{"id":16843,"date":"2020-08-02T16:41:24","date_gmt":"2020-08-02T12:41:24","guid":{"rendered":"http:\/\/clinichelena.kinsta.cloud\/melanoma\/"},"modified":"2025-05-06T13:16:08","modified_gmt":"2025-05-06T11:16:08","slug":"melanooma","status":"publish","type":"page","link":"https:\/\/www.clinichelena.com\/fi\/melanooma\/","title":{"rendered":"Melanooma"},"content":{"rendered":"\n

Melanooma<\/h1>\n\n\n\n

Aikaisen vaiheen melanooma voidaan hoitaa t\u00e4ysin. L\u00e4\u00e4ketieteen jatkuvan kehityksen ansiosta melanoomasta paraneminen on yh\u00e4 todenn\u00e4k\u00f6isemp\u00e4\u00e4. Clinic Helena tarjoaa edistyksekk\u00e4int\u00e4 olemassa olevaa melanoomahoitoa.<\/p>\n\n\n\n

Ota meihin yhteytt\u00e4<\/a>, mik\u00e4li mielt\u00e4si painaa mik\u00e4\u00e4n sivulla olevista asioista.<\/p>\n\n\n\n

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Melanooma alkaa ihon melanosyyttisoluista (ns tummista soluista). Se on l\u00e4nsimaissa rintasy\u00f6v\u00e4n ohella nopeimmin yleistyv\u00e4 sy\u00f6p\u00e4sairaus.<\/span><\/p>\n\n\n\n

T\u00e4rkein riskitekij\u00e4 on auringon UV-s\u00e4teilyn aiheuttama ihon palaminen. Vaalea, pisamainen, punapigmenttinen iho palaa herkimmin. Aurinkoisina p\u00e4ivin\u00e4 suositeltava auringonsuojavoiteiden kerroin on v\u00e4hint\u00e4\u00e4n 20.<\/p>\n<\/div>\n\n\n\n

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\"Muut<\/a>
Melanoma vartalon sivulla<\/em><\/figcaption><\/figure>\n<\/div>\n<\/div><\/section>\n\n\n\n

Melanooma syntyy vain noin kolmanneksessa tapauksia ihon luomeen, ja loput kaksi kolmasosaa aiemmin terveelle iholle. T\u00e4rke\u00e4t\u00e4 on poistaa n\u00e4ytteeksi kaikki luomet ja ihomuutokset, joissa tapahtuu v\u00e4rin vaihtelua, koon kasvua, punoitusta luomen ymp\u00e4rille tai pinta rikkoutuu ja rupeutuu, eik\u00e4 parane.<\/p>\n\n\n\n

Luomi poistetaan kokonaan n\u00e4ytteeksi ja mahdollisuuksien mukaan poistetaan sen ymp\u00e4rilt\u00e4 pieni reunus my\u00f6s tervett\u00e4 kudosta. Kaikki n\u00e4m\u00e4 luomet tulee tutkia mikroskoopilla (PAD).<\/p>\n\n\n\n

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\"\"<\/a><\/figure>\n<\/div>\n\n\n\n
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Hoito<\/h2>\n\n\n\n

Melanooman hoito on ensisijaisesti kirurginen leikkaushoito. <\/p>\n\n\n\n

Leikkauksen laajuus m\u00e4\u00e4ritell\u00e4\u00e4n melanooman paksuuden mukaan. Paksuus ilmoitetaan PAD-n\u00e4ytteest\u00e4 millimetrein\u00e4 Breslow-asteikon mukaan. <\/p>\n\n\n\n

Pinnallinen haavauma (ulceratio) vaikeuttaa paksuuden arviointia ja todellisuudessa muutos on aina ilmoitettua paksumpi. Melanooma tunkeutuu l\u00e4hiymp\u00e4rist\u00f6\u00f6ns\u00e4 muodostaen ns. satelliittipes\u00e4kkeit\u00e4. N\u00e4iden pes\u00e4kkeiden et\u00e4isyys riippuu melanooman paksuudesta. <\/span><\/p>\n\n\n\n

