Types/skin/patient/melanoma-treatment-pdq

Chithandizo cha khansa ya khansa

Zambiri Za Melanoma

MFUNDO ZOFUNIKA

• Melanoma ndi matenda omwe amakhala ndi maselo owopsa (khansa) m'matenda a melanocytes (maselo omwe amawonetsera khungu).

• Pali mitundu yosiyanasiyana ya khansa yomwe imayamba pakhungu.

• Melanoma imatha kupezeka paliponse pakhungu.

• Mpweya wosazolowereka, kuwala kwa dzuwa, komanso mbiri yazaumoyo kumatha kukhudza chiopsezo cha khansa ya pakhungu.

• Zizindikiro za khansa ya khansa imaphatikizapo kusintha momwe mole kapena dera lamatenda zimawonekera.

• Kuyesa komwe kumayesa khungu kumagwiritsidwa ntchito kuti mupeze (kupeza) ndikuzindikira khansa ya khansa.

• Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Melanoma ndi matenda omwe amakhala ndi maselo owopsa (khansa) m'matenda a melanocytes (maselo omwe amawonetsera khungu).

Khungu ndilo chiwalo chachikulu kwambiri mthupi. Zimateteza kutentha, kuwala kwa dzuwa, kuvulala, komanso matenda. Khungu limathandizanso kuchepetsa kutentha kwa thupi ndikusungira madzi, mafuta, ndi vitamini D. Khungu lili ndi zigawo zingapo, koma zigawo zikuluzikulu ziwiri ndi epidermis (wosanjikiza kumtunda kapena kunja) ndi dermis (wosanjikiza kapena wamkati wosanjikiza). Khansa yapakhungu imayamba mu khungu, lomwe limapangidwa ndi mitundu itatu yamaselo:

• Maselo osakanikirana: Maselo opyapyala, apansi omwe amapanga gawo lalikulu la khungu.

• Maselo oyambira: Maselo ozungulira pansi pama cell squamous.

• Ma Melanocyte: Maselo omwe amapanga melanin ndipo amapezeka kumunsi kwa khungu. Melanin ndi pigment yomwe imapatsa khungu mtundu wachilengedwe. Khungu likawonekera padzuwa kapena kuwala kopangira, ma melanocyte amapanga pigment yambiri ndikupangitsa kuti khungu lizidetsedwa.

Chiwerengero cha anthu odwala matenda a khansa akhala akuwonjezeka mzaka 30 zapitazi. Matenda a khansa amapezeka kwambiri kwa akulu, koma nthawi zina amapezeka mwa ana ndi achinyamata. (Onani chidule cha pa Khansa Yachilendo ya Chithandizo cha Ana kuti mumve zambiri za khansa ya khansa mwa ana ndi achinyamata.)

Khungu la khungu, kuwonetsa khungu, khungu, ndi minofu yocheperako. Ma Melanocyte ali m'maselo osanjikiza am'munsi mwa epidermis.

Pali mitundu yosiyanasiyana ya khansa yomwe imayamba pakhungu. Pali mitundu iwiri ikuluikulu ya khansa yapakhungu: khansa ya pakhungu ndi nonmelanoma.

Melanoma ndi khansa yapakhungu yosowa. Nthawi zambiri amatha kulowa m'matumba oyandikira ndikufalikira mbali zina za thupi kuposa mitundu ina ya khansa yapakhungu. Khansa ya khansa ikayamba pakhungu, imatchedwa cutaneous melanoma. Matenda a khansa ya khansa amatha kupezeka m'matumbo (owonda, ofunda a minofu yomwe imaphimba malo monga milomo). Chidule cha ichi ndi cha khungu (khansa) la khansa ya khansa komanso khansa ya khansa yomwe imakhudza mamina.

Mitundu yodziwika bwino ya khansa yapakhungu ndi basal cell carcinoma ndi squamous cell carcinoma. Ndi khansa yapakhungu la nonmelanoma. Khansa yapakhungu la Nonmelanoma sinafalikire kumadera ena a thupi. (Onani chidule cha pa Chithandizo cha Khansa Yapakhungu kuti mumve zambiri za basal cell ndi squamous cell cancer.)

Melanoma imatha kupezeka paliponse pakhungu. Amuna, khansa ya khansa nthawi zambiri imapezeka pa thunthu (dera kuyambira mapewa mpaka m'chiuno) kapena mutu ndi khosi. Kwa amayi, khansa ya khansa imapangidwa kawirikawiri m'manja ndi m'miyendo.

Khansa ya pakhungu ikachitika m'maso, imatchedwa intraocular kapena ocular melanoma. (Onani chidule cha pa Intraocular (Uveal) Melanoma Treatment kuti mumve zambiri.)

Mpweya wosazolowereka, kuwala kwa dzuwa, komanso mbiri yazaumoyo kumatha kukhudza chiopsezo cha khansa ya pakhungu.

Chilichonse chomwe chimakulitsa chiopsezo chotenga matenda chimatchedwa chiopsezo. Kukhala ndi chiwopsezo sikutanthauza kuti udzakhala ndi khansa; kusakhala ndi zoopsa sikutanthauza kuti simudzakhala ndi khansa. Lankhulani ndi dokotala ngati mukuganiza kuti mutha kukhala pachiwopsezo.

Zowopsa za khansa ya khansa ndi izi:

• Kukhala ndi mawonekedwe owoneka bwino, omwe akuphatikizapo izi:

• Khungu loyera lomwe limagundagunda ndikuwotcha mosavuta, siliongola, kapena kusanjika bwino.

• Buluu kapena wobiriwira kapena maso ena owala.

• Tsitsi lofiira kapena lofiira.

• Kuwonetsedwa ndi dzuwa lachilengedwe kapena dzuwa lochita kupanga (monga pamabedi ofufuta).
• Kuwonetsedwa pazinthu zina zachilengedwe (mlengalenga, kwanu kapena kuntchito kwanu, ndi chakudya chanu ndi madzi). Zina mwazomwe zimayambitsa ngozi ya khansa ya khansa ndi radiation, solvents, vinyl chloride, ndi ma PCB.

• Kukhala ndi mbiri yakuwotcha dzuwa kambiri, makamaka ngati mwana kapena wachinyamata.

• Kukhala ndi timadontho tambiri tating'ono kapena tambiri.

• Kukhala ndi mbiriyakale yabanja yampweya zachilendo (atypical nevus syndrome).

• Kukhala ndi banja kapena mbiri yakale ya khansa ya khansa.

• Kukhala mzungu.

• Kukhala ndi chitetezo chamthupi chofooka.

• Kukhala ndi kusintha kwina m'majini komwe kumalumikizidwa ndi khansa ya khansa.

