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Malignant Melanoma-Stage Dictates Prognosis
Your Stage of Melanoma at Diagnosis Will Guide Your Treatment Decisions
Melanoma Prognosis by Stage: What Your Diagnosis Really Means
A diagnosis of skin cancer is difficult. A diagnosis of melanoma, just plain melanoma, is more difficult. And a diagnosis of malignant melanoma may be the worst of all cancer diagnoses. I said “may be” as in this diagnosis could be the worst, depending on your stage at diagnosis.
Malignant melanoma prognosis is heavily dictated by the stage at diagnosis, ranging from near 100% survival for stage 0 to 15%–35% for stage IV. Key prognostic factors include tumor thickness, ulceration, and the spread to lymph nodes or distant organs.
Melanoma at a glance-
Risks– UV Exposure, HPV, Genetics, Skin Pigment, Moles, Immunosuppression, Previous Skin Cancer Diagnosis,
Symptoms- Mole, Shape (A,B, C,D,E), Itching, Bleeding,
Diagnosis- Visual Inspection, Skin Biopsy,
Prognosis– Staging, In-situ, I, II, III, IV, Five-year survival rates
Therapy– Conventional, Non-Conventional, Integrative, Alternative
Melanoma Survival Rates by Stage
- Stage 0: ~99–100%
- Stage I: ~92–97%
- Stage II: ~53–81%
- Stage III: ~40–70%
- Stage IV: ~15–35%
| Stage | Description | 5-Year Survival |
|---|---|---|
| 0 | In situ | ~99–100% |
| I | Localized | ~92–97% |
| II | Deeper tumor | ~53–81% |
| III | Lymph nodes | ~40–70% |
| IV | Metastatic | ~15–35% |
The world of skin cancer is wide and complex. To be fair, I cannot blame you for not listening to whatever your oncologist has to say after he/she says, “you have skin cancer.” But keep in mind that your diagnosis can run the gamut, according to the study linked and excerpted below, from a five-year survival rate of over 90% to less than 10%, depending on your stage at diagnosis.
Why Stage Matters in Melanoma
- thickness
- lymph nodes
- metastasis
Melanoma Stages Explained (0–IV)**
- What it means
- Survival rate
- Treatment overview
Key Prognostic Factors Beyond Stage
- Breslow depth
- ulceration
- immune system
Can Prognosis Be Improved?
- integrative therapies
- lifestyle
- monitoring
FAQ Section
- “Can stage 4 melanoma be cured?”
- “Is stage 1 melanoma serious?”
- “What is the life expectancy?”
I am a long-term cancer survivor and cancer coach. I field questions from cancer patients, survivors and caregivers daily. Many of the questions I’m asked are from cancer patients who don’t know their stage at diagnosis.
The combination of therapies for malignant skin cancer- both conventional (FDA-approved) and evidence-based but not FDA-approved- is extensive. The five-year survival averages listed below take into account only conventional therapies. Not evidence-based Integrative, Complementary and Botanical therapies.
Have you been diagnosed with either melanoma or non-melanoma skin cancer? Scroll down the page, post a question or a comment and I will reply ASAP.
To learn more about melanoma aka skin cancer, go to Skin Cancer: Need-to-Know
Thank you
David Emerson
- Cancer Survivor
- Cancer Coach
- Director PeopleBeatingCancer
Concepts Central to Managing Your Cancer-
- Integrative Oncology: Combining Conventional and Natural Cancer Therapies
- Complementary Cancer Therapies: Evidence-based
- Managing Cancer Treatment Side Effects: An Evidence-Based Guide to Prevention, Relief, and Recovery
- Cancer Financial Toxicity: Costs, Medical Debt, Insurance, Financial Assistance, and Survivorship
What are the stages of melanoma?
Recommended Reading:
- Non-Melanoma Skin Cancer Risk Increases From Radiation
- Preventing Non-Melanoma Skin Cancer Relapse
- How to Identify Skin Cancer in 5 Steps
- Skin Cancer, Vitamin D3 and Sunlight
Malignant Melanoma Staging
Melanoma Stages Explained (0–IV)**
Stage IA:
- Lesions ≤1 mm in thickness with no evidence of ulceration or metastases (T1aN0M0) are associated with a 5-y survival rate of ~97%
Stage IB:
- Lesions ≤1 mm in thickness with ulceration noted but without lymph node involvement (T1bN0M0) or lesions 1.01-2 mm in thickness without ulceration or lymph node involvement (T2aN0M0) are associated with a 5-y survival rate of ~92%
Stage IIA:
- Melanomas >1 mm but ≤2 mm in thickness with no evidence of metastases but with evidence of ulceration (T2bN0M0) or lesions 2.01-4.0 mm in thickness without ulceration or lymph node involvement (T3aN0M0) are associated with an overall 5-y survival rate of ~81%
Stage IIB:
- Melanomas 2.01-4 mm in thickness with ulceration but no lymph node involvement (T3bN0M0) or lesions >4 mm in thickness without ulceration or lymph node involvement (T4aN0M0) are associated with a 5-y survival rate of ~70%
Stage IIC:
- Lesions >4 mm in thickness with ulceration but no lymph node involvement (T4bN0M0) are associated with a 5-y survival rate of ~53%
Stage IIIA:
- Patients with any-depth lesion, no ulceration, and 1 positive (micrometastatic) lymph node (T1-4aN1aM0) have a 5-y survival rate of ~70%
- T1-4aN2aM0 lesions (any-depth lesion, no ulceration, but 2-3 nodes positive for micrometastasis) are associated with a 5-y survival rate of 63%
Stage IIIB:
- Patients with any-depth lesion, positive ulceration, and 1 lymph node positive for micrometastasis (T1-4bN1aM0) or 2-3 nodes positive for micrometastasis (T1-4bN2aM0) have a 5-y survival rate of 50-53%
- Patients with any-depth lesion, no ulceration, and 1 lymph node positive for macrometastasis (T1-4a, N1b, M0) or 2-3 nodes positive for macrometastasis (T1-4aN2bM0) have a 5-y survival rate of 46-59%
Stage IIIC:
- Patients with any-depth lesion, positive ulceration, and 1 lymph node positive for macrometastasis (T1-4bN1bM0); 2-3 nodes positive for macrometastasis (T1-4bN2bM0); or ≥4 metastatic lymph nodes, matted lymph nodes, or in-transit met(s)/satellite(s) have a 5-y survival rate of ~40%
Stage IV:
- Melanoma metastatic to skin, subcutaneous tissue, or lymph nodes with normal LDH level (M1a) is associated with a 5-y survival rate of ~15%-20%
- M1b disease (metastatic disease to lungs with normal LDH level) has a 5-y survival rate of 7%
- M1c disease (metastatic disease to all other visceral organs and normal LDH level or any distant disease with elevated LDH level) is associated with a 5-y survival rate of 10%
Mitotic rate assessment
For mitotic rate assessment, the pathologist counts the number of cells in a certain amount of melanoma tissue that are in the process of dividing. A higher mitotic rate means that the cancer is more likely to grow and spread. The mitotic rate is used to stage thin melanoma.
To learn more about melanoma staging-
Cross-site authority: