Akwai wadata da yawa na yaduwar kumburi na lymph don magance melanoma.
Lokacin da melanoma ya kasance a kan fata, zai iya zama yadda ya kamata kuma a cire shi a cikin mafi yawan lokuta. Wasu lokuta, duk da haka, yana yada ( metastasizes ) zuwa wasu sassan jiki, yawancin tafiya farko zuwa ƙananan ƙwayar lymph a cikin tsutsa, wuyansa, ko ƙuƙwalwa. Idan likitanku sunyi zaton cewa wannan ya faru, za a yi gwajin da ake kira rayayyun kumburi mai kwakwalwa don ganewa da kuma cire kumbun linzamin da cutar ta iya yadawa daga tumɓir.
Idan kullun kullun jikinku yana da kyau (yana dauke da kwayoyin rikitarwa), to, lokaci ne na yanke shawara. Ya kamata a samu duk sauran ƙwayoyin lymph a cikin wannan yanki, a cikin wata hanya mai kwakwalwa da ake kira ƙaddamar ƙirar lymph node dissection (CLND, ko lymphadenectomy)? Manufar ita ce CLND ta tabbatar da cewa an kawar da kwayoyin cutar kanana a duk sauran ƙwayoyin lymph, wanda zai iya hana cutar daga yadawa.
Abin baƙin ciki shine, shaidar ba ta da cikakkiyar matsaya, saboda haka wannan yanke shawara ba daidai ba ce, har ma ga likitoci. Ga wadansu wadata da fursunoni don la'akari.
Abubuwan Hulɗa na Harkokin Node Na Lymph
1. CLND yana taimakawa wajen ƙayyade mataki na melanoma, wanda yake taimaka wa likita a yin shawarwari don maganin tiyata (adjuvant).
2. Ƙididdigar nodes da ke dauke da kwayoyin Melanoma sune mai hangen nesa ga lafiyar marasa lafiya da ke fama da cutar III, kuma CLND ne kaɗai ke iya samar da wannan bayani.
3. Wasu nazarin na nuna cewa kashi 20 cikin 100 na marasa lafiya da ke ɗauke da CLND nan da nan bayan sun gano cewa suna da kwarewa na kumburi na lymph na kwarewar inganta rayuwar rayuwa. Wannan shi ne ainihin gaskiya ga marasa lafiya wadanda suke da matsanancin ciwon sukari a jikin su (1.2 zuwa 3.5 mm).
4. Ta wurin dakatar da yaduwar melanoma a cikin ƙananan lymph, CLND yana inganta damar samun magani.
Ko da magungun ƙwayoyin melanoma na microscopic a cikin ƙwayoyin lymph zai iya ci gaba a cigaba da zama lokaci mai muhimmanci da kuma hadari.
Kamfanin Node Dissection
1. Matsalolin CLND suna da muhimmanci kuma suna faruwa har zuwa kashi 67 cikin 100 na marasa lafiya, musamman ma a cikin wadanda suka wuce 60. Wadannan sun hada da:
- Ginin ruwa a kan shafin tiyata ( seroma )
- Kamuwa da cuta
- Kusar da wani ɓangaren da ya shafi maye gurbin ƙwayar lymph nodes ( lymphedema )
- Ƙunƙara, tingling, ko zafi a cikin m yanki
- Raguwa (raguwa) na fata akan yankin
Ko da yake kumburi bayan tiyata za a iya hana ko sarrafawa ta yin amfani da maganin rigakafi, gyare-gyare mai laushi, tausa, da kuma diuretics, zai iya kasancewa mai wahala.
2. Amfani da CLND na iya dogara akan girman ƙwayar melanoma. Ƙananan ciwon sukari (0.1 mm ko žasa a diamita) a cikin ƙumbadadden lymph na ƙwanƙiri bazai taɓa kaiwa ga masarauta ba, don haka yin CLND bazai zama dole ba. Binciken da aka yi a shekara ta 2009 ya nuna cewa rayukan marasa lafiya tare da wadannan ƙwayoyin cutar sun kasance kamar wadanda ba su da wani nau'i a cikin ƙwayar lymph ɗin su. Sabili da haka, wadannan marasa lafiya "marasa kasuwa" zasu iya yin watsi da CLND kuma suna da wannan sakamako.
Layin Ƙasa
Yin zabe don shawo kan wata hanya mai mahimmanci irin su CLND ba yanke shawara ne ya kamata ka ɗauka ba, musamman idan yawan kwayar jikinka ya nuna kawai ƙananan melanoma a cikin ƙananan lymph.
Akwai dalilai masu yawa, ciki har da girman da kuma wurin da kuka yi na farko, da sakamakon sakamakon kwayar cutar lymph da sauran gwaje-gwaje, da kuma shekarun ku. Kuna iya taimakawa wajen neman ra'ayi na biyu.
Karin bayani:
Boughton B (2009). Ya kamata lymphadenectomy ya zama abin kulawa a cikin matakan da ke cikin melanoma zuwa ga ƙananan lymph? Oncology News Intl. 18 (5).
Morton DL, Thompson JF, Cochran A, et al (2006). Kwanar da ake kira sentinel-node biopsy ko duba ido a cikin melanoma. N Engl J Med. 2006 Zumba 28; 355 (13): 1307-17.
Thomas JM (2005). Lokacin da za a sake kwatanta ƙuƙwalwar suturar kwayoyin Biopsy a cikin Melanoma Post-Multicenter Selective Lymphadenectomy Trial. J Jara Incol. 2005 Dec 20, 23 (36): 9443-4.
Akkooi AC, Rutkowski P, van der Ploeg IM, et al (2009). Tsarin lokaci mai tsawo na marasa lafiya tare da nauyin nauyin ƙananan ƙananan kumburi (<0.1mm) bisa ka'idoji na Rotterdam: Wani bincike akan ƙungiyar EORTC Melanoma. J Cikin Gida 27: 15s, 2009 (abstr 9005).