Types/skin/patient/melanoma-treatment-pdq

Umuti wa Melanoma

Amakuru Rusange Yerekeye Melanoma

INGINGO Z'INGENZI

• Melanoma n'indwara ingirabuzimafatizo (kanseri) zikora muri melanocytes (selile zisiga uruhu).

• Hariho ubwoko butandukanye bwa kanseri butangirira kuruhu.

• Melanoma irashobora kugaragara ahantu hose kuruhu.

• Ibibyimba bidasanzwe, guhura nizuba ryizuba, namateka yubuzima birashobora kugira ingaruka kuri melanoma.

• Ibimenyetso bya melanoma harimo impinduka muburyo mole cyangwa pigmented igaragara.

• Ibizamini bisuzuma uruhu bikoreshwa mugushakisha (gushakisha) no gusuzuma melanoma.

• Ibintu bimwe bigira ingaruka kubitekerezo (amahirwe yo gukira) hamwe nuburyo bwo kuvura.

Melanoma n'indwara ingirabuzimafatizo (kanseri) zikora muri melanocytes (selile zisiga uruhu).

Uruhu ni urugingo runini rwumubiri. Irinda ubushyuhe, urumuri rw'izuba, gukomeretsa, no kwandura. Uruhu rufasha kandi kugenzura ubushyuhe bwumubiri kandi rukabika amazi, ibinure, na vitamine D. Uruhu rufite ibice byinshi, ariko ibice bibiri byingenzi ni epidermis (urwego rwo hejuru cyangwa hanze) na dermisi (hasi cyangwa imbere). Kanseri y'uruhu itangirira muri epidermis, igizwe n'ubwoko butatu bw'uturemangingo:

• Utugingo ngengabuzima: Utugingo duto, uturemangingo tugize urwego rwo hejuru rwa epidermis.

• Utugingo ngengabuzima: Utugingo ngengabuzima munsi ya selile.

• Melanocytes: Ingirabuzimafatizo zikora melanine kandi ziboneka mu gice cyo hepfo ya epidermis. Melanin ni pigment iha uruhu ibara ryarwo. Iyo uruhu ruhuye nizuba cyangwa urumuri rwubukorikori, melanocytes ikora pigment nyinshi kandi igatera uruhu kwijimye.

Umubare w'indwara nshya za melanoma wagiye wiyongera mu myaka 30 ishize. Melanoma ikunze kugaragara mu bantu bakuru, ariko rimwe na rimwe iboneka mu bana ndetse n'ingimbi. (Reba incamake ya kuri Kanseri idasanzwe yo kuvura abana kugirango umenye amakuru menshi kuri melanoma mubana ningimbi.)

Anatomy y'uruhu, yerekana epidermis, dermis, hamwe nuduce duto duto. Melanocytes iri murwego rwa selile zifatizo mugice cyimbitse cya epidermis.

Hariho ubwoko butandukanye bwa kanseri butangirira kuruhu. Hariho uburyo bubiri nyamukuru bwa kanseri yuruhu: melanoma na nonmelanoma.

Melanoma ni uburyo budasanzwe bwa kanseri y'uruhu. Birashoboka cyane gutera ingirangingo zegeranye no gukwirakwira mu bindi bice byumubiri kuruta ubundi bwoko bwa kanseri yuruhu. Iyo melanoma itangiriye mu ruhu, yitwa cutaneous melanoma. Melanoma irashobora kandi kugaragara mumyanya ndangagitsina (ibice bito, bitose byumubiri bitwikiriye ubuso nkiminwa). Iyi ncamake ya ivuga kubyerekeye melanoma ya cutaneous (uruhu) na melanoma igira ingaruka kumitsi.

Ubwoko bwa kanseri y'uruhu ikunze kugaragara ni kanseri y'ibanze ya kanseri na kanseri y'udukoko. Ni kanseri y'uruhu nonmelanoma. Kanseri y'uruhu ya Nonmelanoma ni gake ikwirakwira mu bindi bice by'umubiri. (Reba incamake ya ku Kuvura Kanseri y'uruhu kugira ngo umenye amakuru menshi kuri selile y'ibanze na kanseri y'uruhu rwa selile.)

Melanoma irashobora kugaragara ahantu hose kuruhu. Ku bagabo, melanoma ikunze kuboneka ku gihimba (agace kuva ku bitugu kugeza ku kibuno) cyangwa umutwe n'ijosi. Mu bagore, melanoma ikora cyane kumaboko n'amaguru.

Iyo melanoma ibaye mu jisho, yitwa intraocular cyangwa ocular melanoma. (Reba incamake ya kubuvuzi bwa Intraocular (Uveal) Melanoma kubindi bisobanuro.)

Ibibyimba bidasanzwe, guhura nizuba ryizuba, namateka yubuzima birashobora kugira ingaruka kuri melanoma.

Ikintu cyose cyongera ibyago byo kwandura byitwa impanuka. Kugira ibintu bishobora guteza ibyago ntibisobanura ko uzarwara kanseri; kutagira ibyago bishobora gusobanura ko utazarwara kanseri. Vugana na muganga wawe niba utekereza ko ushobora guhura n'akaga.

Impamvu zishobora gutera melanoma zirimo ibi bikurikira:

• Kugira isura nziza, ikubiyemo ibi bikurikira:

• Uruhu rwiza ruvunika kandi rwaka byoroshye, ntiruhumeka, cyangwa kubyina nabi.

• Ubururu cyangwa icyatsi cyangwa andi maso yijimye.

• Umusatsi utukura cyangwa umuhondo.

• Guhura nizuba ryizuba cyangwa urumuri rwizuba (nko kuva kuburiri bwigitanda).
• Guhura nibintu bimwe mubidukikije (mukirere, urugo rwawe cyangwa aho ukorera, n'ibiryo byawe n'amazi). Bimwe mubintu byangiza ibidukikije kuri melanoma ni imirasire, umusemburo, vinyl chloride, na PCBs.

• Kugira amateka yizuba ryinshi cyane, nkumwana cyangwa ingimbi.

• Kugira ibinini byinshi cyangwa byinshi bito.

• Kugira amateka yumuryango wimitsi idasanzwe (syndrome ya nevus idasanzwe).

• Kugira umuryango cyangwa amateka yihariye ya melanoma.

• Kuba umweru.

• Kugira intege nke z'umubiri.

• Kugira impinduka zimwe muri gen zifitanye isano na melanoma.

Kuba umweru cyangwa kugira isura nziza byongera ibyago bya melanoma, ariko umuntu wese arashobora kugira melanoma, harimo nabantu bafite uruhu rwijimye.

Reba incamake ya ikurikira kugirango ubone ibisobanuro birambuye kubintu bishobora gutera melanoma:

• Imiterere ya Kanseri y'uruhu

• Kwirinda Kanseri y'uruhu

Ibimenyetso bya melanoma harimo impinduka muburyo mole cyangwa pigmented igaragara.

