Sivikele Isikhumba Sakho!

“Abantu abayiqapheli ingozi enkulu ebangelwa ilanga . . . nomonakalo elingawubangela kuyi-DNA yesikhumba. Ukuqhubeka kwalo monakalo kungase kubonakale kungeyona ingozi okwamanje kodwa ekugcineni kungabangela umdlavuza wesikhumba.”—UDkt. Mark Birch-Machin, uchwepheshe womdlavuza wesikhumba.

ISIKHUMBA siyisitho somzimba esikhulu kunazo zonke, futhi singamamitha-skwele angu-1,8 kumuntu wesilisa ovamile kanti singamamitha-skwele angu-1,6 kumuntu wesifazane ovamile. Sinezinzwa ezenza umuntu ezwe ubuhlungu, ezwe lapho ethintwa futhi azwele ukushisa. Isikhumba yisona ngokuyinhloko esivikela umzimba lapho kushisa, lapho kubanda nalapho ulimala, kanti siyawuvikela nasezintweni ezinobuthi nezingcolisa umzimba nakumakhemikhali. Sivikela umzimba ukuba ungangenwa amanzi sibuye sivimbele lawo asemzimbeni ukuba angaphumi. Yize kunjalo, kukhona okuthile okungaba isitha sesikhumba—ilanga. Kodwa alibalulekile yini ilanga ekuphileni?

Yebo, libalulekile. Izimila, lezo abantu abaxhomeke kuzo, zidinga ilanga ukuze zikhule. Ngaphezu kwalokho, isilinganiso esincane nje selanga sishukumisa umzimba ukuba ukhiqize uvithamini D, wona obe usugaya i-calcium eqinisa amathambo. Kodwa njengoba isilinganiso selanga esincane sizuzisa, lokho akusho ukuthi isilinganiso esikhulu sizuzisa ngisho nakakhulu. Ilanga likhipha imisebe yama-ultraviolet (UV), engabangela umonakalo ongenakulungiseka esikhunjeni. Omunye wawo ukushwabana kwesikhumba ngaphambi kwesikhathi.

Incwadi ethi Saving Your Skin ixwayisa ngengozi enkulu nakakhulu: “Ukukhanya kwemisebe yama-ultraviolet kulimaza i-DNA [izinhlayiya eziyisisekelo zofuzo ezilawula imisebenzi eyenziwa amangqamuzana, njengokuphindaphindeka kwawo], futhi kuphazamisa isimiso somzimba sokuzivikela kanti kungase kushukumise amakhemikhali omzimba abangela uhide lwezenzakalo ezingaholela esifweni somdlavuza.” Igama elithi “umdlavuza” liyesabisa. Kodwa wande kangakanani ngempela umdlavuza wesikhumba? Ingabe sikhona isizathu sokwesaba?

Umdlavuza Wesikhumba—Umqedazwe Wanamuhla

I-Merck Manual ithi umdlavuza wesikhumba yiwona owande kakhulu emhlabeni. E-United States, umuntu oyedwa kwabayisithupha kuya kwabayisikhombisa uhlaselwa uhlobo oluthile lomdlavuza wesikhumba. Kodwa izilinganiso ziyanda. Encwadini ethi The Skin Cancer Answer, uDkt. I. William Lane uthi “manje kulinganiselwa ukuthi abantu abangamaphesenti angu-50 abafinyelela eminyakeni yobudala engu-65 bayoba nohlobo oluthile lomdlavuza wesikhumba.” Ngokwe-American Academy of Dermatology, umdlavuza wesikhumba i-melanoma, ubulala abantu abangaba ngu-7 500 ngonyaka e-United States futhi uya ngokuya wanda. Abantu abanesikhumba esinsundu banamathuba amancane kakhulu okuba nomdlavuza wesikhumba, kodwa nabo basengozini.