Kukhala woyera kapena wowoneka bwino kumawonjezera chiopsezo cha khansa ya pakhungu, koma aliyense akhoza kukhala ndi khansa ya khansa, kuphatikiza anthu omwe ali ndi khungu lakuda.

Onani zowerengera zotsatirazi za kuti mumve zambiri pazowopsa za khansa ya khansa:

• Chibadwa cha Khansa Yapakhungu

• Kupewa Khansa Yapakhungu

Zizindikiro za khansa ya khansa imaphatikizapo kusintha momwe mole kapena dera lamatenda zimawonekera.

Zizindikiro ndi zizindikilozi zimatha chifukwa cha khansa ya khansa kapena matenda ena. Funsani dokotala ngati muli ndi izi:

• Mole kuti:

• kusintha kukula, mawonekedwe, kapena utoto.

• ili ndi m'mbali kapena malire osakhazikika.

• ndi mitundu yoposa imodzi.

• ndiyosakanikirana (ngati mole imagawika pakati, magawo awiriwo ndiosiyana kukula kapena mawonekedwe).

• kuyabwa.

• amatuluka, amatuluka magazi, kapena amatuluka zilonda zam'mimba (dzenje limapangika pakhungu pomwe gawo limodzi lamaselo likuphwasuka ndipo minofu yomwe ili pansipa ikuwonekera).

• Kusintha kwa khungu loyera (mtundu).

• Ma satellite (ma moles atsopano omwe amakula pafupi ndi mole yomwe ilipo).

Zithunzi ndi mafotokozedwe of moles and melanoma, onani Common Moles, Dysplastic Nevi, and Risk of Melanoma.

Kuyesa komwe kumayesa khungu kumagwiritsidwa ntchito kuti mupeze (kupeza) ndikuzindikira khansa ya khansa.

Ngati khungu kapena khungu la khungu lisintha kapena likuwoneka lachilendo, mayeso ndi njira zotsatirazi zitha kuthandiza kupeza ndi kupeza khansa yapakhungu:

• Kuyezetsa thupi komanso mbiri yaumoyo: Kuyesedwa kwa thupi kuti muwone zizindikiritso zaumoyo, kuphatikizapo kuyang'ana ngati pali matenda, monga zotupa kapena china chilichonse chomwe chikuwoneka chachilendo. Mbiri yokhudzana ndi thanzi la wodwalayo komanso matenda am'mbuyomu komanso chithandizo chamankhwala adzachitidwanso.

• Kuyezetsa khungu: Dokotala kapena namwino amayang'ana khungu kuti apeze timadontho, zikwangwani zobadwira, kapena madera ena amitundumitundu omwe amawoneka achilendo pamtundu, kukula, mawonekedwe, kapangidwe kake.

• Biopsy: Njira yochotsera minofu yosazolowereka ndi pang'ono pathupi pozungulira. Wodwala amayang'ana minofu pansi pa microscope kuti aone ngati ali ndi khansa. Zingakhale zovuta kusiyanitsa pakati pa mole wachikuda ndi zotupa zoyambirira za khansa ya khansa. Odwala angafune kuti minofu yachiwiri iwunikidwe ndi wodwala wachiwiri. Ngati mole yolemetsa kapena chotupa ndi khansa, mtundu wa minofu ungayesedwenso kusintha kwamitundu ina.

Pali mitundu inayi yayikulu yamatenda achikopa. Mtundu wa biopsy wachitika zimatengera komwe dera lachilendo lidapangidwira komanso kukula kwa dera.

• Shave biopsy: Lumo losabereka limagwiritsidwa ntchito "kumeta" kukula kosawoneka bwino.

• Punch biopsy: Chida chapadera chotchedwa nkhonya kapena trephine chimagwiritsidwa ntchito pochotsa bwalo lazinyama pakukula kosawoneka bwino.

Nkhonya biopsy. Scalpel yopanda pake, yozungulira imagwiritsidwa ntchito kudula pachilonda pakhungu. Chidacho chimasandulika mozungulira ndikuwoloka mobwerezabwereza kuti muchepetse pafupifupi mamilimita 4 (mm) mpaka kusanjikiza kwamafuta amafuta pansipa. Kachilombo kakang'ono kakang'ono kamachotsedwa kuti kafufuzidwe pansi pa microscope. Makulidwe khungu ndi osiyana mbali zosiyanasiyana za thupi.

• Zowonongeka: Scalpel imagwiritsidwa ntchito kuchotsa gawo lokula.

• Chisankho chodabwitsa: Scalpel imagwiritsidwa ntchito kuchotsa kukula konse.

Zinthu zina zimakhudzanso madandaulo (mwayi wochira) ndi njira zamankhwala.

Kulosera (mwayi wochira) ndi njira zamankhwala zimadalira izi:

• Kukula kwa chotupacho komanso komwe kuli mthupi.

• Maselo a khansa akugawana mwachangu.

• Kaya panali chotupa kapena zilonda zam'mimba.

• Kodi khansa ili m'matenda amtundu wanji.

• Chiwerengero cha malo omwe khansa yafalikira mthupi.

• Mulingo wa lactate dehydrogenase (LDH) m'magazi.

• Kaya khansara ili ndi zosintha zina (jini) yotchedwa BRAF.

• Msinkhu wa wodwalayo komanso thanzi lake lonse.

Magawo a Melanoma

MFUNDO ZOFUNIKA

• Pambuyo pa khansa ya khansa, mayesero angachitike kuti mudziwe ngati maselo a khansa afalikira pakhungu kapena mbali zina za thupi.

• Pali njira zitatu zomwe khansa imafalikira mthupi.

• Khansa imatha kufalikira pomwe idayamba kupita mbali zina za thupi.

• Gawo la khansa ya khansa limadalira kukula kwa chotupacho, kaya khansa yafalikira kumatenda am'mimba kapena ziwalo zina za thupi, ndi zina.

• Magawo otsatirawa amagwiritsidwa ntchito pa khansa ya pakhungu:

• Gawo 0 (Melanoma mu Situ)

• Gawo I

• Gawo II

• Gawo III

• Gawo IV

Pambuyo pa khansa ya khansa, mayesero angachitike kuti mudziwe ngati maselo a khansa afalikira pakhungu kapena mbali zina za thupi.

Njira yomwe imagwiritsidwa ntchito pofufuza ngati khansa yapita pakhungu kapena mbali zina za thupi imatchedwa staging. Zomwe amapeza kuchokera pakukonzekera zimatsimikizira gawo la matendawa. Ndikofunikira kudziwa siteji kuti mukonzekere chithandizo.

