Staging Melanoma

Staging is the process of figuring out exactly what the cancer is doing. Oncologists (doctors who specialize in cancer) consider three things when staging melanoma:

1. The thickness of the tumor (how deep the tumor has grown into the skin)

2. Whether the tumor is ulcerated (cracked or bleeding)

3. If, and how far, it has spread

  • In general:
  • Thicker tumors are more serious than thin tumors
  • Ulcerated tumors are more serious than non-ulcerated ones, even if they are thinner
  • Tumors that have spread to the lymph nodes are more serious than tumors that have not spread

The stage of a melanoma is important because it determines what kinds of treatment you will receive. For example, if you have an early stage of melanoma, you might only have surgery and no other treatment. If you have a later-stage melanoma, you might need additional treatment after the tumor has been removed, to reduce the chances of it coming back.

The table below shows the different stages of melanoma, what they mean, and what kind of treatment is usually done.
Note: 1 millimeter = 1/25 of an inch

Staging Classifications

IA

What it Means

The tumor is less than 1 millimeter thick. The outer layer of skin does not look cracked or scraped (ulcerated). It has not spread to any lymph nodes or other organs.

Treatment

The tumor and some surrounding tissue are removed surgically. Usually no further treatment is necessary. 		Staging classification

IB

What it Means

The tumor is either less than 1 millimeter thick and ulcerated, or 1-2 millimeters thick and not ulcerated. It has not spread to any lymph nodes or other organs.

Treatment

The tumor and some surrounding tissue are removed surgically. Usually no other treatment is necessary. 		Staging classification

IIA

What it Means

The tumor is either 1-2 millimeters thick and ulcerated, or 2-4 millimeters thick and not ulcerated. It has not spread to any lymph nodes or other organs.

Treatment

The tumor and some surrounding tissue are removed surgically. Usually no other treatment is necessary. 		Staging classification

IIB

What it Means

The tumor is either 2-4 millimeters thick and ulcerated, or more than 4 millimeters thick and not ulcerated. It has not spread to any lymph nodes or other organs.

Treatment

The tumor and some surrounding tissue are removed surgically. Immunotherapy may be given in cases of thicker tumors. 		Staging classification

IIC

What it Means

The tumor is more than 4 millimeters thick and is ulcerated.

Treatment

The tumor and some surrounding tissue are removed surgically. Immunotherapy may be given. 		Staging classification

IIIA, IIIB, IIIC

What it Means

The tumor may be any thickness. It may or may not be ulcerated. The cancer cells have spread either to a few nearby lymph nodes, or to some tissue just outside the tumor but not to the lymph nodes.

Treatment

The tumor and lymph nodes that have cancer cells are removed surgically. Immunotherapy may be given.

IV

What it Means

The cancer cells have spread to the lymph nodes, other organs in the body, or areas far from the original site of the tumor. This is called metastatic melanoma.

Treatment

The tumor and lymph nodes that have cancer cells are removed surgically. Radiation therapy, chemotherapy, or immunotherapy may be given to relieve symptoms.
Glossary
Chemotherapy
The treatment of cancer (or other disease) with chemicals that are toxic to the cancer cells.
Immunotherapy
A form of therapy that stimulates the immune system to kill or control cancer cells. Also called biochemical therapy or biotherapy.
Lymph Nodes
Glands that produce lymph and that filter out harmful agents (such as bacteria, viruses, and cancer cells).
Melanoma
A highly malignant type of skin cancer that arises in melanocytes, the cells that produce pigment. Melanoma usually begins in a mole.
Metastatic Melanoma
Melanoma that has spread to other parts of the body by way of the bloodstream or the lymphatic system.
Oncologist
A physician who specializes in treating cancer.
Radiation Therapy
The treatment of cancer with high-energy X-rays. Also called radiotherapy.
Staging
A system for determining how far a tumor has spread from its point of origin.
Ulceration
The development of a lesion of the skin or a mucous membrane such as the one lining the stomach or duodenum that is accompanied by formation of pus and necrosis of surrounding tissue, usually resulting from inflammation or ischemia.