The Stage Of Melanoma Depends On The Thickness Of The Tumor Whether Cancer Has Spread To Lymph Nodes Or Other Parts Of The Body And Other Factors
To find out the stage of melanoma, the tumor is completely removed and nearby lymph nodes are checked for signs of cancer. The stage of the cancer is used to determine which treatment is best. Check with your doctor to find out which stage of cancer you have.
The stage of melanoma depends on the following:
- The thickness of the tumor. The thickness of the tumor is measured from the surface of the skin to the deepest part of the tumor.
- Whether there are:
- Satellite tumors: Small groups of tumor cells that have spread within 2 centimeters of the primary tumor.
- Microsatellite tumors: Small groups of tumor cells that have spread to an area right beside or below the primary tumor.
- In-transit metastases: Tumors that have spread to lymph vessels in the skin more than 2 centimeters away from the primary tumor, but not to the lymph nodes.
Recurrence In Nearby Lymph Nodes
If nearby lymph nodes werenât all removed during the initial treatment, the melanoma might come back in these lymph nodes. Lymph node recurrence is treated by lymph node dissection if it can be done, sometimes followed by adjuvant treatments such as radiation therapy and/or immunotherapy or targeted therapy . If surgery is not an option, radiation therapy or systemic treatment can be used.
Signs Of Melanoma Include A Change In The Way A Mole Or Pigmented Area Looks
These and other signs and symptoms may be caused by melanoma or by other conditions. Check with your doctor if you have any of the following:
- A mole that:
- changes in size, shape, or color.
- has irregular edges or borders.
- is more than one color.
- is asymmetrical .
- itches.
- oozes, bleeds, or is ulcerated .
For pictures and descriptions of common moles and melanoma, see Common Moles, Dysplastic Nevi, and Risk of Melanoma.
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The best way to cite this PDQ summary is:
PDQ® Adult Treatment Editorial Board. PDQ Melanoma Treatment. Bethesda, MD: National Cancer Institute. Updated < MM/DD/YYYY> . Available at: . Accessed < MM/DD/YYYY> .
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Melanoma Is A Disease In Which Malignant Cells Form In Melanocytes
The skin is the bodys largest organ. It protects against heat, sunlight, injury, and infection. Skin also helps control body temperature and stores water, fat, and vitamin D. The skin has several layers, but the two main layers are the epidermis and the dermis . Skin cancer begins in the epidermis, which is made up of three kinds of cells:
- Squamous cells: Thin, flat cells that form the top layer of the epidermis.
- Basal cells: Round cells under the squamous cells.
- Melanocytes: Cells that make melanin and are found in the lower part of the epidermis. Melanin is the pigment that gives skin its natural color. When skin is exposed to the sun or artificial light, melanocytes make more pigment and cause the skin to darken.
The number of new cases of melanoma has been increasing over the last 30 years. Melanoma is most common in adults, but it is sometimes found in children and adolescents.
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Treatment Of Stage Ii Melanoma
For information about the treatments listed below, see the Treatment Option Overview section.
Treatment of stage II melanoma may include the following:
- Surgery to remove the tumor and some of the normal tissue around it. Sometimes lymph node mapping and sentinel lymph node biopsy are done to check for cancer in the lymph nodes at the same time as the surgery to remove the tumor. If cancer is found in the sentinel lymph node, more lymph nodes may be removed.
- A clinical trial of new types of treatment to be used after surgery.
Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.
Who Treats Melanoma Skin Cancer
Depending on your options, you may have different types of doctors on your treatment team. These doctors may include:
- A dermatologist: a doctor who treats diseases of the skin
- A surgical oncologist : a doctor who uses surgery to treat cancer
- A medical oncologist: a doctor who treats cancer with medicines such as chemotherapy, immunotherapy, or targeted therapy
- A radiation oncologist: a doctor who treats cancer with radiation therapy
Many other specialists may be involved in your care as well, including physician assistants , nurse practitioners , nurses, psychologists, social workers, rehabilitation specialists, and other health professionals.
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How Serious Is My Cancer
If you have melanoma, the doctor will want to find out how far it has spread. This is called staging. Your doctor will want to find out the stage of your cancer to help decide what type of treatment is best for you.
