwe amadziwika kuti T lymphocytes, osati maselo a khungu. Zilonda zam'kati za T tambiri zimayambira ngati nsalu zofiira, zomwe zimakhala zovuta kwambiri. M'kupita kwa nthawi, zipika, ndiyeno ziwalo zobisika zikhoza kuwonekera.
Zizindikiro
Zizindikiro za khansara ya khungu zimaphatikizapo kusintha kulikonse komwe kumawonekera pakhungu ndipo kungaphatikizepo:
- Matenda omwe samachiritsa.
- A mole amene akusintha.
- Zozizira, zowoneka zowonongeka.
- Mitambo ya pinki, yoyera, kapena ya mnofu yomwe imawoneka ngati yala.
- Kuyabwa.
Momwe mukudziwira zizindikiro zotere za khansa ya khansa ndi iyi:
- A imaimira asymmetry: A mole kapena zilonda zomwe sizingatheke.
- B amaimira malire. Mphepete mwa khansa ya khansa ingakhale yopanda malire, yosakanizidwa, kapena yofiira.
- C imaimira mtundu. Ma Melanomas nthawi zambiri amakhala ndi mtundu umodzi kapena hue.
- D imakhala yozungulira. Mulu umene umakhala waukulu kuposa penipeni penipeni umakhala ngati khansa ya khansa.
- E imayimira kukwera kapena kusinthika. Mayi akhoza kukwezedwa (nthawi zambiri mosalekeza) ndipo nthawi zambiri amasintha (kusintha) pakapita nthawi.
Zifukwa ndi Zoopsa
Sitikudziwa chomwe chimayambitsa khansara ya khungu, ngakhale kuti tazindikira zifukwa zingapo zoopsa . Ena mwa awa ndi awa:
- Kutuluka kwa dzuwa
- Kukhala ndi mtundu wa khungu wotumbululuka, makamaka iwo omwe ali ndi tsitsi lofiira kapena lalitali, maso obiriwira kapena a buluu, ndipo omwe sakhala amodzi komanso amawotcha mosavuta.
- Kukhala ndi mbiri ya banja la khansa ya khungu.
- Kukhala ndi mbiri yakale ya khansara ya khungu.
- Kukhala ndi mitundu yambiri ya majeremusi syndromes, monga xeroderma pigmentosum.
- Kukhala ndi moles ambiri (oposa 50) kapena kukhala ndi atespikipiki (nevi).
- Mipira yotentha kuchokera ku zilonda zamtunduwu kapena matenda opatsirana.
- Kukhala ndi chitetezo chamthupi chofooka.
- Njira zina zamankhwala ndi mankhwala, monga mankhwala opatsirana pogwiritsa ntchito khansa, komanso kuwala kwa psoriasis.
- Kuwonetsera kwa mankhwala pa ntchito monga tar ndi vinyl chloride.
- Kuwonetsera kwa arsenic mu madzi akumwa.
- Kusuta (kumawonjezera ngozi ya squamous cell carcinoma).
Kudziwa
Kuzindikira khansara ya khungu kumayamba ndi mbiri yabwino (kumvetsera zizindikiro ndi zoopsa) ndi kuunika kwa thupi. Malingana ndi maonekedwe a khungu lachikopa, adokotala angapangire kuti chidziwitso chikhale chovuta, chifukwa nthawi zina zimakhala zovuta kudziŵa ngati zosaoneka ndizo khansa kapena ayi chifukwa cha maonekedwe ake. Izi zingakhale zovuta kwambiri kwa anthu osakhala oyera.
Chidziwitso chingathe kuchitika mwa njira imodzi. Chofala kwambiri (ngati basal cell kapena squamous cell carcinoma akukayikiridwa) ndi nsonga yameta, njira yomwe imaphatikizapo kugwedeza khungu ndi kumeta ndekha pachilondacho. Phokoso la chikwapu lingapangidwenso. Chidziwitso chosasinthasintha chimaphatikizapo kupanga chidziwitso ndi kuchotsa gawo lachilendo kuti awonedwe ndi wodwalayo. Ngati mukuganiza kuti khansa ya melanoma imakhalapo, kawirikawiri amalimbikitsidwa kuti azikhala mosakanikirana. Izi zimaphatikizapo kuchotsa zonse zopanda pake komanso malo amodzi. Popeza kukula kwake kwa khungu kumakhala kofunikira kwambiri pakukhalitsa khansa ya khansa, zimakhala zofunikira kwambiri kuti chiwerengero cha matenda odwala matenda a chifuwa chisamayesedwe.
