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.
When Should I Call My Doctor
You should have a skin examination by a doctor if you have any of the following:
- A personal history of skin cancer or atypical moles .
- A family history of skin cancer.
- A history of intense sun exposure as a young person and painful or blistering sunburns.
- New or numerous large moles.
- A mole that changes in size, color or shape.
- Any mole that itches, bleeds or is tender.
A note from Cleveland Clinic
Receiving a diagnosis of melanoma can be scary. Watch your skin and moles for any changes and seeing your doctor regularly for skin examinations, especially if youre fair-skinned, will give you the best chances for catching melanoma early when its most treatable.
Last reviewed by a Cleveland Clinic medical professional on 06/21/2021.
References
How Is Melanoma Treated
Your melanoma treatment will depend on the stage of the melanoma and your general health.
Surgery is usually the main treatment for melanoma. The procedure involves cutting out the cancer and some of the normal skin surrounding it. The amount of healthy skin removed will depend on the size and location of the skin cancer. Typically, surgical excision of melanoma can be performed under local anesthesia in the dermatologist’s office. More advanced cases may require other types of treatment in addition to or instead of surgery.
Treatments for melanoma:
- Melanoma Surgery: In the early stages, surgery has a high probability of being able to cure your melanoma. Usually performed in an office, a dermatologist numbs the skin with a local anesthetic and removes the melanoma and margins .
- Lymphadenectomy: In cases where melanoma has spread, removal of the lymph nodes near the primary diagnosis site may be required. This can prevent the spread to other areas of your body.
- Metastasectomy: Metastasectomy is used to remove small melanoma bits from organs.
- Targeted cancer therapy: In this treatment option, drugs are used to attack specific cancer cells. This targeted approach goes after cancer cells, leaving healthy cells untouched.
- Radiation Therapy: Radiation therapy includes treatments with high-energy rays to attack cancer cells and shrink tumors.
- Immunotherapy: immunotherapy stimulates your own immune system to help fight the cancer.
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Treating Stage 4 Melanoma
If melanoma comes back or spreads to other organs it’s called stage 4 melanoma.
In the past, cure from stage 4 melanoma was very rare but new treatments, such as immunotherapy and targeted treatments, show encouraging results.
Treatment for stage 4 melanoma is given in the hope that it can slow the cancer’s growth, reduce symptoms, and extend life expectancy.
You may be offered surgery to remove other melanomas that have grown away from the original site. You may also be able to have other treatments to help with your symptoms, such as radiotherapy and medicine.
If you have advanced melanoma, you may decide not to have treatment if it’s unlikely to significantly extend your life expectancy, or if you do not have symptoms that cause pain or discomfort.
It’s entirely your decision and your treatment team will respect it. If you decide not to receive treatment, pain relief and nursing care will be made available when you need it. This is called palliative care.
How To Protect Yourself From Melanoma
Fortunately, most melanomas are diagnosed in early, localized stages, says Dr. González, and most patients treated for melanoma make a full recovery. But we do have patients that have ignored that funny looking mole for way too long, and its not uncommon to see cases that have metastasized to other organs, she adds.
Melanoma tends to a very aggressive form of cancer, and it can progress quickly from one stage to another. Says Dr. González: As soon as you see something unusual you should get it checked out, and as soon as you get a diagnosis, you need to be on top of the appropriate treatment.
Risk factors for melanoma include ultraviolet light exposure , having fair skin and light hair, and having a close relative whos also had melanoma. But monitoring skin for abnormal growths and changes is important for everyone, whether or not they are predisposed to skin cancer.
Going to see your board-certified dermatologist yearly and doing regular skin exams may not seem that important, Dr. González says, “but these are the things that could save your life.”
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What Are The Survival Rates For Melanoma
When found early and treated properly, melanoma is highly curable. These are the survival rates by stage according to the American Cancer Society, based in part on the 2008 American Joint Committee on Cancer Melanoma Staging Database:
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Stage IA. The 5-year survival rate is around 97%. The 10-year survival rate is around 95%.
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Stage IB. The 5-year survival rate is around 92%. The 10-year survival rate is around 86%.
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Stage IIA. The 5-year survival rate is 81%. The 10-year survival rate is around 67%.
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Stage IIB. The 5-year survival rate is 70%. The 10-year survival rate is around 57%.
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Stage IIC. The 5-year survival rate is around 53%. The 10-year survival rate is 40%.
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Stage IIIA. The 5-year survival rate is around 78%. The 10-year survival rate is 68%.
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Stage IIIB. The 5-year survival rate is around 59%. The 10-year survival rate is around 43%.