The stage describes the growth or spread of the melanoma through the skin. It also tells if it has spread to other parts of your body.
Your cancer can be stage 0, 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread beyond the skin. Be sure to ask the doctor about the cancer stage and what it means for you.
Treating Stage I Melanoma
Stage I melanoma is typically treated by wide excision . The width of the margin depends on the thickness and location of the melanoma. Most often, no other treatment is needed.
Some doctors may recommend a sentinel lymph node biopsy to look for cancer in nearby lymph nodes, especially if the melanoma is stage IB or has other characteristics that make it more likely to have spread. You and your doctor should discuss this option.
If the SLNB does not find cancer cells in the lymph nodes, then no further treatment is needed, although close follow-up is still important.
If cancer cells are found on the SLNB, a lymph node dissection might be recommended. Another option might be to watch the lymph nodes closely by getting an ultrasound of the nodes every few months.
If the SLNB found cancer, adjuvant treatment with an immune checkpoint inhibitor or targeted therapy drugs might be recommended to try to lower the chance the melanoma will come back. Other drugs or perhaps vaccines might also be options as part of a clinical trial.
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Treatment By Stage Of Melanoma
Different treatments may be recommended for each stage of melanoma. General descriptions by stage are below. Your doctor will recommend a specific treatment plan for you based on the stage and other factors. Detailed descriptions of each type of treatment are provided earlier on this page. Clinical trials may also be a treatment option for each stage.
Stage 0 melanoma
Stage 0 melanoma is almost always treated with surgery alone, usually a wide excision.
Stage I melanoma
Stage I melanoma is usually treated with surgical removal of the tumor and some of the healthy tissue around it. The doctor may recommend lymph node mapping, and some lymph nodes may be removed.
Stage II melanoma
The standard treatment for stage II melanoma is surgery to remove the tumor and some of the healthy tissue around it. While this surgery is being done, lymph node mapping and sentinel lymph node biopsy may also be done. In some people with stage II melanoma, treatment with interferon may be recommended after surgery to lower the chances of the cancer coming back. Treatment in a clinical trial for stage II melanoma may also be an option. Ask your doctor about what clinical trials may be available for you.
Stage III melanoma that can be removed with surgery
Advanced melanoma
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The persons age and overall health
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The locations and number of metastases
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How fast the disease is spreading
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The presence of specific genetic mutations in the tumor
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The patients preferences
Treating brain metastases
Who Are They For
Not every patient has mutations in their melanoma that are affected by the drugs that are currently available or in trial. Part of treatment at Melanoma Institute Australia includes being tested for these mutations and pairing you with the best option for your situation.
Some of the drugs are still under investigation in clinical trial testing. That means that even though you might have the mutation that correlates to a drug, the trials inclusion criteria could still prevent you from qualifying. Take a look at the Clinical Trials section of this site to learn more about how trials work.
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Metastatic Or Advanced Skin Cancer
It is uncommon, but non-melanoma skin cancer can spread to another part in the body from where it started. In these situations, doctors call it metastatic cancer. If this happens, it is a good idea to talk with doctors who have experience in treating it. Doctors can have different opinions about the best standard treatment plan. Clinical trials might also be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan.
Surgery alone cannot always eliminate skin cancer that has metastasized. If cancer cannot be removed with surgery, it is called unresectable. To control distant spread, a persons treatment plan may include chemotherapy, radiation therapy, and/or targeted therapy. Palliative care will also be important to help relieve symptoms and side effects.
Squamous cell carcinoma. Metastatic or unresectable squamous cell carcinoma of the skin is rare, so treatment plans often use the same treatments that have worked in people with squamous cell carcinoma of the head and neck that may not have started on the skin. Chemotherapy usually includes taxanes, such as docetaxel or paclitaxel , and platinums, such as carboplatin or cisplatin . The main side effects of these medicines include fatigue, low blood cell counts, rashes, diarrhea, and changes in sensation in the tips of the fingers or toes. Learn more about the basics of chemotherapy.