Ibi nibindi bimenyetso nibimenyetso bishobora guterwa na melanoma cyangwa nibindi bihe. Menyesha umuganga wawe niba ufite kimwe muri ibi bikurikira:

• Uruhare ngo:

• impinduka mubunini, imiterere, cyangwa ibara.

• ifite impande zidasanzwe cyangwa imipaka.

• ni Birenze Ibara.

• ni asimmetrical (niba mole igabanijwemo kabiri, ibice 2 bitandukanye mubunini cyangwa imiterere).

• itch.

• oozes, kuva amaraso, cyangwa ni ibisebe (umwobo uba muruhu mugihe urwego rwo hejuru rwingirabuzimafatizo zimenetse kandi tissue ikurikira irerekana).

• Guhindura uruhu rwibara (amabara).

• Umuyoboro wa satelite (mole nshya ikura hafi ya mole ihari).

Kumashusho nibisobanuro bya mole na melanoma, reba Moles Rusange, Dysplastic Nevi, na Risk ya Melanoma.

Ibizamini bisuzuma uruhu bikoreshwa mugushakisha (gushakisha) no gusuzuma melanoma.

Niba agace kamwe cyangwa ibara ryuruhu ruhindutse cyangwa rusa nkibidasanzwe, ibizamini nuburyo bukurikira birashobora gufasha kubona no gusuzuma melanoma:

• Ikizamini cyumubiri namateka yubuzima: Ikizamini cyumubiri kugirango ugenzure ibimenyetso rusange byubuzima, harimo no gusuzuma ibimenyetso byindwara, nkibibyimba cyangwa ikindi kintu cyose gisa nkidasanzwe. Hazafatwa kandi amateka yubuzima bwumurwayi nindwara zashize hamwe nubuvuzi.

• Ikizamini cyuruhu : Muganga cyangwa umuforomo asuzuma uruhu rwimitsi, ibimenyetso byavutse, cyangwa ahandi hantu hagizwe nibibara bisa nibidasanzwe mumabara, ubunini, imiterere, cyangwa imiterere.

• Biopsy: Uburyo bwo gukuraho ingirangingo zidasanzwe hamwe nuduce duto duto dusanzwe tuyikikije. Inzobere mu bijyanye n’indwara ireba tissue munsi ya microscope kugirango isuzume selile. Birashobora kugorana kuvuga itandukaniro riri hagati ya mole yamabara na melanoma kare. Abarwayi barashobora kwipimisha icyitegererezo cya tissue yagenzuwe na patologue wa kabiri. Niba mole cyangwa ibisebe bidasanzwe ari kanseri, icyitegererezo cya tissue nacyo gishobora gupimwa kugirango hahindurwe gene.

Hariho ubwoko bune bwingenzi bwibinyabuzima byuruhu. Ubwoko bwa biopsy bwakozwe biterwa nubuso budasanzwe bwakozwe nubunini bwakarere.

• Kogosha biopsy: Urwembe rudasanzwe rukoreshwa mu "kogosha" imikurire idasanzwe.

• Punch biopsy: Igikoresho kidasanzwe cyitwa punch cyangwa trephine gikoreshwa mugukuraho uruziga rwimitsi kumikurire idasanzwe.

Gukubita biopsy. Scalpel yuzuye, izenguruka ikoreshwa mugukata igikomere kuruhu. Igikoresho gihindurwamo amasaha nisaha kugirango ugabanye milimetero 4 (mm) kugeza kurwego rwamavuta yibinure munsi ya dermis. Icyitegererezo gito cya tissue gikurwaho kugirango kigenzurwe munsi ya microscope. Ubunini bwuruhu buratandukanye kubice bitandukanye byumubiri.

• Biopsy incisional: Scalpel ikoreshwa mugukuraho igice cyo gukura.

• Biopsy idasanzwe: Scalpel ikoreshwa mugukuraho imikurire yose.

Ibintu bimwe bigira ingaruka kubitekerezo (amahirwe yo gukira) hamwe nuburyo bwo kuvura.

Kumenyekanisha (amahirwe yo gukira) hamwe nuburyo bwo kuvura biterwa nibi bikurikira:

• Umubyimba w'ikibyimba n'aho uri mu mubiri.

• Ukuntu ingirabuzimafatizo za kanseri zigabanuka vuba.

• Haba kuva amaraso cyangwa ibisebe byikibyimba.

• Ni kanseri ingahe muri lymph node.

• Umubare wa kanseri yakwirakwiriye mu mubiri.

• Urwego rwa lactate dehydrogenase (LDH) mumaraso.

• Niba kanseri ifite ihinduka (ihinduka) muri gene yitwa BRAF.

• Imyaka yumurwayi nubuzima rusange.

Icyiciro cya Melanoma

INGINGO Z'INGENZI

• Melanoma imaze gupimwa, hashobora gukorwa ibizamini kugirango hamenyekane niba kanseri ya kanseri yakwirakwiriye mu ruhu cyangwa mu bindi bice by'umubiri.

• Hariho uburyo butatu kanseri ikwirakwira mu mubiri.

• Kanseri irashobora gukwirakwira aho yatangiriye no mu bindi bice byumubiri.

• Icyiciro cya melanoma giterwa n'ubunini bw'ikibyimba, niba kanseri yarakwirakwiriye mu mitsi cyangwa mu bindi bice by'umubiri, n'ibindi bintu.

• Ibyiciro bikurikira bikoreshwa kuri melanoma:

• Icyiciro 0 (Melanoma muri Situ)

• Icyiciro I.

• Icyiciro cya II

• Icyiciro cya III

• Icyiciro cya IV

Melanoma imaze gupimwa, hashobora gukorwa ibizamini kugirango hamenyekane niba kanseri ya kanseri yakwirakwiriye mu ruhu cyangwa mu bindi bice by'umubiri.

Inzira ikoreshwa mu kumenya niba kanseri yarakwirakwiriye mu ruhu cyangwa mu bindi bice by'umubiri byitwa guterana. Amakuru yakusanyirijwe mubikorwa byateguwe agena icyiciro cyindwara. Ni ngombwa kumenya icyiciro kugirango utegure kuvura.

