Malignant melanoma
☆ Muzotsatira za 2022 Stiftung Warentest zochokera ku Germany, kukhutitsidwa kwa ogula ndi ModelDerm kunali kotsika pang'ono kusiyana ndi kuyankhulana kwa telemedicine komwe kulipiridwa.
melanoma ya pafupifupi 2.5cm (1 inchi) ndi 1.5cm (0.6 inchi)
Ngakhale kuti nkhaniyi inapezeka kuti ndi khansa ya khansa ya m'mapapo, zotsatira zake zimakhala zofanana kwambiri ndi hematoma ya msomali. Misomali ya msomali (benign) imatha mkati mwa mwezi umodzi kapena iwiri ikatulutsidwa. Chifukwa chake, ngati chilondacho chikupitilirabe kwa nthawi yayitali, munthu angaganizidwe kuti ndi melanoma ndipo ayenera kuchitidwa opaleshoni.
References
Melanoma ndi mtundu wa chotupa chomwe chimapanga pamene ma melanocyte amakhala oopsa. Ma melanocyte amachokera ku neural crest. Izi zikutanthauza kuti melanomas imatha kukula osati pakhungu komanso m'malo ena omwe ma cell a neural crest amayenda, monga thirakiti la m'mimba ndi ubongo. Odwala omwe ali ndi gawo 0 la melanoma amakhala ndi moyo zaka zisanu ndi 97%, pomwe omwe ali ndi matenda a stage IV amakhala ndi pafupifupi 10 peresenti yokha.
A melanoma is a tumor produced by the malignant transformation of melanocytes. Melanocytes are derived from the neural crest; consequently, melanomas, although they usually occur on the skin, can arise in other locations where neural crest cells migrate, such as the gastrointestinal tract and brain. The five-year relative survival rate for patients with stage 0 melanoma is 97%, compared with about 10% for those with stage IV disease.
A melanoma is a tumor produced by the malignant transformation of melanocytes. Melanocytes are derived from the neural crest; consequently, melanomas, although they usually occur on the skin, can arise in other locations where neural crest cells migrate, such as the gastrointestinal tract and brain. The five-year relative survival rate for patients with stage 0 melanoma is 97%, compared with about 10% for those with stage IV disease.
Cutaneous melanoma (CM) ndi mtundu wowopsa kwambiri wa chotupa chapakhungu, chomwe chimachititsa 90% kufa ndi khansa yapakhungu. Pofuna kuthana ndi izi, akatswiri ochokera ku the European Dermatology Forum (EDF) , the European Association of Dermato-Oncology (EADO) , and the European Organization for Research and Treatment of Cancer (EORTC) adagwirizana.
Cutaneous melanoma (CM) is a highly dangerous type of skin tumor, responsible for 90% of skin cancer deaths. To address this, experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC) had collaborated.
Cutaneous melanoma (CM) is a highly dangerous type of skin tumor, responsible for 90% of skin cancer deaths. To address this, experts from the European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC) had collaborated.
Melanoma, mtundu wa khansa yapakhungu, imadziwika kwambiri chifukwa cha ubale wake wapamtima ndi chitetezo chamthupi. Izi zikuwonekera chifukwa cha kuchuluka kwake kwa anthu omwe ali ndi chitetezo chamthupi chofooka, kukhalapo kwa maselo oteteza thupi ku zotupa zoyambirira ndi kufalikira kwawo ku ziwalo zina za thupi, komanso kuti chitetezo cha mthupi chimatha kuzindikira mapuloteni ena omwe amapezeka m'maselo a melanoma. Chofunika kwambiri, mankhwala omwe amalimbikitsa chitetezo chamthupi awonetsa kuti ali ndi chiyembekezo chothana ndi melanoma. Ngakhale kuti kugwiritsa ntchito mankhwala ochizira chitetezo cha m'thupi pochiza khansa yapakhungu ndi chitukuko chaposachedwapa, kafukufuku waposachedwapa akusonyeza kuti kuphatikiza mankhwalawa ndi chemotherapy, radiotherapy, kapena mankhwala omwe amawaganizira amatha kusintha kwambiri zotsatira zake. Komabe, immunotherapy yotereyi imatha kuyambitsa zovuta zingapo zokhudzana ndi chitetezo chamthupi zomwe zimakhudza ziwalo zosiyanasiyana, zomwe zingachepetse kugwiritsa ntchito kwake. Kuyang'ana m'tsogolo, njira zamtsogolo zochizira khansa yapakhungu ingaphatikizepo chithandizo choyang'ana malo omwe chitetezo cha mthupi chimayendera ngati PD1, kapena mankhwala omwe amasokoneza njira zamagulu ena monga BRAF ndi MEK.
Melanoma is one of the most immunologic malignancies based on its higher prevalence in immune-compromised patients, the evidence of brisk lymphocytic infiltrates in both primary tumors and metastases, the documented recognition of melanoma antigens by tumor-infiltrating T lymphocytes and, most important, evidence that melanoma responds to immunotherapy. The use of immunotherapy in the treatment of metastatic melanoma is a relatively late discovery for this malignancy. Recent studies have shown a significantly higher success rate with combination of immunotherapy and chemotherapy, radiotherapy, or targeted molecular therapy. Immunotherapy is associated to a panel of dysimmune toxicities called immune-related adverse events that can affect one or more organs and may limit its use. Future directions in the treatment of metastatic melanoma include immunotherapy with anti-PD1 antibodies or targeted therapy with BRAF and MEK inhibitors.