Skin Exam And Physical
If youve been diagnosed with melanoma, youve already had a skin biopsy. This biopsy was taken when you had part of the suspicious spot removed. After it was removed, a doctor looked at the spot under a microscope to find out if it contained cancer cells. This is currently the only way to tell if someone has skin cancer.
After getting the diagnosis, the next step is to get a complete skin exam and physical.
During the physical, your dermatologist will feel your lymph nodes. This is where melanoma usually goes when it begins to spread. It usually travels to the lymph nodes closest to the melanoma.
If there is a risk the cancer could have spread, your dermatologist may recommend that you have a lymph node biopsy. If a sentinel lymph node biopsy is recommended, it can be performed at the time of your surgery for melanoma.
After the skin exam and physical, your dermatologist may recommend testing, such as a CAT scan, MRI, or a blood test. These can also help detect spread.
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Treatment For Metastatic Melanoma
Metastatic melanoma is cancer that has spread beyond its original location to other parts of the body. Drug therapies are usually part of the treatment plan for metastatic melanoma. Surgery or radiation may also be an option for some people.
The outlook for people with metastatic melanoma has dramatically improved in the past decade. This is due in large part to drug therapies developed at MSK. These new options, which include immunotherapy and targeted therapy, have significantly lengthened lives and enhanced quality of life for many people with this condition. Chemotherapy is used much less commonly than it once was. It remains the best treatment option for some people, however. Your doctor will discuss all of these options with you.
What Is The Life Expectancy For Someone Who Has Been Diagnosed With Melanoma
If you have melanoma, many factors affect your life expectancy. Your age, other medical conditions, and stage of the melanoma are just a few factors. For this reason, its impossible to predict how long one person who has melanoma will live.
What researchers do instead is predict how long a group of people who have melanoma will live. This is called survival rate. If you come across this term while looking for information about melanoma, it is important to know what this means.
Survival rate is the percentage of people who will be alive within a certain time period, such as 5 years, after being diagnosed with a certain stage of melanoma. Each stage of melanoma has its own survival rate.
Before you search for the melanoma survival rates, its important to keep the following facts in mind:
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Survival rates are estimates.
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Each person diagnosed with melanoma has unique characteristics, so your outlook may be very different from someone else who has the same stage of melanoma.
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Newer treatments, such as immunotherapy and targeted therapy, are helping people live longer.
Another important consideration is your self-care after treatment. Protecting your skin from the sun and never tanning can help prevent a new melanoma. Yet, studies reveal that many people continue their old habits after treatment and never protect their skin from the sun.
Finding a new melanoma early can also help.
ImageGetty Images
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The Following Stages Are Used For Melanoma:
Stage 0
Stage I
- Stage IA: The tumor is not more than 1millimeter thick, with or without ulceration.
- Stage IB: The tumor is more than 1 but not more than 2 millimeters thick, without ulceration. Enlarge Stage I melanoma. In stage IA, the tumor is not more than 1 millimeter thick, with or without ulceration . In stage IB, the tumor is more than 1 but not more than 2 millimeters thick, without ulceration. Skin thickness is different on different parts of the body.
Stage II
- Stage IIA: The tumor is either:
- more than 1 but not more than 2 millimeters thick, with ulceration or
- more than 2 but not more than 4 millimeters thick, without ulceration. Enlarge Stage IIA melanoma. The tumor is more than 1 but not more than 2 millimeters thick, with ulceration OR it is more than 2 but not more than 4 millimeters thick, without ulceration. Skin thickness is different on different parts of the body.
Stage III
Stage III is divided into stages IIIA, IIIB, IIIC, and IIID.
Risk Of Further Melanomas
Most people treated for early melanoma do not have further trouble with the disease. However, when there is a chance that the melanoma may have spread to other parts of your body, you will need regular check-ups. Your doctor will decide how often you will need check-ups everyone is different. They will become less frequent if you have no further problems. After treatment for melanoma it is important to limit exposure to the sun’s UV radiation. As biological family members usually share similar traits, your family members may also have an increased risk of developing melanoma and other skin cancers. They can reduce their risk by spending less time in the sun and using a combination of sun protection measures during sun protection times. It is important to monitor your skin regularly and if you notice any changes in your skin, or enlarged lymph glands near to where you had the cancer, see your specialist as soon as possible.
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