Kuri melanoma idashoboka gukwirakwira mubindi bice byumubiri cyangwa kwisubiramo, ibizamini byinshi ntibishobora gukenerwa. Kuri melanoma ishobora gukwirakwira mu bindi bice byumubiri cyangwa ikagaruka, ibizamini nuburyo bukurikira birashobora gukorwa nyuma yo kubagwa kugirango bakure melanoma:

• Lymph node mapping na sentinel lymph node biopsy: Gukuraho lymph node ya sentinel mugihe cyo kubagwa. Sentinel lymph node niyambere ya lymph node mumatsinda ya lymph node yakira amazi ya lymphatique ava mubyimba byambere. Nibwo bwa mbere lymph node kanseri ishobora gukwirakwira kuva ikibyimba kibanza. Ikintu gikoresha radiyo na / cyangwa irangi ry'ubururu batewe inshinge hafi yikibyimba. Ibintu cyangwa irangi bitembera mumiyoboro ya lymph node. Lymph ya mbere yakira ibintu cyangwa irangi bivanwaho. Inzobere mu bijyanye n’indwara ireba tissue munsi ya microscope kugirango ishakishe selile. Niba kanseri ya kanseri itabonetse, ntibishobora kuba ngombwa gukuraho izindi lymph node. Rimwe na rimwe, lymph node ya sentinel iboneka mumatsinda arenze imwe.

• CT scan (CAT scan): Uburyo bukora urukurikirane rwamashusho arambuye yibice byimbere mumubiri byafashwe muburyo butandukanye. Amashusho yakozwe na mudasobwa ihujwe na mashini ya x-ray. Irangi rishobora guterwa mumitsi cyangwa kumirwa kugirango bifashe ingingo cyangwa ingirangingo kugaragara neza. Ubu buryo kandi bwitwa computing tomografiya, tomografiya ya mudasobwa, cyangwa mudasobwa ya axial tomografiya. Kuri melanoma, amashusho arashobora gufatwa mwijosi, igituza, inda, nigitereko.

• PET scan (positron emission tomografi scan): Uburyo bwo kubona selile mbi yibibyimba mumubiri. Umubare muto wa glucose ikora radio (isukari) yatewe mumitsi. PET scaneri izenguruka umubiri kandi ikora ishusho yerekana aho glucose ikoreshwa mumubiri. Utugingo ngengabuzima twibibyimba twerekana neza cyane ku ishusho kuko zikora cyane kandi zifata glucose nyinshi kuruta selile zisanzwe.

• MRI . Ikintu cyitwa gadolinium cyatewe mumitsi. Gadolinium ikusanyiriza hafi ya kanseri ya kanseri kugirango igaragare neza ku ishusho. Ubu buryo bwitwa kandi magnetic magnetic resonance imaging (NMRI).

• Ikizamini cya Ultrasound: Uburyo bukoreshwa mu majwi y’amajwi menshi (ultrasound) asohoka mu ngingo zimbere, nka lymph node, cyangwa ingingo kandi bigasubiramo. Ijwi ryerekana ishusho yumubiri wumubiri witwa sonogram. Ishusho irashobora gucapurwa kugirango irebe nyuma.

• Ubushakashatsi bwa chimie yamaraso: Uburyo bwo gusuzuma urugero rwamaraso kugirango bapime urugero rwibintu bimwe na bimwe bisohoka mumaraso ningingo nuduce twumubiri. Kuri melanoma, amaraso asuzumwa enzyme yitwa lactate dehydrogenase (LDH). Urwego rwo hejuru rwa LDH rushobora guhanura uburyo budakira bwo kuvura abarwayi bafite indwara ziterwa na metastique.

Ibisubizo by'ibi bizamini bireba hamwe n'ibisubizo bya biopsy y'ibibyimba kugirango umenye icyiciro cya melanoma.

Hariho uburyo butatu kanseri ikwirakwira mu mubiri.

Kanseri irashobora gukwirakwira binyuze mu ngingo, sisitemu ya lymph, n'amaraso:

• Tissue. Kanseri ikwirakwira aho yatangiriye ikurira mu turere twegereye.

• Sisitemu ya Lymph. Kanseri ikwirakwira aho yatangiriye yinjira muri sisitemu ya lymph. Kanseri inyura mu mitsi ya lymph igana mu bindi bice by'umubiri.

• Amaraso. Kanseri ikwirakwira aho yatangiriye yinjira mu maraso. Kanseri inyura mu mitsi y'amaraso igana mu bindi bice by'umubiri.

Kanseri irashobora gukwirakwira aho yatangiriye no mu bindi bice byumubiri.

Iyo kanseri ikwirakwira mu kindi gice cy'umubiri, yitwa metastasis. Ingirabuzimafatizo za kanseri zitandukana aho zatangiriye (ikibyimba kibanza) zikanyura muri sisitemu ya lymph cyangwa maraso.

Sisitemu ya Lymph. Kanseri yinjira muri sisitemu ya lymph, ikanyura mu mitsi ya lymph, igakora ikibyimba (ikibyimba metastatike) mu kindi gice cy'umubiri.

Amaraso. Kanseri yinjira mu maraso, ikanyura mu mitsi y'amaraso, igakora ikibyimba (ikibyimba metastatike) mu kindi gice cy'umubiri. Ikibyimba metastatike nubwoko bumwe bwa kanseri nkibibyimba byibanze. Kurugero, niba melanoma ikwirakwira mu bihaha, kanseri ya kanseri mu bihaha ni selile melanoma. Indwara ni metanatike melanoma, ntabwo ari kanseri y'ibihaha.

Icyiciro cya melanoma giterwa n'ubunini bw'ikibyimba, niba kanseri yarakwirakwiriye mu mitsi cyangwa mu bindi bice by'umubiri, n'ibindi bintu.

Kugirango umenye icyiciro cya melanoma, ikibyimba kivanyweho burundu kandi hafi ya lymph node isuzumwa ibimenyetso bya kanseri. Icyiciro cya kanseri gikoreshwa mukumenya uburyo bwiza bwo kuvura. Menyesha muganga wawe kugirango umenye icyiciro cya kanseri ufite.

Icyiciro cya melanoma biterwa nibi bikurikira:

• Umubyimba w'ikibyimba. Ubunini bwikibyimba bupimirwa hejuru yuruhu kugeza igice cyimbitse cyikibyimba.

• Niba ikibyimba cyakomeretse (cyacitse mu ruhu).

• Niba kanseri iboneka muri lymph node ikizamini cyumubiri, ibizamini byerekana amashusho, cyangwa biopsy ya sentinel.

• Niba lymph node ihujwe (ihujwe hamwe).

• Niba hari:

• Ibibyimba bya satelite: Amatsinda mato ya selile yibibyimba yakwirakwije muri santimetero 2 z'ikibyimba kibanza.

• Ibibyimba bya Microsatellite: Amatsinda mato ya selile yibibyimba yakwirakwiriye ahantu hafi cyangwa munsi yibibyimba byibanze.

• In-transit metastase: Ibibyimba byakwirakwiriye mu mitsi ya lymph mu ruhu hejuru ya santimetero 2 uvuye ku kibyimba kibanza, ariko ntigere kuri lymph node.

• Niba kanseri yarakwirakwiriye mu bindi bice by'umubiri, nk'ibihaha, umwijima, ubwonko, ingirangingo zoroshye (harimo n'imitsi), inzira ya gastrointestinal, na / cyangwa lymph node ya kure. Kanseri irashobora gukwirakwira ahantu h'uruhu kure cyane y'aho yatangiriye.