Kungani umdlavuza wesikhumba usuwumqedazwe kangaka? Nakuba kungase kube nezici eziningi eziwumthelela, njengokuphakama kwezwe, ibanga lezwe ukusuka emkhathizwe, ukuthi amafu asibekela kangakanani kanye nesimo songqimba lwe-ozone, imbangela eyinhloko kungaba ukuchayeka kakhulu elangeni. Izindlela zokuphila zishintshile. Ukuchitha amaholidi ogwini nokuzilibazisa ngaphandle njengokuqwala intaba nokuntweza eqhweni sekuthandwa kakhulu futhi nabantu abangasebenzi ngaphandle bangakwazi ukuzilibazisa ngalezi ndlela. Izimfashini zishintshile. Nakuba ngaphambili amadoda nabesifazane babegqoka izingubo zokubhukuda ezinde ngenxa yesizotha, namuhla izingubo zokubhukuda ziya ziwuveza kakhulu umzimba, okuwenza uchayeke kakhulu elangeni. Umdlavuza wesikhumba uye wanda ngezinga elifanayo. Ingabe abantu abahlala ogwadule njengamaBedouin, ababegqoka izembatho ezinde ezikhululekile nezigqoko, babazi okuthile thina esibonakala sikushaya indiva?

Umdlavuza Wesikhumba—Ingozi Yangempela

Kukhona izinhlobo ezintathu ezivame kakhulu zomdlavuza wesikhumba, i-basal cell carcinoma, i-squamous cell carcinoma ne-melanoma ebulalayo. I-basal cell carcinoma kanye ne-squamous cell carcinoma ziwuhlobo lomdlavuza oqala olwelwesini lwesikhumba esingaphandle, ngokwesilinganiso oluyimilimitha elilodwa. Lezi nhlobo zomdlavuza ezingeyona i-melanoma zibonakala zibangelwa ukuba selangeni njalo, njengabantu abasebenza ngaphandle, futhi zitholakala emalungwini omzimba achayeka kakhulu elangeni, njengobuso nezandla.a Ngokuvamile lezi zinhlobo ziqale zibe insumpa encane nje esesikhunjeni noma isilonda esibhibhayo esivame ukopha futhi esingapholi ngokuphelele. Zingase zande zisakazekele nakwezinye izingxenye ezingakuleyo nsumpa, zihlasele nezicubu eziseduze. Cishe amaphesenti angu-75 omdlavuza wesikhumba abangelwa i-basal cell carcinoma. Nakuba ingandile, i-squamous cell carcinoma ngokuvamile iyakhula, noma isakazekele kwezinye izingxenye zomzimba ukusuka kuleyo ndawo etholakale kuyo okokuqala. Kubalulekile ukuba odokotela bazithole ngokushesha lezi zinhlobo zomdlavuza ezingeyona i-melanoma ngoba nakuba zelapheka, zingase zimbulale umuntu uma zingelashwa.

I-melanoma ebulalayo, ebangela amaphesenti amahlanu kuphela omdlavuza wesikhumba, nayo iqala olwelwesini lwesikhumba esingaphandle. Enye yezinto eziyinhloko ezibangela i-melanoma kubonakala iwukuchayeka kakhulu elangeni ngezikhathi ezithile, njengalapho umuntu ongasebenzi ngaphandle eyochitha iholidi endaweni eshisa kakhulu. Cishe amaphesenti angu-50 e-melanoma ebulalayo aqala ezinsumpeni esezikhona kakade esikhunjeni, ikakhulu enhla nomhlane nasezithweni.

Lolu hlobo lomdlavuza wesikhumba luyingozi kakhulu, ngoba uma lungazange lwelashwe ngokushesha lapho lusaqala, lungase luhlasele ulwelwesi lwesikhumba esingaphakathi, i-dermis, lapho kutholakala khona imithambo yegazi nemithambo ye-lymph. Ukusuka lapho lungasakazekela nakwezinye izingxenye zomzimba ngokushesha. Isazi somdlavuza uDkt. Larry Nathanson sithi: “Okufike kudide nge-melanoma ukuthi iyisifo eselaphekayo uma yelashwe ngokushesha lapho isaqala. Kodwa uma isize yasakazekela nakwezinye izingxenye zomzimba ayelapheki nhlobo ngemithi noma ngemisebe.” Empeleni, amaphesenti amabili noma amathathu kuphela azo zonke iziguli aphila iminyaka emihlanu. (Bheka ibhokisi elisekhasini 7 ukuze uthole ukuthi iziphi izimpawu eziyisixwayiso ze-melanoma.)