Kwa khansa ya khansa yomwe siingafalikire mbali zina za thupi kapena kubwereranso, mayeso ena sangasowe. Kwa khansa ya khansa yomwe imafalikira kumadera ena a thupi kapena kubwereranso, mayeso ndi njira zotsatirazi zitha kuchitidwa pambuyo pochitidwa opaleshoni kuti achotse khansa ya khansa:

• Mapu amtundu wa lymph and sentinel lymph node biopsy: Kuchotsa kwa sentinel lymph node panthawi yochita opareshoni. Sentinel lymph node ndiye njira yoyamba yam'magulu am'magazi kuti alandire madzi m'mimba kuchokera pachotupa choyambirira. Ndi lymph node yoyamba yomwe khansa imafalikira kuchokera ku chotupa choyambirira. Mankhwala a radioactive ndi / kapena utoto wabuluu amabayidwa pafupi ndi chotupacho. Katunduyu kapena utoto umadutsa m'mitsempha yam'mimba kupita kumalo am'mimba. Nthenda yoyamba yolandila mankhwala kapena utoto imachotsedwa. Wodwala amayang'ana minofu pansi pa microscope kuti ayang'ane maselo a khansa. Ngati maselo a khansa sapezeka, mwina sikofunikira kuchotsa ma lymph node ambiri. Nthawi zina, sentinel lymph node imapezeka m'magulu angapo am'magulu.

• CT scan (CAT scan): Njira yomwe imapanga zithunzi zingapo zamatupi amthupi zomwe zidatengedwa mbali zosiyanasiyana. Zithunzizo zimapangidwa ndi kompyuta yolumikizidwa ndi makina a x-ray. Utoto ukhoza kulowetsedwa mumtsempha kapena kumeza kuti ziwalo kapena ziwalo ziwoneke bwino. Njirayi imatchedwanso computed tomography, kompyuta tomography, kapena kompyuta axial tomography. Zithunzi za khansa ya khansa imatha kujambulidwa pakhosi, pachifuwa, pamimba, komanso m'chiuno.

• PET scan (positron emission tomography scan): Njira yopezera maselo oyipa mthupi. Gulu laling'ono la shuga (radio) limabayidwa mumtsempha. Chojambulira cha PET chimazungulira thupi ndikupanga chithunzi cha komwe glucose imagwiritsidwa ntchito mthupi. Maselo otupa owopsa amawonekera pachithunzichi chifukwa amakhala otanganidwa ndipo amatenga shuga wambiri kuposa momwe maselo amachitira.

• MRI (magnetic resonance imaging) yokhala ndi gadolinium: Njira yomwe imagwiritsa ntchito maginito, mafunde a wailesi, ndi kompyuta kuti ipange zithunzi zingapo zazomwe zili mkati mwa thupi, monga ubongo. Chinthu chotchedwa gadolinium chimalowetsedwa mumtsempha. Gadolinium imasonkhanitsa mozungulira maselo a khansa kuti athe kuwonekera pachithunzichi. Njirayi imatchedwanso nuclear magnetic resonance imaging (NMRI).

• Kuyesa kwa Ultrasound: Njira yomwe mafunde amawu amphamvu (ultrasound) amachotsedwa pamatumba amkati, monga ma lymph node, kapena ziwalo ndikupanga ma echoes. Zolembawo amapanga chithunzi cha matupi amthupi otchedwa sonogram. Chithunzicho chimatha kusindikizidwa kuti chiwonedwe pambuyo pake.

• Kafukufuku wamagazi: Njira yoyeserera magazi kuti ayese kuchuluka kwa zinthu zina zomwe zimatulutsidwa m'magazi ndi ziwalo ndi minyewa mthupi. Kwa khansa ya pakhungu, magazi amayang'aniridwa ndi enzyme yotchedwa lactate dehydrogenase (LDH). Maseŵera a LDH apamwamba anganeneratu kuti odwala omwe ali ndi matenda opatsirana amatha kusalandira chithandizo.

Zotsatira zamayesowa zimawonedwa limodzi ndi zotsatira za chotupa chotupa kuti mudziwe khansa ya khansa.

Pali njira zitatu zomwe khansa imafalikira mthupi.

Khansa imatha kufalikira kudzera mu minofu, ma lymph system, ndi magazi:

• Minofu. Khansara imafalikira kuchokera pomwe idayamba ndikukula kupita kumadera oyandikana nawo.

• Lymph dongosolo. Khansara imafalikira kuchokera pomwe idayamba polowa m'mitsempha. Khansara imadutsa m'mitsempha yamafuta kupita mbali zina za thupi.

• Magazi. Khansara imafalikira kuchokera pomwe idayamba ndikulowa m'magazi. Khansara imadutsa m'mitsempha yamagazi kupita mbali zina za thupi.

Khansa imatha kufalikira pomwe idayamba kupita mbali zina za thupi.

Khansa ikafalikira mbali ina ya thupi, imatchedwa metastasis. Maselo a khansa amachoka pomwe adayamba (chotupa choyambirira) ndikuyenda mumitsempha kapena magazi.

Lymph dongosolo. Khansara imalowa mumitsempha, imadutsa m'mitsempha yamafuta, ndikupanga chotupa (chotupa cha metastatic) gawo lina la thupi.

Magazi. Khansara imalowa m'magazi, imadutsa m'mitsempha yamagazi, ndikupanga chotupa (chotupa cha metastatic) gawo lina la thupi. Chotupa cha metastatic ndi khansa yofanana ndi chotupa chachikulu. Mwachitsanzo, ngati khansa ya pakhungu imafalikira m'mapapu, maselo a khansa m'mapapo ndiye maselo a khansa ya khansa. Matendawa ndi metastatic melanoma, osati khansa yamapapo.

Gawo la khansa ya khansa limadalira kukula kwa chotupacho, kaya khansa yafalikira kumatenda am'mimba kapena ziwalo zina za thupi, ndi zina.

Kuti mupeze gawo la khansa ya khansa, chotupacho chimachotsedweratu ndipo ma lymph node oyandikira amayang'aniridwa ngati ali ndi khansa. Gawo la khansa limagwiritsidwa ntchito kuti mudziwe mankhwala abwino kwambiri. Funsani dokotala wanu kuti mudziwe khansa yomwe muli nayo.

Gawo la khansa ya khansa limadalira izi:

• Kutalika kwa chotupacho. Kukula kwa chotupacho kumayesedwa kuchokera pakhungu mpaka mbali yakuya ya chotupacho.

• Kaya chotupacho chili ndi zilonda zam'mimba (chadutsa pakhungu).

• Kaya khansa imapezeka mu ma lymph node poyesa thupi, kuyesa kuyerekezera, kapena sentinel lymph node biopsy.

• Kaya ma lymph node aphatikizana (olumikizidwa pamodzi).

• Kaya alipo:

• Zotupa za Satelayiti: Magulu ang'onoang'ono am'mimba omwe afalikira mkati mwa masentimita awiri kuchokera ku chotupacho.