Ibyiciro bikurikira bikoreshwa kuri melanoma:

Icyiciro 0 (Melanoma muri Situ)

Mu cyiciro cya 0, melanocytes idasanzwe iboneka muri epidermis. Iyi melanocytes idasanzwe irashobora guhinduka kanseri igakwirakwira mubice bisanzwe. Icyiciro 0 nacyo cyitwa melanoma mumwanya.

Icyiciro I.

Mu cyiciro cya I, kanseri yarakozwe. Icyiciro cya I kigabanyijemo ibyiciro IA na IB.

Millimetero (mm). Ikaramu ikarishye igera kuri mm 1, ingingo nshya ya crayon igera kuri mm 2, naho gusiba ikaramu nshya ni mm 5.

• Icyiciro cya IA: Ikibyimba ntikirenza milimetero 1 z'ubugari, hamwe cyangwa nta bisebe.

• Icyiciro IB: Ikibyimba kirenze 1 ariko ntikirenza milimetero 2, nta gisebe.

Icyiciro cya II

Icyiciro cya II kigabanyijemo ibyiciro IIA, IIB, na IIC.

• Icyiciro cya IIA: Ikibyimba ni:

• kurenza 1 ariko ntibirenze milimetero 2 z'ubugari, hamwe n'ibisebe; cyangwa

• birenze 2 ariko ntibirenze milimetero 4 z'ubugari, nta ibisebe.

• Icyiciro cya IIB: Ikibyimba ni:

• kurenza 2 ariko ntibirenze milimetero 4 z'ubugari, hamwe n'ibisebe; cyangwa

• hejuru ya milimetero 4 z'ubugari, nta ibisebe.

• Icyiciro cya IIC: Ikibyimba kirenze milimetero 4 z'ubugari, hamwe n'ibisebe.

Icyiciro cya III

Icyiciro cya III kigabanyijemo ibyiciro IIIA, IIIB, IIIC, na IIID.

• Icyiciro cya IIIA: Ikibyimba ntikirenza milimetero 1 z'ubugari, hamwe n'ibisebe, cyangwa ntibirenze milimetero 2 z'ubugari, nta gisebe. Kanseri iboneka muri lymph node 1 kugeza 3 na sentinel lymph node biopsy.

• Icyiciro cya IIIB:

(1) Ntabwo bizwi aho kanseri yatangiriye cyangwa ikibyimba cyibanze ntigishobora kugaragara, kandi kimwe muribi gikurikira nukuri:

• kanseri iboneka muri 1 lymph node ikizamini cyumubiri cyangwa ibizamini byerekana amashusho; cyangwa

• hari ibibyimba bya microsatellite, ibibyimba bya satelite, na / cyangwa muri transit metastase kuri cyangwa munsi yuruhu.

cyangwa

(2) Ikibyimba ntikirenza milimetero 1 z'ubugari, hamwe n'ibisebe, cyangwa ntibirenze milimetero 2 z'ubugari, nta bisebe, kandi kimwe muri ibi bikurikira ni ukuri:

• kanseri iboneka muri lymph node 1 kugeza kuri 3 ukoresheje ibizamini byumubiri cyangwa ibizamini byerekana amashusho; cyangwa

• hari ibibyimba bya microsatellite, ibibyimba bya satelite, na / cyangwa muri transit metastase kuri cyangwa munsi yuruhu.

cyangwa

.

• kanseri iboneka muri lymph 1 kugeza 3; cyangwa

• hari ibibyimba bya microsatellite, ibibyimba bya satelite, na / cyangwa muri transit metastase kuri cyangwa munsi yuruhu.

• Icyiciro cya IIIC:

(1) Ntabwo bizwi aho kanseri yatangiriye, cyangwa ikibyimba cyibanze ntigishobora kuboneka. Kanseri iboneka:

• muri lymph 2 cyangwa 3; cyangwa

• muri lymph node 1 kandi hari ibibyimba bya microsatellite, ibibyimba bya satelite, na / cyangwa muri transit metastase kuri cyangwa munsi yuruhu; cyangwa

• muri lymph 4 cyangwa nyinshi, cyangwa mumibare iyo ari yo yose ya lymph node ihujwe hamwe; cyangwa

• muri 2 cyangwa byinshi bya lymph node na / cyangwa mumibare iyo ari yo yose ya lymph node ihujwe hamwe. Hariho ibibyimba bya microsatellite, ibibyimba bya satelite, na / cyangwa muri transit metastase kuri cyangwa munsi yuruhu.

cyangwa

(2) Ikibyimba ntikirenza milimetero 2 z'ubugari, gifite cyangwa kidafite ibisebe, cyangwa ntibirenze milimetero 4 z'ubugari, nta gisebe. Kanseri iboneka:

• muri lymph node 1 kandi hari ibibyimba bya microsatellite, ibibyimba bya satelite, na / cyangwa muri transit metastase kuri cyangwa munsi yuruhu; cyangwa

• muri lymph 4 cyangwa nyinshi, cyangwa mumibare iyo ari yo yose ya lymph node ihujwe hamwe; cyangwa

• muri 2 cyangwa byinshi bya lymph node na / cyangwa mumibare iyo ari yo yose ya lymph node ihujwe hamwe. Hariho ibibyimba bya microsatellite, ibibyimba bya satelite, na / cyangwa muri transit metastase kuri cyangwa munsi yuruhu.

cyangwa

(3) Ikibyimba kirenze 2 ariko ntikirenza milimetero 4 z'ubugari, gifite ibisebe, cyangwa uburebure bwa milimetero 4, nta gisebe. Kanseri iboneka muri 1 cyangwa nyinshi ya lymph node na / cyangwa mumibare iyo ari yo yose ya lymph node ihujwe hamwe. Hashobora kubaho ibibyimba bya microsatellite, ibibyimba bya satelite, hamwe na / cyangwa muri transit metastase kuruhu cyangwa munsi yuruhu.

cyangwa

(4) Ikibyimba kirenze milimetero 4 z'ubugari, hamwe n'ibisebe. Kanseri iboneka muri 1 cyangwa nyinshi ya lymph node kandi / cyangwa hariho ibibyimba bya microsatellite, ibibyimba bya satelite, na / cyangwa metastase muri transitase cyangwa munsi yuruhu.

• Icyiciro cya IIID: Ikibyimba kirenze milimetero 4 z'ubugari, hamwe n'ibisebe. Kanseri iboneka:

• muri lymph 4 cyangwa nyinshi, cyangwa mumibare iyo ari yo yose ya lymph node ihujwe hamwe; cyangwa

• muri 2 cyangwa byinshi bya lymph node na / cyangwa mumibare iyo ari yo yose ya lymph node ihujwe hamwe. Hariho ibibyimba bya microsatellite, ibibyimba bya satelite, na / cyangwa muri transit metastase kuri cyangwa munsi yuruhu.