Obani abasengozini yokuba nomdlavuza wesikhumba? Ngaphandle kwalabo ababa selangeni njalo noma abachayeka kakhulu elangeni ngezikhathi ezithile, abantu abanesikhumba esikhanyayo, abanezinwele namehlo akhanyayo, abanezinsumpa namachashaza ansundu kanye nalabo abavela emikhayeni enamalungu ake aba nomdlavuza basengozini enkulu. Umdlavuza wesikhumba awuvamile kubantu abanesikhumba esinsundu. Kodwa ingabe lokhu kusho ukuthi uma umbala wesikhumba sakho uya ushintsha kakhulu uba nsundu, aya encipha kakhulu namathuba okuba ube nomdlavuza wesikhumba? Cha, ngoba nakuba isikhumba sizivikela emisebeni yama-UV ngokushintsha umbala sibe nsundu, siyalimala phakathi nale nqubo yokushintsha umbala, futhi ukulimala kwaso ngokuphindaphindiwe kwandisa ingozi yokuba nomdlavuza wesikhumba.

Ukwelashwa Komdlavuza Wesikhumba

Kukhona izindlela eziningana zokwelapha umdlavuza wesikhumba, kuye ngohlobo lwensumpa, indawo ekuyo nokuthi ingakanani kanye nendlela owelashwa ngayo ngaphambili: umuntu angase ahlinzwe ukuze kusikwe leyo nsumpa, kanti kungase kuphalwe izicubu ezinomdlavuza noma zishiswe ngogesi, kungase kubulawe amangqamuzana anomdlavuza ngokuwaqandisa ngamakhemikhali athile (cryosurgery), futhi kusetshenziswe indlela yokwelapha ngemisebe (radiotherapy). Inselele iwukuwasusa wonke amangqamuzana anomdlavuza. Inqubo ebizwa ngokuthi i-Mohs surgery, okuyinqubo lapho kuphalwa khona amangqamuzana anomdlavuza kusetshenziswa imishini elawulwa ngezibonakhulu, iyaphumelela ekususeni umdlavuza i-basal cell carcinoma ne-squamous cell carcinoma (izinga olapheka ngalo lo mdlavuza lingamaphesenti angu-95 kuya kwangu-99), kuyilapho kulondolozwa inani elikhulu lezicubu ezisaphilile futhi kugwenywa nokuba umuntu asale nenkambabeyibuza yezibazi zokuhlinzwa. Kungakhathaliseki ukuthi iyiphi inqubo esetshenziswayo, kungase kudingeke ukuba kwakhiwe kabusha izicubu.

I-U.S. National Institute on Aging ithi: “Zonke izinhlobo zomdlavuza wesikhumba zingelashwa uma zitholakale lapho zisaqala futhi zelashwe udokotela ngaphambi kokuba zisakazekele kwezinye izingxenye zomzimba.” Ngakho, ukutholakala komdlavuza usaqala kubaluleke kakhulu. Kodwa yini esingayenza ukuze sizivikele emdlavuzeni wesikhumba?

Funda Izindlela Ongazivikela Ngazo Elangeni

Kubalulekile ukuba umuntu afunde ngezindlela zokuzivikela elangeni kusukela esemncane. I-Skin Cancer Foundation ithi ‘ngaphambi kokuba bafinyelele iminyaka engu-18 ubudala, abantu abaningi basuke sebechithe amaphesenti angu-80 aso sonke isikhathi abazosichitha beselangeni ekuphileni kwabo. Ukuchayeka kanye nje elangeni eliveza amashashazi anamanzi lapho usengumntwana kuthiwa kuwandisa ngokuphindwe kabili amathuba okuba ube ne-melanoma lapho usukhulile.’ Lokhu kungenxa yokuthi umdlavuza wesikhumba ungathatha iminyaka engu-20 noma ngaphezulu ngaphambi kokuba uqale. (Bheka ibhokisi elisekhasini 8 ukuze uthole amacebiso awusizo ngezindlela ongazivikela ngazo elangeni.)