• Zotupa za Microsatellite: Magulu ang'onoang'ono am'mimba omwe afalikira kudera lomwe lili pafupi kapena pansi pa chotupacho.

• M'mayendedwe am'mimba: Zotupa zomwe zafalikira ku zotengera zam'mimba pakhungu kupitirira masentimita awiri kuchokera pachotupa choyambirira, koma osati kumatenda am'mimba.

• Kaya khansara yafalikira mbali zina za thupi, monga mapapo, chiwindi, ubongo, minofu yofewa (kuphatikiza minofu), m'mimba, ndi / kapena ma lymph node akutali. Khansa ikhoza kufalikira kumadera akhungu kutali ndi komwe idayamba.

Magawo otsatirawa amagwiritsidwa ntchito pa khansa ya pakhungu:

Gawo 0 (Melanoma mu Situ)

Mu gawo la 0, ma melanocytes osadziwika amapezeka mu epidermis. Ma melanocyte osazolowerekawa amatha kukhala khansa ndikufalikira m'minyewa yabwinobwino. Gawo 0 limatchedwanso melanoma in situ.

Gawo I

Pachigawo choyamba, khansa yapanga. Gawo I lagawika magawo IA ndi IB.

Mamilimita (mm). Pensulo yakuthwa ili pafupifupi 1 mm, krayoni yatsopano ndi pafupifupi 2 mm, ndipo chofufutira pensulo chatsopano ndi pafupifupi 5 mm.

• Gawo IA: Chotupacho sichiposa 1 millimeter wandiweyani, wopanda kapena chilonda.

• Gawo IB: Chotupacho chimaposa 1 koma osapitilira 2 millimeter wandiweyani, wopanda zilonda.

Gawo II

Gawo II lidagawika magawo IIA, IIB, ndi IIC.

• Gawo IIA: Chotupacho mwina:

• osapitilira 1 koma osapitilira 2 millimeter wandiweyani, ndi zilonda zam'mimba; kapena

• osapitilira 2 koma osapitilira mamilimita 4 makulidwe, opanda zilonda.

• Gawo IIB: Chotupacho ndi:

• osapitilira 2 koma osapitilira mamilimita 4, ndi zilonda zam'mimba; kapena

• oposa 4 millimeters wandiweyani, popanda zilonda.

• Gawo IIC: Chotupacho chimakhala chopitilira mamilimita 4, ndi zilonda.

Gawo III

Gawo lachitatu lagawika magawo IIIA, IIIB, IIIC, ndi IIID.

• Gawo IIIA: Chotupacho sichoposa 1 millimeter wandiweyani, ndi zilonda zam'mimba, kapena osapitilira 2 millimeter wandiweyani, wopanda zilonda. Khansa imapezeka mu 1 mpaka 3 ma lymph node ndi sentinel lymph node biopsy.

• Gawo IIIB:

(1) Sidziwika komwe khansara idayambira kapena chotupa choyambirira sichimawonekeranso, ndipo chimodzi mwazinthu izi ndi chowonadi:

• khansa imapezeka mu 1 lymph node poyesa thupi kapena kuyerekezera kulingalira; kapena

• pali zotupa za microsatellite, zotupa za satellite, ndi / kapena metastases mkati kapena pansi pa khungu.

kapena

(2) Chotupacho sichoposa 1 millimeter wandiweyani, ndi zilonda zam'mimba, kapena osapitilira 2 millimeter wandiweyani, wopanda zilonda, ndipo chimodzi mwazinthu izi ndi chowonadi:

• khansa imapezeka mu 1 mpaka 3 ma lymph node poyesa thupi kapena kuyerekezera kulingalira; kapena

• pali zotupa za microsatellite, zotupa za satellite, ndi / kapena metastases mkati kapena pansi pa khungu.

kapena

(3) Chotupacho chimaposa 1 koma osapitilira 2 millimeter wandiweyani, ali ndi zilonda zam'mimba, kapena kupitilira 2 koma osapitilira mamilimita 4 wandiweyani, wopanda zilonda, ndipo chimodzi mwazotsatira ndi chowonadi:

• khansa imapezeka mu 1 mpaka 3 ma lymph node; kapena

• pali zotupa za microsatellite, zotupa za satellite, ndi / kapena metastases mkati kapena pansi pa khungu.

• Gawo IIIC:

(1) Sidziwika komwe khansara idayambira, kapena chotupa choyambirira sichitha kuwonanso. Khansa imapezeka:

• 2 kapena 3 mwanabele; kapena

• mu 1 lymph node ndipo pali zotupa za microsatellite, zotupa za satellite, ndi / kapena ma metastases mkati kapena pansi pa khungu; kapena

• mu ma lymph node anayi kapena kupitilira apo, kapena ma nambala amtundu uliwonse omwe amalumikizana; kapena

• mu 2 kapena kuposa ma lymph node ndi / kapena kuchuluka kwamankhwala am'mimba omwe amalumikizana. Pali zotupa za microsatellite, zotupa za satellite, ndi / kapena metastases mkati kapena pansi pa khungu.

kapena

(2) Chotupacho sichoposa mamilimita awiri, chopanda zilonda kapena chopanda, kapena osapitirira mamilimita 4, chopanda zilonda. Khansa imapezeka:

• mu 1 lymph node ndipo pali zotupa za microsatellite, zotupa za satellite, ndi / kapena ma metastases mkati kapena pansi pa khungu; kapena

• mu ma lymph node anayi kapena kupitilira apo, kapena ma nambala amtundu uliwonse omwe amalumikizana; kapena

• mu 2 kapena kuposa ma lymph node ndi / kapena kuchuluka kwamankhwala am'mimba omwe amalumikizana. Pali zotupa za microsatellite, zotupa za satellite, ndi / kapena metastases mkati kapena pansi pa khungu.

kapena

(3) Chotupacho chimaposa 2 koma osapitilira mamilimita 4 wokulirapo, ndi zilonda zam'mimba, kapena kuposa mamilimita 4 wokulirapo, wopanda zilonda. Khansara imapezeka mu 1 kapena kuposa ma lymph node ndi / kapena ma nambala am'mimba omwe amalumikizana. Pakhoza kukhala zotupa za microsatellite, zotupa za satellite, ndi / kapena ma metastases mkati kapena pansi pa khungu.

kapena

(4) Chotupacho n'cholemera kuposa mamilimita 4, ndi zilonda. Khansa imapezeka mu 1 kapena ma lymph node ambiri komanso / kapena pali zotupa za microsatellite, zotupa za satellite, ndi / kapena ma metastases mkati kapena pansi pa khungu.