Icyiciro cya IV

Mu cyiciro cya IV, kanseri yakwirakwiriye mu bindi bice by'umubiri, nk'ibihaha, umwijima, ubwonko, uruti rw'umugongo, amagufwa, ingirangingo zoroshye (harimo imitsi), gastrointestinal (GI), na / cyangwa lymph node ya kure. Kanseri ishobora kuba yarakwirakwiriye ahantu h'uruhu kure cyane y'aho yatangiriye.

Melanoma

Melanoma isubirwamo ni kanseri yagarutse (garuka) imaze kuvurwa. Kanseri irashobora kugaruka mu gace yatangiriye bwa mbere cyangwa mu bindi bice by'umubiri, nk'ibihaha cyangwa umwijima.

Incamake yo kuvura

INGINGO Z'INGENZI

• Hariho uburyo butandukanye bwo kuvura abarwayi bafite melanoma.

• Ubwoko butanu bwo kuvura busanzwe bukoreshwa:

• Kubaga

• Chimoterapi

• Imiti ivura imirasire

• Immunotherapy

• Ubuvuzi bugamije

• Ubwoko bushya bwo kuvura burimo kugeragezwa mubigeragezo byamavuriro.

• Ubuvuzi bw'inkingo

• Umuti wa melanoma urashobora gutera ingaruka.

• Abarwayi barashobora kwifuza gutekereza kubijyanye no kwipimisha kwa muganga.

• Abarwayi barashobora kwipimisha kwa muganga mbere, mugihe, cyangwa nyuma yo gutangira kuvura kanseri.

• Ibizamini byo gukurikirana birashobora gukenerwa.

Hariho uburyo butandukanye bwo kuvura abarwayi bafite melanoma.

Ubwoko butandukanye bwo kuvura burahari kubarwayi barwaye melanoma. Bumwe mu buryo busanzwe (ubuvuzi bukoreshwa ubu), kandi bumwe burimo kugeragezwa mubigeragezo byamavuriro. Ikigeragezo kivura ni ubushakashatsi bwakozwe bugamije gufasha kunoza imiti igezweho cyangwa kubona amakuru ku buvuzi bushya ku barwayi ba kanseri. Iyo ibizamini byo kwa muganga byerekana ko ubuvuzi bushya buruta ubuvuzi busanzwe, ubuvuzi bushya bushobora kuba ubuvuzi busanzwe. Abarwayi barashobora kwifuza gutekereza kubijyanye no kwipimisha kwa muganga. Ibigeragezo bimwe na bimwe bivura abarwayi batatangiye kwivuza.

Ubwoko butanu bwo kuvura busanzwe bukoreshwa:

Kubaga

Kubaga kugirango ukureho ikibyimba nubuvuzi bwibanze bwa melanoma. Igice kinini cyaho gikoreshwa mugukuraho melanoma hamwe na tissue zimwe zisanzwe ziyikikije. Guhuza uruhu (gufata uruhu mu kindi gice cyumubiri kugirango usimbuze uruhu rwavanyweho) birashobora gukorwa kugirango uhishe igikomere cyatewe no kubagwa.

Rimwe na rimwe, ni ngombwa kumenya niba kanseri yarakwirakwiriye. Lymph node mapping na sentinel lymph node biopsy ikorwa kugirango hamenyekane kanseri muri lymph node ya sentinel (lymph node ya mbere mu itsinda rya lymph node yakira amazi ya lymphatique ava mu kibyimba kibanza). Nibwo bwa mbere lymph node kanseri ishobora gukwirakwira kuva ikibyimba kibanza. Ikintu gikoresha radiyo na / cyangwa irangi ry'ubururu batewe inshinge hafi yikibyimba. Ibintu cyangwa irangi bitembera mumiyoboro ya lymph node. Lymph ya mbere yakira ibintu cyangwa irangi bivanwaho. Inzobere mu bijyanye n’indwara ireba tissue munsi ya microscope kugirango ishakishe selile. Niba kanseri ya kanseri ibonetse, lymph node izakurwaho kandi hasuzumwe ingero za tissue zerekana ibimenyetso bya kanseri. Ibi bita lymphadenectomy. Rimwe na rimwe,

Muganga amaze gukuraho melanoma yose ishobora kugaragara mugihe cyo kubagwa, abarwayi bamwe bashobora guhabwa chimiotherapie nyuma yo kubagwa kugirango bice selile zose zisigaye. Chimiotherapie yatanzwe nyuma yo kubagwa, kugirango igabanye ibyago ko kanseri izagaruka, byitwa kuvura indwara.

Kubagwa kugirango ukureho kanseri yakwirakwiriye mu mitsi ya lymph, ibihaha, gastrointestinal (GI), amagufwa, cyangwa ubwonko birashobora gukorwa kugirango ubuzima bw’umurwayi bugerweho hagamijwe kugenzura ibimenyetso.

Chimoterapi

Chimiotherapie ni umuti wa kanseri ukoresha ibiyobyabwenge kugirango uhagarike imikurire ya kanseri, haba mu kwica selile cyangwa kubabuza gutandukana. Iyo chimiotherapie ifashwe numunwa cyangwa igaterwa mumitsi cyangwa imitsi, imiti yinjira mumaraso kandi irashobora kugera kanseri ya kanseri mumubiri (chimiotherapie sisitemu). Iyo chimiotherapie ishyizwe mumazi yubwonko, urugingo, cyangwa umwobo wumubiri nkinda, imiti yibasira kanseri ya kanseri muri utwo turere (chimiotherapie yo mukarere).

Ubwoko bumwe bwa chimiotherapie yo mukarere ni hyperthermic yitaruye ingingo. Hamwe nubu buryo, imiti igabanya ubukana ijya mu kuboko cyangwa ku kuguru kanseri irimo. Gutembera kw'amaraso kugera no mu gihimba bihagarikwa by'agateganyo hamwe na tourneque. Umuti ushyushye hamwe numuti urwanya anticancer ushyirwa mumaraso yingingo. Ibi bitanga urugero rwinshi rwibiyobyabwenge mugace kanseri iri.

Uburyo chimiotherapie itangwa biterwa nubwoko nicyiciro cya kanseri ivurwa.

Reba Ibiyobyabwenge Byemewe kuri Melanoma kubindi bisobanuro.

Imiti ivura imirasire

Imishwarara ivura ni imiti ikoresha kanseri ikoresha ingufu nyinshi za x-imirasire cyangwa ubundi bwoko bwimirasire yica kanseri cyangwa ikabuza gukura. Hariho ubwoko bubiri bwo kuvura imirasire:

• Imiti ivura hanze ikoresha imashini hanze yumubiri kugirango yohereze imirasire kuri kanseri.

