How Do Damaged Skin Cells Turn Into Stage 4 Melanoma?

来自太阳的紫外线照射,或单宁g bed, strongly correlates to melanoma, says Rachel Maiman, M.D., a clinical instructor at The Mount Sinai Hospital department of dermatology in New York City. UV light damages the DNA in melanocytes, which are specialized skin cells that produce melanin (the pigment that colors our skin); these cells are also active in the skin’s immune system. The damaged DNA can be repaired only partially, says Dr. Maiman. “Over time, the remaining DNA damage can lead to mutations [in the melanocytes] that produce melanoma.”

Most melanomas show up as a new skin growth. They occur in existing moles just 20% to 30% of the time. “The cancer may be evident as a flat or barely raised lesion with irregular borders and a diameter about the size of a pencil (eraser),” says Omar Hamid, M.D., director of the melanoma program at Cedars-Sinai The Angeles Clinic and Research Institute in Los Angeles. If the melanocytes are still producing pigment, the spot will be brown, tan or black; if not, it can manifest as pink or even white.

Mutated melanocytes can replicate quickly and start to form a tumor in the top layer of skin known as the basal layer of the epidermis. When the cells show abnormal horizontal growth within this superficial layer, doctors diagnose as melanoma in situ, or stage 0 melanoma. (Melanoma diagnoses are based on the depth/thickness of the tumor and how much it has spread.) “If you’re going to have a melanoma, this is where you want to catch it,” says Ramin Fathi, M.D., a board-certified dermatologist and Mohs surgeon at Phoenix Surgical Dermatology Group in Phoenix. “The survival rate is 98-plus percent.”

穿透下一层皮肤（称为真皮）的肿瘤被归类为第1阶段黑色素瘤。在那一点上，它通常衡量不超过2毫米，仍然是本地的，但它现在被称为“侵入性”。与第0阶段一样，用轻微的手术治疗1阶段的黑色素瘤并考虑可固化。根据黑素瘤研究联盟的说法，还有好消息：复发或转移的风险仍然被认为是低的。

As melanoma progresses, the tumor will grow and change. At stage 2, it’s still local, meaning that while there is cancer in the epidermis and dermis, there is no evidence that it has spread to the lymph nodes. Stage 2 is defined by tumor thickness and extent of ulceration (microscopic breaks in the skin)— ulceration makes for a worse prognosis. Stage 2 tumors can still be treated with surgery, called a wide local excision. But without early detection and treatment, however, the melanoma will likely spread to the lymph nodes and, eventually, beyond.

这种更先进的阶段意味着黑色素瘤细胞已将较深的更深的进入真皮和/或从皮肤行进到附近的淋巴结中。讲述迹象表明，您可能有第3阶段的黑色素瘤可以在皮肤，肿胀或痛苦的淋巴结下发现硬化的肿块，一般疲劳，食欲丧失以及其他令人担忧的问题。治疗方案包括免疫疗法和靶向药物疗法。“那些是医生的首选治疗方法，”Fathi博士说。

黑色素瘤的最后阶段称为转移性，或第4阶段。这意味着它比应该进一步得多，“哈米德博士说。肿瘤细胞现在已经扩散到远处淋巴结和/或静脉曲室，如脑，肺，肝，骨骼或胃肠道。取决于它的降落在哪里，您可能会呼吸，破碎骨痛，甚至癫痫发作。免疫疗法或有针对性的疗法，有时与其他治疗等化疗的组合，是通常的行动方案。

好消息是，大多数黑色素瘤病例在早期检测到时可固化。保持安全的主要方式是限制在阳光下的时间，穿防晒霜和帽子，一般掩盖。Fathi博士还建议在皮肤科办公室常规，全身皮肤检查。Maiman博士增加了“[黑色素瘤]如果没有早点捕获和治疗，更可能蔓延。你应该知道要注意什么。“为此，美国癌症协会提供了一个综合自我考试that you can perform at any time.