• Gawo IIID: Chotupacho chimakhala chopitilira mamilimita 4, ndi zilonda. Khansa imapezeka:

• mu ma lymph node anayi kapena kupitilira apo, kapena ma nambala amtundu uliwonse omwe amalumikizana; kapena

• mu 2 kapena kuposa ma lymph node ndi / kapena kuchuluka kwamankhwala am'mimba omwe amalumikizana. Pali zotupa za microsatellite, zotupa za satellite, ndi / kapena metastases mkati kapena pansi pa khungu.

Gawo IV

Pa gawo IV, khansara yafalikira mbali zina za thupi, monga mapapo, chiwindi, ubongo, msana, fupa, minofu yofewa (kuphatikiza minofu), thirakiti la m'mimba (GI), ndi / kapena ma lymph node akutali. Khansa ikhoza kufalikira kumadera akhungu kutali ndi komwe idayambira.

Melanoma Yambiri

Matenda a khansa yapakhungu ndi khansa yomwe yabwereranso (kubwerera) itachiritsidwa. Khansara imatha kubwerera komwe idayambira kapena mbali zina za thupi, monga mapapo kapena chiwindi.

Chithandizo Chosankha Mwachidule

MFUNDO ZOFUNIKA

• Pali mitundu yosiyanasiyana ya chithandizo cha odwala khansa ya khansa.

• Mitundu isanu yamankhwala amtundu uliwonse imagwiritsidwa ntchito:

• Opaleshoni

• Chemotherapy

• Thandizo la radiation

• Chitetezo chamatenda

• Chithandizo chofuna

• Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

• Thandizo la katemera

• Chithandizo cha khansa ya pakhungu chingayambitse mavuto.

• Odwala angaganize zopita nawo kukayezetsa.

• Odwala amatha kulowa m'mayesero azachipatala asanayambe, asanayambe, kapena atayamba kulandira chithandizo cha khansa.

• Mayeso otsatirawa angafunike.

Pali mitundu yosiyanasiyana ya chithandizo cha odwala khansa ya khansa.

Pali mitundu ingapo yamankhwala othandizira odwala khansa ya khansa. Mankhwala ena ndi ofanana (mankhwala omwe akugwiritsidwa ntchito pano), ndipo ena akuyesedwa m'mayesero azachipatala. Kuyesedwa kwachipatala ndi kafukufuku wofufuza wothandizira kusintha chithandizo chamakono kapena kupeza zidziwitso zamankhwala atsopano kwa odwala khansa. Pamene mayesero azachipatala awonetsa kuti chithandizo chatsopano ndichabwino kuposa chithandizo chamankhwala, chithandizocho chitha kukhala chamankhwala wamba. Odwala angaganize zopita nawo kukayezetsa. Mayesero ena azachipatala ndi otseguka kwa odwala omwe sanayambe kulandira chithandizo.

Mitundu isanu yamankhwala amtundu uliwonse imagwiritsidwa ntchito:

Opaleshoni

Opaleshoni yochotsa chotupacho ndiye chithandizo choyambirira cha magawo onse a khansa ya khansa. Amagwiritsidwa ntchito pochotsa khansa ya khansa ndi ziwalo zina zoyizungulira. Kulumikiza khungu (kutenga khungu kuchokera mbali ina ya thupi kuti lisinthe khungu lomwe lachotsedwa) kumatha kuchitidwa kuti tiphimbe chilonda choyambitsidwa.

Nthawi zina, ndikofunikira kudziwa ngati khansa yafalikira kumatenda am'mimba. Mapu a lymph node ndi sentinel lymph node biopsy amachitidwa kuti ayang'ane khansa mu sentinel lymph node (woyamba lymph node mu gulu la ma lymph node kuti alandire ngalande ya lymphatic kuchokera pachotupa choyambirira). Ndi lymph node yoyamba yomwe khansa imafalikira kuchokera ku chotupa choyambirira. Mankhwala a radioactive ndi / kapena utoto wabuluu amabayidwa pafupi ndi chotupacho. Katunduyu kapena utoto umadutsa m'mitsempha yam'mimba kupita kumalo am'mimba. Nthenda yoyamba yolandila mankhwala kapena utoto imachotsedwa. Wodwala amayang'ana minofu pansi pa microscope kuti ayang'ane maselo a khansa. Ngati maselo a khansa apezeka, ma lymph node ambiri amachotsedwa ndipo zitsanzo za minofu zidzafufuzidwa ngati zili ndi khansa. Izi zimatchedwa lymphadenectomy. Nthawi zina,

Dokotala atachotsa khansa yapakhungu yokhayo yomwe imawoneka panthawi yopanga opaleshoni, odwala ena amatha kupatsidwa chemotherapy pambuyo pochitidwa opaleshoni kuti aphe maselo aliwonse a khansa omwe atsala. Chemotherapy yoperekedwa pambuyo pa opaleshoniyi, kuti achepetse chiopsezo kuti khansayo ibwereranso, amatchedwa adjuvant therapy.

Opaleshoni yochotsa khansa yomwe yafalikira kumatenda am'mimba, m'mapapo, m'mimba, m'mafupa, kapena muubongo itha kuchitidwa kuti moyo wa wodwalayo ukhale wabwino pochepetsa zizindikilo.

Chemotherapy

Chemotherapy ndi mankhwala a khansa omwe amagwiritsa ntchito mankhwala oletsa kukula kwa maselo a khansa, mwina popha ma cell kapena kuwaletsa kuti asagawane. Chemotherapy ikamamwa pakamwa kapena kulowetsedwa mumtsempha kapena minofu, mankhwalawa amalowa m'magazi ndipo amatha kufikira ma cell a khansa mthupi lonse (systemic chemotherapy). Chemotherapy ikaikidwa molunjika m'matumbo a cerebrospinal, chiwalo, kapena thupi monga pamimba, mankhwalawa amakhudza kwambiri ma cell a khansa m'malo amenewo (chemotherapy am'madera).

Mtundu umodzi wamachiritso am'madera am'magazi ndi hyperthermic yokhayokha. Pogwiritsa ntchito njirayi, mankhwala olimbana ndi khansa amapita molunjika kudzanja kapena mwendo womwe khansayo ilimo. Kutuluka kwa magazi kupita kumalekezerowo kumayimitsidwa kwakanthawi ndiulendo wapaulendo. Njira yothetsera kutentha ndi mankhwala a anticancer imayikidwa mwachindunji m'magazi a chiwalocho. Izi zimapereka mankhwala ochuluka kwambiri kudera lomwe kuli khansa.

Momwe chemotherapy imaperekedwa imadalira mtundu ndi gawo la khansa yomwe ikuchitidwa.

Onani Mankhwala Ovomerezeka a Melanoma kuti mumve zambiri.