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Stage IIIC. The 5-year survival rate is around 40%. The 10-year survival rate is around 24%.
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Stage IV. The 5-year survival rate is around 15% to 20%. The 10-year survival rate is 10% to 15%. This rate is higher if the cancer has spread only to the skin or distant lymph nodes and not to vital organs.
Factors other than stage also affect survival. For example:
What Are The Stages Of Melanoma
Cancerstaging is how doctors describe the extent of cancer in your body. Staging is defined by the characteristics of the original melanomatumor and if/how far it has spread in your body.
Melanoma is divided into stages using five Roman numerals and up to four letters that indicate a higher risk within each stage. The stage is determined mostly by specific details about the tumor and its growth that are tallied in a system called TNM. Read more about the TNM system.
Your stage is important because cancer treatment options and prognoses are determined by stage.
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Is Stage 1 Melanoma Serious
All stages of melanoma are serious, but stage 1 melanoma is one of the mildly-serious stages of the cancer. When detected early in stage 1, the cancerous mole or growth has spread from the epidermis to the dermis . However, it’s not yet spread to other parts of the body. Generally, surgical removal of the growth and some surrounding tissue will get rid of the melanoma and generally has a five-year survival rate of 89percent to 95percent, which means that about 90 percent of people with this surgery will still be alive five years later. However, once the disease has spread from the skin to other parts of the body, it may become fatal. That being said, it’s very important to see a doctor if you notice any changes in existing moles or any new skin growths, since the chance for a full recovery is better the earlier you treat it.
Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.
How Is Melanoma Staged
Melanoma stages are assigned using the TNM system.
The stage of the disease indicates how much the cancer has progressed by taking into account the size of the tumor, whether its spread to lymph nodes, and whether its spread to other parts of the body.
A doctor can identify a possible melanoma during a physical exam and confirm the diagnosis with a biopsy, where the tissue is removed to determine if its cancerous.
But more sophisticated technology, such as PET scans and sentinel lymph node biopsies, are necessary to determine the cancers stage or how far its progressed.
There are five stages of melanoma. The first stage is called stage 0, or melanoma in situ. The last stage is called stage 4. Survival rates decrease with later stages of melanoma.
Its important to note that survival rates for each stage are just estimates. Each person with melanoma is different, and your outlook can vary based on a number of different factors.
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What Is A Stage 1 Melanoma
When the specimen is examined there are certain features looked at the give the melanoma a staging level. These include the thickness of the melanoma , which measures how far the melanoma cells have invaded through into the layers of skin. The pathologist will also note other special features such as ulceration and pigmentation. This information is used as part of the staging process and according to this system you have been diagnosed with stage 1 melanoma. Stage 1 is considered a thin melanoma.
If your melanoma is caught before it is too thick the prognosis is very good. Nearly 19 in 20 people who have a stage 1 melanoma are alive at least five years after being diagnosed. Stage 1 is the least serious type of melanoma.
Why Are There Melanoma Stages
There is a lot to say whether or not this is at a point in time where it can be treated by simply removing the freckle and never hearing of it again. Then again, if it spread to a more important organ in the body, there might not be a chance in saving yourself. How do you distinguish between one and the other?
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Whats Different In The Stage 0 Melanoma Patient Than The Stage 1 Patient Such That 10
The earlier that melanoma is caught , the higher the survival rate when projected 5-10 years out. So for stage 0 melanoma, the 10-year survival rate is about 99 percent.
For stage 1A melanoma the 10-year survival rate is 95 percent for stage 1B its 86 percent.
Whats going on here? All of these tumors are thin and not penetrated into the dermis layer of the skin.
My own sense of this is as follows, begins Judith Hellman, MD, Associate Clinical Professor of Dermatology, Mt. Sinai Hospital, NY, who has a private practice in Manhattan.
When a melanoma is treated, we follow guidelines in the treatment, and excise some extra skin around the melanoma according to the stage it is.
That extra-excised skin is normal, as a precaution that in case any tumor cells have strayed, they too get removed.
In theory, this should be a good measure to know that there will be no mets , continues Dr. Hellman.
However, sometimes random melanoma cells can escape the confines of a lesion and the margins of a surgical excision.
This is more likely to be the case with a deeper tumor. Stage 0 isnt as deep as stage 1A isnt as deep as stage 1B, and so on.
Melanoma stages. Cancer Research UK
These cells can certainly survive, multiply and find their way to other parts of the body, says Dr. Hellman.
Nothing in nature is 100%, so there can always be some undetected cells that can make their own way and grow at a different site.
