Melanoma Staging
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Melanoma Staging
Melanoma forms on the top layer of the skin called the epidermis. As the cancer develops, it may go deeper into the skin, extending down through the dermis and into the subcutaneous layer. The cancer may reach other parts of the body, including the lymph nodes, if it gets into the blood or lymph fluids. If the cancer spreads to the lymph nodes or to another site, it is still considered melanoma because it originated in the melanocytes.
The melanoma staging process is a method for evaluating how the cancer has developed and whether or not it has spread to other sites. Early stages are often localized to a mole or area on the skin where the cancer originated. Advanced stages are often characterized by cancer that has either penetrated past the epidermis (top skin layer) or spread beyond the skin to other sites such as organs or lymph nodes.
The size and extent of the tumor, spread to the lymph nodes, and whether or not the cancer has metastasized (spread) to other organs or structures is summarized by the TNM staging system.
Rating Tumors and Other Factors
The first main component of the TNM staging system assesses the size and extent of the tumor. This may be done by a direct measurement of the biopsied tissue under a microscope. The thicker the tumor the higher the rating, as indicated by letter and numeral combinations, T0-T4.
If a mole looks like an open bleeding sore, it may be a sign of ulceration (an ulcer on the tumor). The presence or absence of an ulcer is indicated by the letters "A" (no ulcer) or "B" (ulceration).
In some cases, the Clark scale may be used. The scale spans from I-V and rates the depth the cancer has penetrated. Level I indicates that the cancer is only in the epidermis. If the cancer has reached the subcutaneous layer (below the skin), it is rated as a level V. Clark levels are only a component of the TNM staging process and should not be used on their own to describe the stage of melanoma. The "A" and "B" designations still apply.
In addition to evaluating the size and extent of the tumors, your doctor will also indicate whether he or she found evidence of cancer in the lymph nodes (N0-N3) and whether it has metastasized to different sites (M0 or M1). The lowest rating, a "0" (zero), indicates that there is no evidence of spread to lymph nodes or distant sites. Different sub-categories may apply depending on the sites to which the cancer has spread.
Melanoma Stage Grouping
Each aforementioned component is evaluated and the ratings are grouped in the following fashion:
- Stage 0 melanoma is confined to the epidermis and is usually removable by surgery.
- Stages I-IV indicate different degrees of depth and spread. The tumors may or may not be ulcerated.
- Stage IV melanomas have metastasized to other sites like the liver, lungs or bones.
Understanding Melanoma Staging
Understanding the melanoma staging process can be difficult. At Cancer Treatment Centers of America (CTCA), we empower you to make decisions that are right for you. Your assigned team of cancer experts will explain the staging process and melanoma treatment options to you in detail and will spend time answering any questions you may have.
When you're ready to learn more, call 1-800-615-3055 or Chat Now to talk with one of our Oncology Information Specialists. Our representatives are available 24 hours a day, every day of the week. We're ready to help, at any stage.
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