Thandizo la radiation

Thandizo la radiation ndi chithandizo cha khansa chomwe chimagwiritsa ntchito ma x-ray amphamvu kapena mitundu ina ya radiation kuti iphe ma cell a khansa kapena kuti asakule. Pali mitundu iwiri ya mankhwala a radiation:

• Mankhwala ochiritsira akunja amagwiritsa ntchito makina kunja kwa thupi kuti atumize cheza chaku khansa.

• Njira yothandizira poizoniyu yamkati imagwiritsa ntchito mankhwala a radioactive otsekedwa ndi singano, njere, mawaya, kapena ma catheters omwe amayikidwa mwachindunji kapena pafupi ndi khansa.

Momwe mankhwala a radiation amaperekedwera zimadalira mtundu ndi gawo la khansa yomwe ikuthandizidwa. Thandizo la radiation lakunja limagwiritsidwa ntchito kuchiza khansa ya khansa, ndipo itha kugwiritsidwanso ntchito ngati mankhwala ochepetsa nkhawa kuti muchepetse zizindikiritso ndikukhala ndi moyo wabwino.

Chitetezo chamatenda

Immunotherapy ndi chithandizo chomwe chimagwiritsa ntchito chitetezo cha mthupi cha wodwalayo kuthana ndi khansa. Zinthu zomwe thupi limapanga kapena zopangidwa mu labotale zimagwiritsidwa ntchito kukulitsa, kuwongolera, kapena kubwezeretsa chitetezo chamthupi cha khansa. Chithandizo cha khansa choterechi chimatchedwanso biotherapy kapena biologic therapy.

Mitundu yotsatirayi ya immunotherapy ikugwiritsidwa ntchito pochiza khansa ya khansa:

• Mankhwala oteteza ku chitetezo cha mthupi: Mitundu ina yamaselo amthupi, monga ma T cell, ndi ma cell ena a khansa ali ndi mapuloteni ena, omwe amatchedwa checkpoint protein, kumtunda kwawo omwe amayang'anira kuyankha kwa chitetezo cha mthupi. Maselo a khansa ali ndi mapuloteni ambiri, samenyedwa ndikuphedwa ndi ma T. Chitetezo cha chitetezo cha mthupi chimatseka mapuloteniwa ndipo kuthekera kwa maselo a T kupha ma cell a khansa kumakulitsidwa. Amagwiritsidwa ntchito pochiza odwala ena omwe ali ndi khansa yapakhungu yotupa kapena zotupa zomwe sizingachotsedwe ndi opaleshoni.

Pali mitundu iwiri ya chitetezo cha chitetezo cha mthupi:

• CTLA-4 inhibitor: CTLA-4 ndi mapuloteni pamwamba pa ma T omwe amathandiza kuti chitetezo cha mthupi chitetezedwe. CTLA-4 ikamangirira puloteni ina yotchedwa B7 pa khungu la khansa, imayimitsa T cell kuti isaphe khungu la khansa. CTLA-4 inhibitors amadziphatika ku CTLA-4 ndikulola ma T maselo kupha ma cell a khansa. Ipilimumab ndi mtundu wa CTLA-4 inhibitor.

Chitetezo cha chitetezo cha mthupi. Mapuloteni a checkpoint, monga B7-1 / B7-2 pama cell antigen-presenting cell (APC) ndi CTLA-4 pama cell a T, amathandizira kuteteza mayankho a chitetezo cha mthupi. T-cell receptor (TCR) ikamangirira ku antigen komanso mapuloteni akuluakulu a histocompatibility complex (MHC) pa APC ndi CD28 amamangiriza ku B7-1 / B7-2 pa APC, T cell imatha kuyatsidwa. Komabe, kumangiriza kwa B7-1 / B7-2 mpaka CTLA-4 kumapangitsa kuti ma T maselo akhale osagwira ntchito kotero kuti sangathe kupha ma cell am'mimba mthupi (kumanzere). Kuletsa kumangiriza kwa B7-1 / B7-2 mpaka CTLA-4 yokhala ndi chitetezo cha chitetezo cha mthupi (anti-CTLA-4 antibody) kumalola ma T kuti azitha kugwira ntchito ndikupha ma cell a chotupa (gulu lamanja).

• PD-1 inhibitor: PD-1 ndi mapuloteni pamwamba pa ma T omwe amathandiza kuti chitetezo cha mthupi chitetezedwe. PD-1 ikamangirira puloteni ina yotchedwa PDL-1 pakhungu la khansa, imayimitsa T cell kuti isaphe khungu la khansa. PD-1 inhibitors amadziphatika ku PDL-1 ndikulola ma T maselo kupha ma cell a khansa. Pembrolizumab ndi nivolumab ndi mitundu ya PD-1 inhibitors.

Chitetezo cha chitetezo cha mthupi. Mapuloteni owunika, monga PD-L1 pama cell a chotupa ndi PD-1 pama cell a T, amathandizira kuyang'anira mayankho amthupi. Kumanga kwa PD-L1 mpaka PD-1 kumapangitsa kuti ma T asaphe ma cell am'mimba (gulu lakumanzere). Kuletsa kumangiriza kwa PD-L1 mpaka PD-1 yokhala ndi chitetezo chodzitetezera (anti-PD-L1 kapena anti-PD-1) kumalola ma T maselo kupha ma cell a chotupa (gulu lamanja).

• Interferon: Interferon imakhudza kugawanika kwa maselo a khansa ndipo imatha kuchepetsa kukula kwa chotupa.

• Interleukin-2 (IL-2): IL-2 imathandizira kukula ndi magwiridwe antchito am'magazi ambiri amthupi, makamaka ma lymphocyte (mtundu wa maselo oyera amwazi). Ma lymphocyte amatha kuwononga ndikupha ma cell a khansa.

• Chithandizo cha tumor necrosis factor (TNF): TNF ndi protein yomwe imapangidwa ndi maselo oyera amwazi chifukwa cha antigen kapena matenda. TNF imapangidwa mu labotore ndipo imagwiritsidwa ntchito ngati mankhwala kupha ma cell a khansa. Akuwerengedwa pochiza khansa ya khansa.

Onani Mankhwala Ovomerezeka a Melanoma kuti mumve zambiri.