Siksi sairaan ihomuutoksen ymp\u00e4rilt\u00e4 poistetaan tervett\u00e4 kudosta yksil\u00f6llisesti Breslow-luokituksen perusteella.<\/span><\/p>\n\n\n\n

Breslow-luokitus<\/h4>\n\n\n\n

Breslow-paksuus alle 1 mm kertoo pinnallisesta, hyv\u00e4ennusteisesta varhaisvaiheen taudista. T\u00e4ll\u00f6in melanooman tai aikaisemmin leikatun arven ymp\u00e4rille tehd\u00e4\u00e4n 1 cm:n lis\u00e4poisto.<\/p>\n\n\n\n

Breslow-paksuus 1-2 mm on my\u00f6skin viel\u00e4 pinnallinen, suhteellisen hyv\u00e4ennusteinen ja 2 cm:n tervekudospoisto muutoksen ymp\u00e4rill\u00e4 on riitt\u00e4v\u00e4.<\/p>\n\n\n\n

Yli 2 mm paksuissa melanoomissa muutoksen reunojen poisto tehd\u00e4\u00e4n 2-3 cm:n marginaalilla. T\u00e4m\u00e4n laajemmasta poistosta ei ole hy\u00f6ty\u00e4. <\/p>\n\n\n\n

Aikaisemmin tehdyt laajat 5 cm:n marginaalilla tehdyt kudospoistot ovat historiaa.<\/p>\n\n\n\n

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\"Helena<\/a><\/figure>\n<\/div>\n\n\n\n
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\"Leikkaussalissa\"<\/a><\/figure>\n\n\n\n

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Vartijaimusolmuke<\/h2>\n\n\n\n

Melanooman leikkaushoitoon kuuluu aina imusolmukealueiden vartijasolmuketukimus (sentinel node biopsy), jos melanooman paksuus on yli 1 mm.<\/p>\n\n\n\n

Leikkausta edelt\u00e4v\u00e4n\u00e4 p\u00e4iv\u00e4n\u00e4 melanooma-arpeen laitetaan Technetium-isotooppia ja kuvataan imusolmukekartta. Isotooppia ker\u00e4nneet imusolmukkeet poistetaan melanooma-arven lis\u00e4leikkauksen yhteydess\u00e4.<\/p>\n\n\n\n

Jos n\u00e4ist\u00e4 merkkautuneista vartijasolmukkeista l\u00f6ytyy jatkotukimuksissa melanoomasoluja, tehd\u00e4\u00e4n imusolmuke-evakuaatio kyseiselle imusolmukealueelle.<\/p>\n\n\n\n

My\u00f6s yksitt\u00e4isi\u00e4 et\u00e4pes\u00e4kkeit\u00e4 leikataan harkinnan mukaan
Leikkaus voidaan tehd\u00e4 paikallispuudutuksessa p\u00e4iv\u00e4kirurgisena, mutta riippuen imusolmukealueiden laajuudesta tehd\u00e4\u00e4n toimenpide nukutuksessa. Tarvittaessa potilas voi y\u00f6py\u00e4 valvontaosastolla y\u00f6n yli.<\/p>\n\n\n\n

Leikkaus tehd\u00e4\u00e4n meill\u00e4 plastiikkakirurgin toimesta k\u00e4ytt\u00e4en onkoplastisia menetelmi\u00e4. K\u00e4ytet\u00e4\u00e4nn paikallisia ihokielekkeit\u00e4, et\u00e4kielekkeit\u00e4 ja tarvittaessa mikrovaskulaarisia kudoskielekkeit\u00e4.
Leikkauksen hinta m\u00e4\u00e4r\u00e4ytyy toimenpiteen laajuuden mukaan ja arvioidaan konsultaatiok\u00e4ynnill\u00e4.<\/p>\n\n\n\n

Melanooman liit\u00e4nn\u00e4ishoidot<\/h2>\n\n\n\n

Yli 1 mm paksuisessa melanoomassa konsultoidaan onkologia (Esa M\u00e4nnist\u00f6) liit\u00e4nn\u00e4ishoitojen tarpeellisuudesta.<\/p>\n\n\n\n