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Who Is Involved In The Process
Staging is not assigned by a single person. Unfortunately, it is not a black and white image of where everything is. Its the result of effort from a group of highly trained individuals that bring their knowledge and expertise together to evaluate all perspectives of the illness. There are two ways cancer is staged. It can be clinical or pathologic. The former is concluded using all information obtained before surgery takes place.
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This includes the physical examination where you feel lumps and note discolor, blood tests , blood protein testing , tumor marker tests , 125 , calcitonin, alpha fetoprotein , human chronic gonadotropin ), and circulating tumor tests), radiologic techniques , nuclear medicine , magnetic resonance imaging ), biopsies, and endoscopies. The later component is when a pathologist exams the contents of the mass under the microscopic. The time of which these readings are carried out varies between the case and you should listen to what your oncologist recommends as it is thoroughly researched.
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What To Ask Your Doctor About Stage I Melanoma
When your doctor tells you that you have Stage I melanoma, it can be overwhelming. But it is important to use the time with your doctor to learn as much about your cancer as you can. S/he will provide you important information about your diagnosis.
The following questions are those you may want to ask your doctor. Remember, it is ALWAYS okay to ask your doctor to repeat or clarify something s/he said so that you can better understand it. You may find it helpful to print out these questions and bring them with you to your next appointment.
Treating Stage 3 Melanoma
If the melanoma has spread to nearby lymph nodes , further surgery may be needed to remove them.
Stage 3 melanoma may be diagnosed by a sentinel node biopsy, or you or a member of your treatment team may have felt a lump in your lymph nodes.
The diagnosis of melanoma is usually confirmed using a needle biopsy .
Removing the affected lymph nodes is done under general anaesthetic.
The procedure, called a lymph node dissection, can disrupt the lymphatic system, leading to a build-up of fluids in your limbs. This is known as lymphoedema.
Cancer Research UK has more information about surgery to remove lymph nodes.
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Stage : Melanoma In Situ
The earliest stage of melanoma is stage 0, also known as melanoma in situ or carcinoma in situ. In situ is a Latin phrase that means in position, and this diagnosis means that the cancer cells are present only in the epidermisthe bodys most superficial layer of skinand nowhere else.
This diagnosis has a very good prognosis, Noelani González, MD, an instructor of dermatology at the Mount Sinai Icahn School of Medicine in New York City, tells Health. People with localized melanomas who are treated quickly have a 5-year survival rate of 97%meaning they are, on average, about 97% as likely to still be alive in five years as people who dont have these cancers.
Treatment for this stage cancer involves a wide excision surgery, where the affected skin is cut away and the wound is stitched and bandaged. The skin will be removed with margins, explains Dr. González. That means that some normal skin will also be removed around the edges to make sure there arent any cancer cells left over.
The removed skin is then looked at under a microscope to ensure that all of the cancer was removed with clean margins, says Dr. González. Because stage 0 cancer has not spread to any other tissues or organs, no further treatment is required.
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Factors Used For Staging Melanoma
To determine the stage of a melanoma, the lesion and some surrounding healthy tissue need to be surgically removed and analyzed using a microscope. Doctors use the melanomas thickness, measured in millimeters , and the other characteristics described in Diagnosis to help determine the diseases stage.
Doctors also use results from diagnostic tests to answer these questions about the stage of melanoma:
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How thick or deep is the original melanoma, often called the primary melanoma or primary tumor?
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Where is the melanoma located?
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Has the melanoma spread to the lymph nodes? If so, where and how many?
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Has the melanoma metastasized to other parts of the body? If so, where and how much?
The results are combined to determine the stage of melanoma for each person. The stages of melanoma include: stage 0 and stages I through IV . The stage provides a common way of describing the cancer, so doctors can work together to create the best treatment plan and understand a patient’s prognosis.
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Can Changing My Diet Help Prevent Melanoma
The American Cancer Society advocates eating a plant-based diet over an animal-based diet as part of a healthy plan to avoid all cancers. Growing evidence suggests that plants pack a powerful punch in any fight against cancer because they’re nutritious, cholesterol-free and fiber-rich.
Theres no doubt that a healthy diet can protect your immune system. Having a strong immune system is important to help your body fight disease. Some research has shown that a Mediterranean diet is a healthy choice that may help prevent the development of cancer. Talk to your healthcare provider about the role food plays in lowering your cancer risks.
Some skin and immune-system healthy foods to consider include:
- Daily tea drinking: The polyphenols in tea help strengthen your immune system. Green tea contains more polyphenols than black tea.
- High vegetable consumption: Eating carrots, cruciferous and leafy vegetables is linked to the prevention of cutaneous melanoma.
- Weekly fish intake: Study participants who ate fish weekly seemed to avoid developing the disease when compared to those who did not eat fish weekly.