Chithandizo chofuna

Chithandizo choyenera ndi mtundu wa chithandizo chomwe chimagwiritsa ntchito mankhwala osokoneza bongo kapena zinthu zina kuti ziwononge maselo a khansa. Njira zochiritsira zomwe zimayang'aniridwa sizimavulaza maselo wamba kuposa chemotherapy kapena radiation. Mitundu yotsatirayi imagwiritsidwa ntchito kapena kuphunziridwa pochiza khansa ya khansa:

• Signal transduction inhibitor therapy: Signal transduction inhibitors amaletsa zikwangwani zomwe zimadutsa kuchokera molekyulu imodzi kupita mzake mkati mwa selo. Kuletsa izi kumatha kupha ma cell a khansa. Amagwiritsidwa ntchito pochiza odwala ena omwe ali ndi khansa yapakhungu yotupa kapena zotupa zomwe sizingachotsedwe ndi opaleshoni. Ma Signal transduction inhibitors ndi awa:

• BRAF inhibitors (dabrafenib, vemurafenib, encorafenib) omwe amaletsa zochitika za mapuloteni opangidwa ndi majeremusi a BRAF osinthika; ndipo

• MEK inhibitors (trametinib, cobimetinib, binimetinib) omwe amaletsa mapuloteni otchedwa MEK1 ndi MEK2 omwe amakhudza kukula ndi kupulumuka kwa maselo a khansa.

Kuphatikiza kwa BRAF inhibitors ndi MEK inhibitors omwe amagwiritsidwa ntchito pochiza khansa ya khansa ndi awa:

• Dabrafenib kuphatikiza trametinib.

• Vemurafenib kuphatikiza cobimetinib.

• Encorafenib kuphatikiza binimetinib.

• Oncolytic virus therapy: Mtundu wa mankhwala olimbana nawo omwe amagwiritsidwa ntchito pochiza khansa ya khansa. Oncolytic virus therapy imagwiritsa ntchito kachilombo kamene kamagwira ndikuphwanya maselo a khansa koma osati maselo abwinobwino. Mankhwala a radiation kapena chemotherapy atha kuperekedwa pambuyo pa oncolytic virus therapy kupha ma cell ambiri a khansa. Talimogene laherparepvec ndi mtundu wa mankhwala a oncolytic virus omwe amapangidwa ndi mawonekedwe a herpesvirus omwe asinthidwa mu labotale. Amalowetsedwa mwachindunji m'matumba akhungu ndi ma lymph node.

• Angiogenesis inhibitors: Mtundu wa mankhwala olimbana nawo omwe akuphunziridwa pochiza khansa ya khansa. Angiogenesis inhibitors amalepheretsa kukula kwa mitsempha yatsopano. Pochiza khansa, amatha kuperekedwa kuti ateteze kukula kwa mitsempha yatsopano yomwe zotupa zimayenera kukula.

Njira zatsopano zochiritsira komanso kuphatikiza kwa mankhwala zikuwerengedwa pochiza khansa ya khansa.

Onani Mankhwala Ovomerezeka a Melanoma kuti mumve zambiri.

Mitundu yatsopano yamankhwala ikuyesedwa m'mayesero azachipatala.

Gawo lachiduleli likufotokoza zamankhwala omwe akuwerengedwa m'mayesero azachipatala. Sizingatchule chithandizo chilichonse chatsopano chomwe akuphunzira. Zambiri zamayeso azachipatala zimapezeka patsamba la NCI.

Thandizo la katemera

Chithandizo cha katemera ndi mankhwala a khansa omwe amagwiritsa ntchito chinthu kapena gulu lazinthu zolimbikitsa chitetezo cha mthupi kuti chipeze chotupacho ndikuchipha. Chithandizo cha katemera chikuwerengedwa pochiza siteji yachitatu ya khansa ya khansa yomwe imatha kuchotsedwa ndi opaleshoni.

Chithandizo cha khansa ya pakhungu chingayambitse mavuto.

Kuti mumve zambiri zamankhwala obwera chifukwa cha khansa, onani tsamba lathu la Zotsatira Zotsatira.

Odwala angaganize zopita nawo kukayezetsa.

Kwa odwala ena, kutenga nawo mbali pakuyesa chithandizo chachipatala kungakhale njira yabwino kwambiri yothandizira. Mayesero azachipatala ndi gawo limodzi la kafukufuku wa khansa. Mayesero azachipatala amachitika kuti apeze ngati mankhwala atsopano a khansa ndi otetezeka komanso ogwira ntchito kapena abwinoko kuposa mankhwala wamba.

Njira zambiri zamankhwala zochiritsira khansa zimachokera kumayeso am'mbuyomu azachipatala. Odwala omwe amatenga nawo mbali pachipatala atha kulandira chithandizo chofananira kapena kukhala oyamba kulandira chithandizo chatsopano.

Odwala omwe amatenga nawo mbali pazoyeserera zamankhwala amathandizanso kukonza momwe khansa idzathandizire mtsogolo. Ngakhale mayesero azachipatala satsogolera kuchipatala chatsopano, nthawi zambiri amayankha mafunso ofunikira ndikuthandizira kupititsa patsogolo kafukufuku.

Odwala amatha kulowa m'mayesero azachipatala asanayambe, asanayambe, kapena atayamba kulandira chithandizo cha khansa.

Mayesero ena azachipatala amangophatikizapo odwala omwe sanalandire chithandizo. Mayesero ena amayesa chithandizo kwa odwala omwe khansa yawo sinakhale bwino. Palinso mayesero azachipatala omwe amayesa njira zatsopano zothetsera khansa kuti isabwererenso (kubwerera) kapena kuchepetsa zovuta zoyambitsidwa ndi khansa.

Mayesero azachipatala akuchitika m'malo ambiri mdziko muno. Zambiri zamayeso azachipatala othandizidwa ndi NCI zitha kupezeka patsamba lofufuza zamankhwala la NCI. Mayesero azachipatala othandizidwa ndi mabungwe ena amapezeka patsamba la ClinicalTrials.gov.

Mayeso otsatirawa angafunike.

Ena mwa mayesero omwe adachitika kuti apeze khansa kapena kuti adziwe momwe khansa iliri angabwerezedwenso. Mayesero ena adzabwerezedwa kuti awone momwe mankhwalawa akugwirira ntchito. Zisankho zakuti mupitilize, kusintha, kapena kusiya kulandira chithandizo zitha kutengera zotsatira za mayeso awa.

Kuyesaku kumangopitilira kuchitika nthawi ndi nthawi mankhwala atatha. Zotsatira zamayesowa zitha kuwonetsa ngati vuto lanu lasintha kapena ngati khansa yabwereranso (bwererani). Mayesowa nthawi zina amatchedwa kuyesa kutsata kapena kukayezetsa.

Njira Zothandizira ndi Gawo

M'chigawo chino

• Gawo 0 (Melanoma mu Situ)

• Gawo I Melanoma

• Gawo II Melanoma

• Gawo lachitatu la khansa ya khansa yomwe ingathetsedwe ndi opaleshoni

• Gawo Lachitatu la Melanoma lomwe Silingachotsedwe ndi Opaleshoni, Gawo IV Melanoma, ndi Melanoma Wowonekera

Kuti mumve zambiri zamankhwala omwe atchulidwa pansipa, onani gawo la Chisankho Chachidule.