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Levinneisyyden tutkimiseksi katsotaan keuhkokuva ja maksan ultra\u00e4\u00e4nitutkimus. Imusolukepositiivisessa taudissa vartatonCT-tutkimukset ja luustokartta ovat aiheelliset.<\/p>\n\n\n\n

Melanooman l\u00e4\u00e4kehoidot ovat viime aikoina merkitt\u00e4v\u00e4sti kehittyneet.<\/p>\n\n\n\n

Mitogeeniaktivoidun proteiinikinaasin (MAPK) merkitys solujen geeni-ilmentym\u00e4n, solujen kasvun ja hengiss\u00e4 pysymisen s\u00e4\u00e4telyn\u00e4 on tuonut uusia kasvainmerkkiaineita (ns. signaalimolekyylej\u00e4). Muun muassa B-RAF geenimutaatio voidaan m\u00e4\u00e4ritt\u00e4\u00e4 kasvaimesta. N\u00e4iden avulla voidaan valita uusista l\u00e4\u00e4kkeist\u00e4 radikaalisti jo levinnytt\u00e4 melanoomaa hoitavia valmisteita (vemurafenib, dabrafenibjne). Haittapuolena on n\u00e4iden uusien l\u00e4\u00e4kkeiden kalliit hinnat.<\/p>\n<\/div>\n\n\n\n

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\"Muut<\/a><\/figure>\n<\/div>\n<\/div><\/section>\n\n\n\n

Onkologimme Esa M\u00e4nnist\u00f6 suosittelee yksil\u00f6llisesti parasta mahdollista hoitoa. My\u00f6s pitk\u00e4\u00e4n k\u00e4yt\u00f6ss\u00e4 olevat l\u00e4\u00e4kkeet kuten alfainterferoni (IFN-alfa) ovat edelleen tehokkaita valituissa tapauksissa uusiutumisen ennalta ehk\u00e4isyss\u00e4.<\/p>\n\n\n\n

Liit\u00e4nn\u00e4ishoitona voidaan k\u00e4ytt\u00e4\u00e4 my\u00f6s monisolunsalpaajahoitoa, kemoimmunoterapiaa (solunsalpaajahoidon ja IFN-alfan yhdistelm\u00e4hoito) tai s\u00e4dehoitoa. Melanoomarokotukset ovat t\u00e4ll\u00e4 hetkell\u00e4 viel\u00e4 tutkimusvaiheessa.<\/p>\n","protected":false},"excerpt":{"rendered":"

Melanooma Aikaisen vaiheen melanooma voidaan hoitaa t\u00e4ysin. L\u00e4\u00e4ketieteen jatkuvan kehityksen ansiosta melanoomasta paraneminen on yh\u00e4 todenn\u00e4k\u00f6isemp\u00e4\u00e4. Clinic Helena tarjoaa edistyksekk\u00e4int\u00e4 olemassa olevaa melanoomahoitoa. Ota meihin yhteytt\u00e4, mik\u00e4li mielt\u00e4si painaa mik\u00e4\u00e4n sivulla olevista asioista. Melanooma alkaa […]<\/p>\n","protected":false},"author":17,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_uag_custom_page_level_css":"","_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","site-sidebar-layout":"left-sidebar","site-content-layout":"default","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"disabled","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"default","adv-header-id-meta":"","stick-header-meta":"default","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-16843","page","type-page","status-publish","hentry"],"yoast_head":"\nMelanooma - Clinic Helena<\/title>\n<meta name=\"description\" content=\"Aikaisen vaiheen melanooma voidaan hoitaa t\u00e4ysin. 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L\u00e4\u00e4ketieteen jatkuvan kehityksen ansiosta melanoomasta paraneminen on yh\u00e4 todenn\u00e4k\u00f6isemp\u00e4\u00e4. Clinic Helena tarjoaa edistyksekk\u00e4int\u00e4 olemassa olevaa melanoomahoitoa. Ota meihin yhteytt\u00e4, mik\u00e4li mielt\u00e4si painaa mik\u00e4\u00e4n sivulla olevista asioista. 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