• Imiti ivura imbere ikoresha ibintu bifata radiyo bifunze inshinge, imbuto, insinga, cyangwa catheteri bishyirwa muri kanseri cyangwa hafi yayo.

Uburyo imiti ivura imirasire itangwa biterwa n'ubwoko bwa kanseri ivurwa. Imiti ivura hanze ikoreshwa mu kuvura melanoma, kandi irashobora no gukoreshwa nk'ubuvuzi bwa palliative kugirango igabanye ibimenyetso kandi izamure ubuzima.

Immunotherapy

Immunotherapy nubuvuzi bukoresha sisitemu yumubiri yumurwayi kurwanya kanseri. Ibintu bikozwe numubiri cyangwa bikozwe muri laboratoire bikoreshwa mukuzamura, kuyobora, cyangwa kugarura umubiri kamere irinda kanseri. Ubu bwoko bwo kuvura kanseri nabwo bwitwa biotherapy cyangwa biologique therapy.

Ubwoko bukurikira bwa immunotherapie burimo gukoreshwa mu kuvura melanoma:

• Immune checkpoint inhibitor therapy: Ubwoko bumwebumwe bwingirangingo, nka selile T, hamwe na kanseri zimwe na zimwe zifite poroteyine zimwe na zimwe, bita proteine ​​proteyine, hejuru yabyo bikomeza kugenzura ubudahangarwa bw'umubiri. Iyo kanseri ya kanseri ifite proteine ​​nyinshi, ntabwo zizaterwa no kwicwa na selile T. Immune igenzura ibuza izo poroteyine kandi ubushobozi bwa selile T bwo kwica kanseri bwiyongera. Bakoreshwa mu kuvura abarwayi bamwe na bamwe bafite melanoma yateye imbere cyangwa ibibyimba bidashobora gukurwaho no kubagwa.

Hariho ubwoko bubiri bwubudahangarwa bwo kugenzura indwara:

• CTLA-4 inhibitor: CTLA-4 ni poroteyine hejuru ya selile T ifasha kugenzura ubudahangarwa bw'umubiri. Iyo CTLA-4 ifashe indi poroteyine yitwa B7 kuri selile ya kanseri, ibuza selile T kwica kanseri. Inzitizi za CTLA-4 zifatanije na CTLA-4 kandi zemerera selile T kwica kanseri. Ipilimumab ni ubwoko bwa CTLA-4 inhibitor.

Immune igenzura. Intungamubiri za poroteyine, nka B7-1 / B7-2 kuri selile zerekana antigen (APC) na CTLA-4 kuri selile T, zifasha kugenzura ubudahangarwa bw'umubiri. Iyo reseptor ya T-selile (TCR) ihuza na poroteyine za antigen hamwe ningenzi zikomeye za histocompatibilité (MHC) kuri APC na CD28 zihuza B7-1 / B7-2 kuri APC, selile T irashobora gukora. Ariko, guhuza B7-1 / B7-2 na CTLA-4 bituma selile T zidakora kuburyo zidashobora kwica selile yibibyimba mumubiri (panne ibumoso). Guhagarika guhuza B7-1 / B7-2 na CTLA-4 hamwe na inhibitor igenzura (antibody anti-CTLA-4) ituma selile T ikora kandi ikica selile yibibyimba (panel iburyo).

• PD-1 inhibitor: PD-1 ni poroteyine hejuru ya selile T ifasha kugenzura ubudahangarwa bw'umubiri. Iyo PD-1 ifatanye nindi poroteyine yitwa PDL-1 kuri selile ya kanseri, ihagarika selile T kwica kanseri. Inzitizi za PD-1 zifatanije na PDL-1 kandi zemerera selile T kwica selile. Pembrolizumab na nivolumab ni ubwoko bwa PD-1 inhibitor.

Immune igenzura. Intungamubiri za poroteyine, nka PD-L1 ku ngirabuzimafatizo na PD-1 kuri selile T, zifasha kugenzura ibisubizo by’ubudahangarwa. Guhambira PD-L1 na PD-1 bituma selile T itica selile yibibyimba mumubiri (panne ibumoso). Guhagarika guhuza PD-L1 na PD-1 hamwe na inhibitor igenzura (anti-PD-L1 cyangwa anti-PD-1) ituma selile T yica selile yibibyimba (panne iburyo).

• Interferon: Interferon igira uruhare mu igabana ry'uturemangingo twa kanseri kandi irashobora gutinda gukura kw'ibibyimba.

• Interleukin-2 (IL-2): IL-2 ituma imikurire n'ibikorwa bya selile nyinshi z'umubiri, cyane cyane lymphocytes (ubwoko bw'amaraso yera). Lymphocytes irashobora gutera no kwica selile.

• Ubuvuzi bwa Tumor necrosis (TNF): TNF ni poroteyine ikorwa na selile yera kugirango isubize antigen cyangwa infection. TNF ikorerwa muri laboratoire kandi ikoreshwa nk'ubuvuzi bwo kwica kanseri. Irimo kwigwa mukuvura melanoma.

Reba Ibiyobyabwenge Byemewe kuri Melanoma kubindi bisobanuro.

Ubuvuzi bugamije

Ubuvuzi bugamije ni uburyo bwo kuvura bukoresha ibiyobyabwenge cyangwa ibindi bintu byibasira kanseri. Ubuvuzi bugamije ubusanzwe butera kwangirika kwingirabuzimafatizo zisanzwe kuruta chimiotherapie cyangwa imiti ivura imirasire. Ubwoko bukurikira bwo kuvura bugenewe gukoreshwa cyangwa kwigwa mukuvura melanoma:

• Ubuvuzi bwa signal transduction inhibitor therapy: Inhibitori ya transduction ibuza guhagarika ibimenyetso biva muri molekile ikajya mubindi imbere muri selire. Guhagarika ibyo bimenyetso bishobora kwica selile. Bakoreshwa mu kuvura abarwayi bamwe na bamwe bafite melanoma yateye imbere cyangwa ibibyimba bidashobora gukurwaho no kubagwa. Inhibitori ya transduction ibuza harimo:

• Inhibitori ya BRAF (dabrafenib, vemurafenib, encorafenib) ihagarika ibikorwa bya poroteyine zakozwe na genes ya mutant BRAF; na

• Inhibitori ya MEK (trametinib, cobimetinib, binimetinib) ibuza poroteyine bita MEK1 na MEK2 bigira ingaruka kumikurire no kubaho kwingirangingo za kanseri.

Ihuriro rya BRAF inhibitor na MEK inhibitor zikoreshwa mukuvura melanoma zirimo:

• Dabrafenib wongeyeho trametinib.

• Vemurafenib wongeyeho cobimetinib.

• Encorafenib wongeyeho binimetinib.