Gawo 0 (Melanoma mu Situ)

Kuchiza kwa gawo 0 nthawi zambiri kumachitidwa opareshoni kuti muchotse maselo achilendo ndi minofu yaying'ono yozungulira.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Gawo I Melanoma

Chithandizo cha siteji ya khansa ya khansa ikhoza kukhala ndi izi:

• Opaleshoni yochotsa chotupacho ndi zina mwazomwe zimazungulira. Nthawi zina mapu am'mapapo am'mimba amachotsa ma lymph node amachitidwanso.

• Kuyesedwa kwachipatala kwa njira zatsopano zopezera ma cell a khansa muma lymph node.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Gawo II Melanoma

Chithandizo cha siteji yachiwiri ya khansa ya khansa ingaphatikizepo izi:

• Opaleshoni yochotsa chotupacho ndi zina mwazomwe zimazungulira. Nthawi zina mapu a lymph node ndi ma sentinel lymph node biopsy amachitidwa kuti aone ngati ali ndi khansa m'matumba am'mimba munthawi yomweyo opaleshoni yochotsa chotupacho. Ngati khansa imapezeka mu sentinel lymph node, ma lymph node ambiri amatha kuchotsedwa.

• Opaleshoni yotsatiridwa ndi immunotherapy ndi interferon ngati pali chiopsezo chachikulu kuti khansayo ibwerera.

• Kuyesedwa kwamankhwala kwamitundu yatsopano yamankhwala yomwe ingagwiritsidwe ntchito atachitidwa opaleshoni.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Gawo lachitatu la khansa ya khansa yomwe ingathetsedwe ndi opaleshoni

Chithandizo cha siteji yachitatu ya khansa ya khansa yomwe ingachotsedwe ndi opaleshoni ingaphatikizepo izi:

• Opaleshoni yochotsa chotupacho ndi zina mwazomwe zimazungulira. Kulumikiza khungu kumatha kuchitidwa kuti aphimbe chilonda choyambitsidwa. Nthawi zina mapu a lymph node ndi ma sentinel lymph node biopsy amachitidwa kuti aone ngati ali ndi khansa m'matumba am'mimba munthawi yomweyo opaleshoni yochotsa chotupacho. Ngati khansa imapezeka mu sentinel lymph node, ma lymph node ambiri amatha kuchotsedwa.

• Opaleshoni yotsatiridwa ndi immunotherapy ndi nivolumab, ipilimumab, kapena interferon ngati pali chiopsezo chachikulu kuti khansayo ibwerera.

• Opaleshoni yotsatiridwa ndi mankhwala omwe ali ndi dabrafenib ndi trametinib ngati pali chiopsezo chachikulu kuti khansayo ibwerera.

• Kuyesedwa kwachipatala kwa immunotherapy kapena popanda katemera.

• Kuyesedwa kwachipatala kwa opaleshoni komwe kumatsatiridwa ndi mankhwala omwe amayang'ana kusintha kwa majini.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Gawo Lachitatu la Melanoma lomwe Silingachotsedwe ndi Opaleshoni, Gawo IV Melanoma, ndi Melanoma Wowonekera

Chithandizo cha gawo lachitatu la khansa ya khansa yomwe singachotsedwe ndi opaleshoni, khansa ya khansa ya khansa ya IV, komanso khansa yapakhungu yapawokha ikhoza kuphatikiza izi:

• Oncolytic virus therapy (talimogene laherparepvec) jekeseni mu chotupacho.

• Immunotherapy ndi ipilimumab, pembrolizumab, nivolumab, kapena interleukin-2 (IL-2). Nthawi zina ipilimumab ndi nivolumab amaperekedwa limodzi.

• Chithandizo chotsata ndi ma transhibitction inhibitors (dabrafenib, trametinib, vemurafenib, cobimetinib, encorafenib, binimetinib). Izi

itha kuperekedwa yokha kapena kuphatikiza.

• Chemotherapy.

• Thandizo lothandizira kuti muchepetse matenda komanso kusintha moyo wabwino. Izi zingaphatikizepo:

• Kuchita opaleshoni kuchotsa ma lymph node kapena zotupa m'mapapo, m'mimba, m'mimba, m'mafupa, kapena muubongo.

• Thandizo la radiation kuubongo, msana, kapena fupa.

Mankhwala omwe akuwerengedwa m'mayesero azachipatala a gawo lachitatu la khansa ya khansa yomwe singachotsedwe ndi opaleshoni, khansa ya khansa ya khansa ya IV, komanso khansa yapakhungu yapawirayi ndi iyi:

• Immunotherapy yokha kapena kuphatikiza mankhwala ena monga othandizira.

• Kwa khansa ya khansa yomwe yafalikira kuubongo, immunotherapy ndi nivolumab kuphatikiza ipilimumab.

• Njira zochiritsira, monga ma transduction inhibitors, angiogenesis inhibitors, oncolytic virus therapy, kapena mankhwala omwe amakhudza kusintha kwa majini. Izi zitha kuperekedwa zokha kapena kuphatikiza.

• Opaleshoni yochotsa khansa yonse yodziwika.

• Regional chemotherapy (hyperthermic yokhayokha kupangika kwamiyendo). Odwala ena amathanso kukhala ndi immunotherapy yokhala ndi chotupa necrosis factor.

• Chemotherapy yokhazikika.

Gwiritsani ntchito kusaka kwathu kwamankhwala kuti mupeze mayesero azachipatala omwe amathandizidwa ndi NCI omwe akulandira odwala. Mutha kusaka mayesero kutengera mtundu wa khansa, zaka za wodwalayo, komanso komwe mayeserowo akuchitika. Zambiri pazokhudza mayesero azachipatala zimapezekanso.

Kuti mudziwe zambiri za khansa ya pakhungu

Kuti mumve zambiri kuchokera ku National Cancer Institute yokhudzana ndi khansa ya khansa, onani izi:

• Khansa Yapakhungu (Kuphatikiza Melanoma) Tsamba Loyambira

• Kupewa Khansa Yapakhungu

• Kuwunika Khansa Yapakhungu

• Sentinel Lymph Node Zolemba

• Mankhwala Ovomerezeka a Melanoma

• Immunotherapy Kuchiza Khansa

• Njira Zochizira Khansa

• Moles to Melanoma: Kuzindikira Makhalidwe a ABCDE

Kuti mumve zambiri za khansa ndi zinthu zina zochokera ku National Cancer Institute, onani izi:

• Za Khansa

• Kusinthana

• Chemotherapy and You: Kuthandiza Anthu Omwe Ali Ndi Khansa

• Thandizo la Radiation ndi Inu: Thandizo kwa Anthu Omwe Ali ndi Khansa

• Kulimbana ndi khansa

• Mafunso oti mufunse dokotala wanu za khansa

• Kwa Opulumuka ndi Owasamalira