Ngati khansara ya khungu (khansa ya khansa komanso nthawi zina squamous cell carcinoma) ikupita, mayesero ena amachitika kuti athetse matendawa ndikufuna kukhalapo kwa metastases. Izi zingaphatikizepo ndondomeko yotchedwa sentinel node biopsy, CT scans, PET scan, kapena mayesero ena malinga ndi malo a khansara ya khungu.
Kuchiza
Mankhwala a kansa ya khungu adzadalira pa zinthu zambiri, monga mtundu wa khansara, kukula kwake ndi kuya kwake, ndi zina zambiri.
Kuchotsa chotupacho ndizofala kwambiri. Kuchita opaleshoni yapadera yotchedwa opaleshoni ya Moh kumaphatikizapo kuchotsa minofu yotsatizana ndi kuyang'ana m'mphepete mwa umboni uliwonse wa khansara, kotero kuti opaleshoni yochepetsetsayo yathetseratu vutoli. Ndi ma melanomas, dera lalikulu la minofu yozungulira likuchotsedwa.
Kwa zotupa zapamwamba kwambiri zomwe zafalikira ku maselo a mitsempha kapena zigawo zina za thupi, mankhwala monga immunotherapy, chemotherapy, mankhwala opatsirana, ndi mankhwala odzoza mazira angafunike.
Kupewa ndi Kutulukira Kwambiri
Pali zinthu zambiri zimene anthu angachite kuti athane ndi khansa ya khungu , kapena kuchepetsa ngozi. Kukhala osamala padzuwa n'kofunika, koma kumaphatikizapo zambiri osati kungovala zowunikira, komanso kugwiritsa ntchito njira zina zotetezera (monga zovala, zipewa, ndi kupewa dzuwa). Ntchito zina zowonjezera ntchito zingapangitse ngozi, ndipo magolovesi amalimbikitsidwa pogwira ntchito ndi mankhwala osiyanasiyana ndi zinthu zosiyanasiyana.
Sikuti khansa yonse ya khungu ingalephereke, ndipo kuzindikira koyambirira kumakhala cholinga. Kufufuza khungu kumaganizidwe, makamaka kwa omwe ali ndi zifukwa zilizonse zoopsa za matendawa. Anthu ena omwe ali ndi zifukwa zazikulu zoopsa, kapena matenda omwe amachititsa chiopsezo chachikulu, angafunike kuganizira kawirikawiri maulendo awo ndi dermatologist.
Mawu Ochokera
Pafupifupi theka la anthu adzakhala ndi khansa yamtundu wina m'moyo wawo wonse. Kudziwa zizindikiro zowononga za matendawa, komanso kudziŵa zoopsa zanu, ndikofunika kupeza khansa m'magawo oyambirira komanso ochiritsidwa kwambiri a matendawa. Ngakhale dermatologist ikhoza kudziwa ngati cholakwika ndi khansara kapena ayi, chiwopsezo kawirikawiri ndi chofunikira kuti mupeze matenda. Ngati muli ndi kusintha kwa khungu komwe kumakukhudzani, musayembekezere, ndipo pangani msonkhano kuti muwone dokotala wa dokotala wodziwa lero.
> Zotsatira:
> National Cancer Institute. Chithandizo cha Melanoma (PDQ) -Health Professional Version. Kusinthidwa 03/22/18.
> National Cancer Institute. Kuchiza Khansa Kwakhungu (PDQ) -Health Professional Version. Kusinthidwa 01/01/18.
> Weller, Richard PJB, Hamish JA Hunter, ndi Margaret W. Mann. Dermatology Clinic. Chichester (West Sussex): John Wiley & Son Inc., 2015. Print.