• Kuvura virusi ya Oncolytike: Ubwoko bwo kuvura bugamije gukoreshwa mu kuvura melanoma. Ubuvuzi bwa Oncolytic bukoresha virusi yanduza kandi igasenya kanseri ariko ntabwo ari selile zisanzwe. Imiti ivura imirasire cyangwa chimiotherapie irashobora gutangwa nyuma yo kuvura virusi ya oncolytike kugirango yice selile nyinshi. Talimogene laherparepvec ni ubwoko bwa virusi ya oncolytic ivura ikozwe muburyo bwa herpesvirus yahinduwe muri laboratoire. Yatewe mu bibyimba mu ruhu na lymph node.

• Angiogenezi inhibitor: Ubwoko bwubuvuzi bugamije kwigwa mukuvura melanoma. Angiogenez ibuza guhagarika imikurire yimitsi mishya. Mu kuvura kanseri, barashobora gutangwa kugirango birinde gukura kw'imiyoboro mishya y'amaraso ibibyimba bigomba gukura.

Ubuvuzi bushya bugamije hamwe nubuvuzi burimo kwigwa mukuvura melanoma.

Reba Ibiyobyabwenge Byemewe kuri Melanoma kubindi bisobanuro.

Ubwoko bushya bwo kuvura burimo kugeragezwa mubigeragezo byamavuriro.

Iki gice cyincamake gisobanura imiti irimo kwigwa mubigeragezo byamavuriro. Ntishobora kuvuga ubuvuzi bushya burimo kwigwa. Amakuru yerekeye ibizamini byamavuriro araboneka kurubuga rwa NCI.

Ubuvuzi bw'inkingo

Ubuvuzi bwinkingo nubuvuzi bwa kanseri bukoresha ibintu cyangwa itsinda ryibintu kugirango bikangure sisitemu yumubiri kugirango ibone ikibyimba ikice. Ubuvuzi bw'inkingo burimo kwigwa mu kuvura icyiciro cya III melanoma gishobora gukurwaho no kubagwa.

Umuti wa melanoma urashobora gutera ingaruka.

Kumakuru yingaruka ziterwa no kuvura kanseri, reba urupapuro rwuruhande rwacu.

Abarwayi barashobora kwifuza gutekereza kubijyanye no kwipimisha kwa muganga.

Ku barwayi bamwe, kwitabira ikizamini cyamavuriro birashobora kuba uburyo bwiza bwo kuvura. Ibigeragezo bivura biri mubikorwa byubushakashatsi bwa kanseri. Igeragezwa rya Clinical rikorwa kugirango hamenyekane niba imiti mishya ya kanseri itekanye kandi ifite akamaro cyangwa nziza kuruta ubuvuzi busanzwe.

Benshi mubuvuzi busanzwe bwa kanseri bushingiye kubigeragezo byambere byubuvuzi. Abarwayi bitabiriye kwipimisha barashobora kuvurwa bisanzwe cyangwa kuba mubambere bahawe imiti mishya.

Abarwayi bitabira ibizamini byo kwa muganga nabo bafasha kunoza uburyo kanseri izavurwa mugihe kizaza. Nubwo ibigeragezo bivura bitaganisha ku buvuzi bushya, akenshi basubiza ibibazo byingenzi kandi bigafasha gutera imbere ubushakashatsi.

Abarwayi barashobora kwipimisha kwa muganga mbere, mugihe, cyangwa nyuma yo gutangira kuvura kanseri.

Igeragezwa rimwe na rimwe ririmo abarwayi bataravurwa. Ibindi bigeragezo bipima abarwayi bafite kanseri itameze neza. Hariho kandi ibizamini byo kwa muganga bipima uburyo bushya bwo guhagarika kanseri kongera kugaruka (kugaruka) cyangwa kugabanya ingaruka zo kuvura kanseri.

Igeragezwa rya Clinical ririmo kubera mu bice byinshi by'igihugu. Amakuru yerekeye ibizamini byamavuriro ashyigikiwe na NCI urashobora kubisanga kurubuga rwa NCI. Ibizamini bya Clinical bishyigikiwe nandi mashyirahamwe murashobora kubisanga kurubuga rwa ClinicalTrials.gov.

Ibizamini byo gukurikirana birashobora gukenerwa.

Bimwe mubizamini byakozwe mugupima kanseri cyangwa kumenya icyiciro cya kanseri birashobora gusubirwamo. Ibizamini bimwe bizasubirwamo kugirango harebwe uburyo ubuvuzi bukora neza. Ibyemezo bijyanye no gukomeza, guhindura, cyangwa guhagarika ubuvuzi birashobora gushingira kubisubizo byibi bizamini.

Bimwe mubizamini bizakomeza gukorwa buri gihe nyuma yubuvuzi burangiye. Ibisubizo by'ibi bizamini birashobora kwerekana niba ubuzima bwawe bwarahindutse cyangwa niba kanseri yarongeye (garuka). Ibi bizamini rimwe na rimwe byitwa gukurikirana-ibizamini cyangwa kugenzura.

Amahitamo yo Kuvura Icyiciro

Muri iki gice

• Icyiciro 0 (Melanoma muri Situ)

• Icyiciro cya I Melanoma

• Icyiciro cya II Melanoma

• Icyiciro cya III Melanoma ishobora gukurwaho no kubaga

• Icyiciro cya III Melanoma idashobora gukurwaho no kubagwa, Icyiciro cya IV Melanoma, na Melanoma isubirwamo

Kumakuru yerekeye imiti yavuzwe hepfo, reba igice cyo kuvura.

Icyiciro 0 (Melanoma muri Situ)

Kuvura icyiciro cya 0 mubisanzwe kubagwa kugirango ukureho uturemangingo tudasanzwe hamwe nuduce duto duto dusanzwe tuyukikije.

Koresha ubushakashatsi bwamavuriro kugirango ushakishe NCI ifashwa na kanseri ivura abarwayi. Urashobora gushakisha ibigeragezo ukurikije ubwoko bwa kanseri, imyaka yumurwayi, n’aho ibizamini bikorerwa. Amakuru rusange yerekeye ibizamini byamavuriro nayo arahari.

Icyiciro cya I Melanoma

Kuvura icyiciro I melanoma birashobora kuba bikubiyemo ibi bikurikira:

• Kubaga kugirango ukureho ikibyimba na bimwe mubice bisanzwe bikikije. Rimwe na rimwe, lymph node mapping no gukuraho lymph node nayo irakorwa.

• Igeragezwa rya clinique yuburyo bushya bwo kubona kanseri ya lymph node.

Koresha ubushakashatsi bwamavuriro kugirango ushakishe NCI ifashwa na kanseri ivura abarwayi. Urashobora gushakisha ibigeragezo ukurikije ubwoko bwa kanseri, imyaka yumurwayi, n’aho ibizamini bikorerwa. Amakuru rusange yerekeye ibizamini byamavuriro nayo arahari.