I-Australia inabantu abaningi kakhulu abanomdlavuza wesikhumba—ikakhulu i-melanoma.b Lokhu kubangelwa ukuthi abantu abaningi abahlala kuleli zwe bangabafuduki abanesikhumba esikhanyayo abavela eNyakatho Yurophu, futhi iningi labo lihlala ezindaweni ezingasolwandle ezinamabhishi ashisayo. Ukuhlola okwenziwa maqondana nalaba bafuduki kwaveza ukuthi uma befika besebancane kakhulu e-Australia, ayeba makhulu nakakhulu amathuba okuba babe ne-melanoma, okugcizelela isidingo sokuba umuntu afunde izindlela zokuzivikela elangeni kusukela esemncane. Uhulumeni wase-Australia uye waqala umkhankaso omkhulu wokufundisa abantu ngezingozi zelanga, kugcizelelwa kakhulu ukuba abantu bagqoke izikibha nezigqoko bese begcoba umuthi wokuvikela isikhumba elangeni. Lolu shintsho olungatheni endleleni yokuphila luye lwaba negalelo elikhulu kakhulu ekuvikeleni isizukulwane sabantu abasebasha kulelo zwe ekuhlaselweni i-melanoma.

Ngokuqondene nomuthi ovikela isikhumba elangeni, kuwukuhlakanipha ukusebenzisa lowo ovikela isikhumba emisebeni yama-UVA neyama-UVB. Lokhu kubalulekile ngisho nalapho amafu esibekele ngoba amaphesenti angu-85 emisebe yama-UV angathubeleza nasemafwini. Kanti futhi le misebe ingangena nasemanzini. Ochwepheshe abathile batusa ukuba umuntu athenge umuthi wokuvikela isikhumba elangeni onezinga lokuvikela (SPF [sun protection factor]) elingaba ngu-15 okungenani. Ukuze uthole ukuthi lo muthi uvikela kangakanani elangeni, phindaphinda imizuzu oyichitha uselangeni ngo-15. Lo muthi kufanele uphinde ugcotshwe njalo ngemva kwamahora amabili, kodwa lokho akwandisi izinga ovikeleka ngalo elangeni.

Ngaphezu kwalokho, i-Skin Cancer Answer ixwayisa ngokuthi akufanele ulutheke ucabange ukuthi uvikeleke ngokuphelele ngenxa nje yokuthi ugcobe umuthi wokuvikela isikhumba elangeni. Awukho umuthi ongakuvikela ngokuphelele elangeni elishisayo, ungekho nongakuvikela emdlavuzeni wesikhumba. Empeleni, ngokugcoba lo muthi ungase uzifake engozini enkulu kakhulu yokuba nomdlavuza wesikhumba ungahlosile—uma ukwenza uhlale elangeni kakhulu. Le ncwadi iyaphawula: “Ayikho into engathatha isikhundla sokufunda izindlela zokuzivikela elangeni. Ukugqoka izingubo ezivikelayo nokuhlala endlini uma ilanga lishisa kakhulu kubhekwa njengezikhali ‘ezinamandla’ zokuzivikela esifweni somdlavuza wesikhumba.”

Kuthiwani-ke ngokusenza sibe nsundu ngemishini yasendlini ekhipha imisebe yelanga (sun lamp) noma ngemibhede yokusishisa (tanning bed)? Kusikiselwa ukuthi ukuchitha imizuzu engu-20 nje kuphela kulezo zikhungo zokuzishintsha umbala wesikhumba ube nsundu kulingana nokuchitha amahora amane elangeni. Ukusebenzisa le mishini kwakucatshangwa ukuthi kuphephile ngoba le mishini ngokuyinhloko ikhipha imisebe yama-UVA, okwakubonakala ingashisi kakhulu. Kodwa i-Skin Cancer Answer ithi: “Manje sekuyaziwa ukuthi imisebe yama-UVA ingena ijule esikhunjeni kunemisebe yama-UVB, nokuthi ingabangela umdlavuza wesikhumba, iphazamise nesimiso somzimba sokuzivikela.” Okunye ukuhlola okwabikwa ngakho ephephandabeni elinyatheliswa emhlabeni wonke i-Miami Herald kwathola ukuthi abesifazane ababeya kanye ngenyanga noma ngaphezulu ezikhungweni zokushintsha umbala wesikhumba ube nsundu “babandisa amathuba abo okuba ne-melanoma ngamaphesenti angu-55.”