Melanoma is one of the most immunologic malignancies based on its higher prevalence in immune-compromised patients, the evidence of brisk lymphocytic infiltrates in both primary tumors and metastases, the documented recognition of melanoma antigens by tumor-infiltrating T lymphocytes and, most important, evidence that melanoma responds to immunotherapy. The use of immunotherapy in the treatment of metastatic melanoma is a relatively late discovery for this malignancy. Recent studies have shown a significantly higher success rate with combination of immunotherapy and chemotherapy, radiotherapy, or targeted molecular therapy. Immunotherapy is associated to a panel of dysimmune toxicities called immune-related adverse events that can affect one or more organs and may limit its use. Future directions in the treatment of metastatic melanoma include immunotherapy with anti-PD1 antibodies or targeted therapy with BRAF and MEK inhibitors.
Choyambitsa chachikulu cha melanoma ndi kuwonetseredwa kwa kuwala kwa ultraviolet kwa omwe ali ndi khungu lochepa la pigment melanin (anthu oyera). Kuwala kwa UV kumatha kukhala kochokera kudzuwa kapena zida zowotcha. Anthu omwe ali ndi khansa ya khansa ya khansa ya khansa ya khansa ya khansa ya khansa ya khansa ya khansa ya khansa ya khansa ya khansa ya khansa ya m'mabanja awo, komanso kuchepa kwa chitetezo cha mthupi mwawo ali pachiopsezo chachikulu cha khansa ya melanoma.
Kugwiritsa ntchito mafuta oteteza ku dzuwa komanso kupewa kuwala kwa UV kungalepheretse melanoma. Chithandizo chimachotsedwa ndi opaleshoni. Kwa omwe ali ndi khansa yokulirapo pang'ono, ma lymph nodes oyandikana nawo amatha kuyesedwa kuti afalikire (metastasis). Anthu ambiri amachiritsidwa ngati metastasis sichinachitike. Kwa iwo omwe melanoma yafalikira, immunotherapy, biologic therapy, radiation therapy, kapena chemotherapy amatha kupulumuka. Ndi chithandizo, zaka zisanu zopulumuka ku United States ndi 99% mwa omwe ali ndi matenda am'deralo, 65% pamene matendawa afalikira ku ma lymph nodes, ndi 25% mwa omwe akufalikira kutali.
Khansara yapakhungu ndi khansa yapakhungu yowopsa kwambiri. Australia ndi New Zealand ali ndi chiwerengero chapamwamba cha melanoma padziko lonse lapansi. Matenda a melanoma amapezekanso ku Northern Europe ndi North America. Melanoma imapezeka mocheperapo ku Asia, Africa, ndi Latin America. Ku United States, melanoma imapezeka pafupifupi nthawi 1.6 mwa amuna kuposa akazi.
○ Zizindikiro ndi zizindikiro
Zizindikiro zoyambirira za melanoma ndi kusintha kwa mawonekedwe kapena mtundu wa nevus yomwe ilipo. Pankhani ya nodular melanoma, ndikuwoneka kwa chotupa chatsopano pakhungu. Pambuyo pa khansa ya khansa ya m'mawere, nevi imatha kuyabwa, zilonda zam'mimba, kapena kutuluka magazi.
[A-Asymmetry] Asymmetry mawonekedwe
[B-Borders] Border (osakhazikika ndi m'mphepete ndi ngodya)
[C-Color] Utoto (wamitundumitundu ndi wosakhazikika)
[D-Diameter] Diameter (yachikulu kuposa 6 mm = 0.24 inchi = pafupifupi kukula kwa chofufutira cha pensulo)
[E-Evolving] Kusintha pakapita nthawi
cf) Seborrheic keratosis ikhoza kukumana ndi zina kapena zonse za ABCD, ndipo zingayambitse ma alarm abodza.
Metastasis oyambirira khansa ya pakhungu ndi zotheka, koma ndi osowa; ochepera gawo limodzi mwa magawo asanu a melanomas omwe amapezeka msanga amakhala metastatic. Ma metastases muubongo amapezeka mwa odwala omwe ali ndi melanoma. Metastatic melanoma imathanso kufalikira ku chiwindi, mafupa, pamimba, kapena ma lymph nodes akutali.
○ Matenda
Kuyang'ana dera lomwe likufunsidwa ndi njira yodziwika kwambiri yokayikira melanoma. Ma Nevus omwe sakhala amtundu kapena mawonekedwe osakhazikika nthawi zambiri amatengedwa ngati ofuna kudwala khansa yapakhungu.
Madokotala nthawi zambiri amawunika ma moles onse, kuphatikiza omwe ali osakwana 6 mm m'mimba mwake. Akagwiritsidwa ntchito ndi akatswiri ophunzitsidwa bwino, dermoscopy imathandiza kwambiri kuzindikira zilonda zopweteka kusiyana ndi kugwiritsa ntchito diso lokha. Kuzindikira ndi biopsy ya chotupa chilichonse chapakhungu chomwe chili ndi zizindikiro zokhala ndi khansa.
○ Machiritso
#Mohs surgery
Dokotala wanu angakulimbikitseni immunotherapy makamaka ngati muli ndi siteji 3 kapena 4 melanoma yomwe singathe kuchotsedwa ndi opaleshoni.
#Ipilimumab [Yervoy]
#Pembrolizumab [Keytruda]
#Nivolumab [Opdivo]