Icyiciro cya II Melanoma

Kuvura icyiciro cya kabiri melanoma irashobora kuba ikubiyemo ibi bikurikira:

• Kubaga kugirango ukureho ikibyimba hamwe na tissue zimwe zisanzwe ziyikikije. Rimwe na rimwe, lymph node mapping na sentinel lymph node biopsy ikorwa kugirango hamenyekane kanseri mu mitsi ya lymph icyarimwe hamwe no kubaga gukuramo ikibyimba. Niba kanseri iboneka muri sentinel lymph node, hashobora gukurwaho lymph node nyinshi.

• Kubaga bikurikirwa na immunotherapy hamwe na interferon niba hari ibyago byinshi ko kanseri izagaruka.

• Ikigeragezo cyamavuriro yubwoko bushya bwo kuvura buzakoreshwa nyuma yo kubagwa.

Koresha ubushakashatsi bwamavuriro kugirango ushakishe NCI ifashwa na kanseri ivura abarwayi. Urashobora gushakisha ibigeragezo ukurikije ubwoko bwa kanseri, imyaka yumurwayi, n’aho ibizamini bikorerwa. Amakuru rusange yerekeye ibizamini byamavuriro nayo arahari.

Icyiciro cya III Melanoma ishobora gukurwaho no kubaga

Kuvura icyiciro cya III melanoma gishobora gukurwaho no kubagwa gishobora kubamo ibi bikurikira:

• Kubaga kugirango ukureho ikibyimba na bimwe mubice bisanzwe bikikije. Uruhu rushobora gukorwa kugirango rutwikire igikomere cyatewe no kubagwa. Rimwe na rimwe, lymph node mapping na sentinel lymph node biopsy ikorwa kugirango hamenyekane kanseri mu mitsi ya lymph icyarimwe hamwe no kubaga gukuramo ikibyimba. Niba kanseri iboneka muri sentinel lymph node, hashobora gukurwaho lymph node nyinshi.

• Kubaga bikurikirwa na immunotherapy hamwe na nivolumab, ipilimumab, cyangwa interferon niba hari ibyago byinshi ko kanseri izagaruka.

• Kubaga bikurikirwa no kuvura hamwe na dabrafenib na trametinib niba hari ibyago byinshi ko kanseri izagaruka.

• Igeragezwa rya clinique yubudahangarwa hamwe nubuvuzi bwinkingo.

• Igeragezwa rya clinique yo kubagwa rikurikirwa nubuvuzi bugamije guhindura gene yihariye.

Koresha ubushakashatsi bwamavuriro kugirango ushakishe NCI ifashwa na kanseri ivura abarwayi. Urashobora gushakisha ibigeragezo ukurikije ubwoko bwa kanseri, imyaka yumurwayi, n’aho ibizamini bikorerwa. Amakuru rusange yerekeye ibizamini byamavuriro nayo arahari.

Icyiciro cya III Melanoma idashobora gukurwaho no kubagwa, Icyiciro cya IV Melanoma, na Melanoma isubirwamo

Kuvura icyiciro cya III melanoma idashobora gukurwaho no kubagwa, icyiciro cya IV melanoma, na melanoma isubirwamo bishobora kuba bikubiyemo ibi bikurikira:

• Kuvura virusi ya Oncolytike (talimogene laherparepvec) yatewe mu kibyimba.

• Immunotherapy hamwe na ipilimumab, pembrolizumab, nivolumab, cyangwa interleukin-2 (IL-2). Rimwe na rimwe ipilimumab na nivolumab zitangwa hamwe.

• Ubuvuzi bugamije hamwe na inhibitori ya transduction (dabrafenib, trametinib, vemurafenib, cobimetinib, encorafenib, binimetinib). Ibi

irashobora gutangwa wenyine cyangwa mukomatanya.

• Chimoterapi.

• Ubuvuzi bwa Palliative bwo kugabanya ibimenyetso no kuzamura imibereho. Ibi bishobora kubamo:

• Kubaga kugirango ukureho lymph node cyangwa ibibyimba mu bihaha, gastrointestinal (GI), amagufwa, cyangwa ubwonko.

• Imishwarara ivura ubwonko, uruti rw'umugongo, cyangwa amagufwa.

Ubuvuzi burimo kwigwa mubigeragezo byamavuriro yo mu cyiciro cya III melanoma idashobora gukurwaho no kubagwa, icyiciro cya IV melanoma, na melanoma isubirwamo harimo ibi bikurikira:

• Immunotherapy wenyine cyangwa ifatanije nubundi buryo bwo kuvura nko kuvura intego.

• Kuri melanoma yakwirakwiriye mu bwonko, immunotherapy hamwe na nivolumab wongeyeho ipilimumab.

• Ubuvuzi bugamije, nk'ibikoresho byo kwanduza ibimenyetso, inhibitori ya angiogenezi, kuvura virusi ya oncolytike, cyangwa ibiyobyabwenge byibasira ihinduka ry’imiterere ya gene. Ibi birashobora gutangwa wenyine cyangwa hamwe.

• Kubaga kugirango ukureho kanseri yose izwi.

• Chimoterapi yo mu karere (hyperthermic yonyine yimikorere yimikorere). Bamwe mu barwayi barashobora kandi gukingira indwara hamwe na kanseri ya niyose.

• Imiti ya chimiotherapie.

Koresha ubushakashatsi bwamavuriro kugirango ushakishe NCI ifashwa na kanseri ivura abarwayi. Urashobora gushakisha ibigeragezo ukurikije ubwoko bwa kanseri, imyaka yumurwayi, n’aho ibizamini bikorerwa. Amakuru rusange yerekeye ibizamini byamavuriro nayo arahari.

Kumenya byinshi kuri Melanoma

Ushaka amakuru menshi yikigo cyigihugu cya kanseri kubyerekeye melanoma, reba ibi bikurikira:

• Kanseri y'uruhu (Harimo na Melanoma) Urupapuro rwibanze

• Kwirinda Kanseri y'uruhu

• Kugenzura Kanseri y'uruhu

• Sentinel Lymph Node Biopsy

• Ibiyobyabwenge Byemewe kuri Melanoma

• Immunotherapy yo kuvura Kanseri

• Intego zo kuvura Kanseri

• Inshingano kuri Melanoma: Kumenya ibiranga ABCDE

Kumakuru rusange ya kanseri nibindi bikoresho biva mu kigo cyigihugu cya kanseri, reba ibi bikurikira:

• Ibyerekeye Kanseri

• Gutegura

• Chimiotherapie nawe: Inkunga kubantu barwaye Kanseri

• Ubuvuzi bwimirasire nawe: Inkunga kubantu barwaye Kanseri

• Guhangana na Kanseri

• Ibibazo byo Kubaza Muganga wawe kuri Kanseri

• Abacitse ku icumu n'abarezi