Skin Cancer Staging
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Skin cancer staging is a process that involves evaluating and summarizing the development and spread of the cancer. Tests can help determine how deep the cancer has extended through the layers of the skin, as well as whether the lymph nodes have been affected. Early stages often do not go beyond the superficial layer of the epidermis. Once the cancer goes deeper than the epidermis (top skin layer), into the dermis or subcutaneous layer, the cancer is more likely to spread into nearby tissues or into the lymph system. Your skin cancer treatment options will depend on how deep the cancer is and if other tissues or organs are affected.
Staging Different Types of Skin Cancer
The most common type of skin cancer, basal cell carcinomas, develop slowly and the risk of the cancer spreading is quite low. On the other hand, melanomas behave very differently. Staging, therefore, may depend on the type of cancer. For the non-melanoma skin cancers that are found to have a low likelihood of spreading, like basal cell or squamous cell carcinomas, the staging process may not be necessary. Melanomas are more likely to spread quickly, so the staging process becomes a very useful tool when it comes time to plan for treatment. In summary:
- Non-melanoma skin cancers - Basal cell carcinomas rarely spread and may not be staged. The chance that squamous cell carcinomas will spread is slightly higher and may be staged using the American Joint Committee on Cancer (AJCC) TNM System.
- Melanoma - Melanomas are more aggressive and likely to spread. This type of skin cancer is usually staged by the AJCC TNM system or the Clark levels. Read more about melanoma staging.
TNM Staging System
The TNM staging process assesses 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.
- T - The first part, rating the tumor, may be accomplished by actually taking a direct measurement of the thickness of the tumor. The thicker the tumor, the higher the rating, as indicated by the letter and numeral combinations, T0-T4.
- N - Physical exams, imaging tests or even surgical procedures may be done to determine if the cancer has spread into the lymph nodes. This is assessed and rated on a scale, N0-N3.
- M - Advanced stages are usually characterized by the spread of cancer to distant sites or lymph nodes. An M1 is used to indicate that the cancer has spread (metastasized). If the cancer has not spread, M0 is used.
TNM Stage Grouping
Each skin cancer may have slightly different staging criteria. In general, a Stage 0 skin cancer has not moved beyond the epidermis. Advanced stages, like Stage III or Stage IV, are used for cancers that have gone deep into the tissue and may have spread to other sites. Treatment options will vary depending on the degree and severity of the spread.
Understanding the Skin Cancer Staging Process
The staging process considers many different factors that may affect your prognosis and treatment options. Chat online with an Oncology Information Specialist to find out more about staging and treating skin cancer at Cancer Treatment Centers of America (CTCA). Or, call 1-800-615-3055. Oncology Information Specialists are available 24 hours a day, every day to answer your questions. At CTCA, we understand that staging is the first step towards finding a treatment plan that's right for you.
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