Melanoma: a Stage-By-Stage Analysis

Melanoma: a Stage-By-Stage Analysis

Melanoma is the most serious form of skin cancer and, because it’s also the most aggressive, requires equally aggressive treatment in order to cure. When a person is diagnosed his medical team will employ what’s known as “staging” as a means of tracking tumors and determining their progress. Only with proper staging is it possible to develop an appropriate treatment plan.

Early diagnosis of melanoma is vital to increasing the chances of survival. In fact, WebMD suggests an overall 98% five-year survival rate among those who have been diagnosed at an early enough stage — before the melanoma has begun to spread. As the disease progresses through its four stages, survival rates drop off drastically.

The four stages of melanoma are as follows:

melanoma staging

  • Stage I – The first stage of melanoma involves very small tumors of 1 mm or less that have not spread to the nodes. This stage is divided into two sub stages known as IA and IB. In stage IA tumors are not ulcerated, while in stage IB they are. In either case the survival rate of patients diagnosed in stage I is about 95%.
  • Stage II – In stage II doctors are dealing with tumors that can be slightly larger and have started to spread to other sites. Stage II melanoma can still be cured but there are a number of additional complications to consider. Like the first stage, stage II is also divided into sub-stages:
  1. Stage IIA – At this point tumors are between 1 and 2 mm and also ulcerated. Tumors up to 4 mm can be diagnosed as stage II if they are not ulcerated. Survival rates in this stage are estimated between 77% and 79%.
  2. Stage IIB – In this stage tumors have still have not spread to the nodes. Ulcerated tumors between 2 and 4 mm, as well as non-ulcerated tumors of 4 mm or greater fall under this category. A survival rate between 63% 67% is expected for this stage.
  3. Stage IIC – A 45% survival rate is common with this stage, which involves ulcerated tumors greater than 4 mm that have not yet spread to the nodes.
  • Stage III – At stage III melanoma tumors have begun to spread (metastasize) to other locations, including the nodes. This stage is divided into three sub-stages which we won’t go into detail with here. The differences in the three sub-stages lie only in the amount of spread that’s been observed. Spreading of the cancerous cells is usually only noticeable at the microscopic level. At the high end, the five-year survival rate for stage III is 69%. At the low end it is closer to 30%.
  • Stage IV – Stage IV melanoma is the most critical and the most likely to result in death. At this stage tumors have spread to the lymph nodes, thereby carrying cancer cells to other parts of the body including the liver, brain, and lungs. Once melanoma reaches this stage the five-year survival rate is only between 7% and 9%.

Symptoms of Early Onset

Cancer specialists suggest annual skin examinations for anyone older than 40. In the absence of such examinations you can look for the signs of melanoma yourself. Keep in mind that it’s normal for us to develop moles and other skin growths as we age. If you notice a number of moles and blemishes that’s not necessarily reason to panic. Melanoma can develop in moles but most often it begins in skin that was previously unmarked.

abcde method for identifying cancerous moles

We recommend to use the ABCDE method when examining the skin for the presence of early-stage melanoma:

  • asymmetry (A) – moles usually look uniform across the entire surface; a blemish that is uneven on one half is cause for concern
  • border (B) – look for edges that have a ragged, blurred, or a rough appearance
  • color (C) – moles and natural blemishes have an even color; melanoma tumors will have different shades of black, brown, and tan along with red, blue, and white spots
  • diameter (D) – any blemish that is larger than a pencil eraser should be looked at; also watch out for blemishes that grow in size or shape fairly rapidly
  • evolution (E) – a melanoma tumor will evolve in terms of color, size, and shape; keep an eye on any skin blemishes for any signs of evolution

Melanoma in Existing Moles

When melanoma occurs in an existing mole you should notice some definite symptoms. First off, the mole will become elevated where it was previously relatively flat. You may also notice pieces of the mole flaking and falling off; this is sometimes accompanied by scaling. Finally, moles may become tender and accompanied by redness, swelling, bleeding or oozing, itching, and burning.

If you have any reason to believe you might be in the early stages of melanoma please don’t hesitate to see your doctor right away. With five-year survival rates so high among those who have gotten an early diagnosis, there’s really no reason not to have yourself checked out. The longer you wait, the more difficult melanoma can be to treat.