Ngakho, kubalulekile ukuba ucabange nzulu ngezindlela zokuzivikela elangeni. Khumbula, ukushiswa ilanga namuhla kungase kubangele umdlavuza wesikhumba eminyakeni engu-20 noma ngaphezulu ezayo. Nokho, abanye baye bashikashikana kanjani nale nkinga yomdlavuza wesikhumba, futhi yini eye yabasiza ukuba bakwazi ukubhekana nayo?

[Imibhalo yaphansi]

[Ibhokisi/Izithombe ekhasini 7]

IZIMPAWU EZIYISIXWAYISO ZE-MELANOMA EBULALAYO

1. UKUNGALINGANI KWEZINHLANGOTHI. Ngokuvamile lapho zisaqala, izinsumpa ezinomdlavuza okuthiwa i-melanoma ziba nezinhlangothi ezingalingani. Kanti izinsumpa ezivamile ziba yindilinga futhi izinhlangothi zazo ziyalingana.

2. UKUNGALINGANI KWAMAPHETHELO. Lapho lezi zinsumpa ezinalo mdlavuza zisaqala, ngokuvamile amaphethelo azo awalingani futhi angase abe mahhadlahhadla. Kanti amaphethelo ezinsumpa ezivamile aba bushelelezi futhi ayalingana.

3. UKUHLUKAHLUKA KWEMIBALA. Ekuqaleni lezi zinsumpa ziba nemibala ehlukahlukene, zingaba nsundu noma zibe mnyama. Njengoba lo mdlavuza uqhubeka, insumpa ingase ibe nombala obomvu, omhlophe noluhlaza okwesibhakabhaka. Kanti izinsumpa ezijwayelekile ngokuvamile ziba nombala onsundu nje kuphela.

4. UBUKHULU. Lapho zisaqala, izinsumpa ezinomdlavuza i-melanoma zivame ukukhula zibe nkulu kunezinsumpa ezivamile, cishe zibe ngaphezu kwamamilimitha ayisithupha ubukhulu.

[Imithombo]

Source: The Skin Cancer Foundation

Skin samples: Images courtesy of the Skin Cancer Foundation, New York, NY, www.skincancer.org

[Ibhokisi/Izithombe ekhasini 8]

AMACEBISO OKUVIKELA ISIKHUMBA SAKHO

1. Nciphisa isikhathi osichitha uselangeni, ikakhulu phakathi kuka-10:00 ekuseni no-4:00 ntambama, lapho imisebe eyingozi yama-ultraviolet (UV) inamandla khona.

2. Hlola isikhumba sakho kusuka ekhanda kuya ematheni onyawo okungenani kanye ngemva kwezi- nyanga ezintathu.

3. Lapho ungaphandle, gcoba umuthi ovikela isikhumba emisebeni yama-UVA neyama-UVB onezinga le-SPF elingu-15 noma ngaphezulu. Ugcobe kakhulu emizuzwini engu-30 ngaphambi kokuba uphumele elangeni bese uphinda uwugcoba njalo ngemva kwamahora amabili. (Izingane ezinezinyanga ezingaphansi kweziyisithupha akufanele zigcotshwe lo muthi.)

4. Fundisa izingane zakho izindlela zokuzivikela elangeni kusukela zisencane, ngoba umonakalo oholela ezifweni zomdlavuza wesikhumba lapho abantu sebebadala uqala ebuntwaneni.

5. Gqoka izingubo ezivikelayo njengamabhulukwe amade, amahembe anemikhono emide, izigqoko zelanga eziwumhelane nezibuko ezivikela emisebeni yama-UV.