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Stages Of Melanoma Skin Cancer

If you have melanoma skin cancer, your doctor will say it's in one of five stages as a way to describe how far along it is. These are numbers, going from 0 through Roman numerals I to IV. Stage 0 melanoma has developed the least. Stage IV has gone the farthest.

Your stage will help your doctor decide how to treat the cancer. Most doctors use the TNM system to figure out the stage. It's based on the following questions:

  • T(umor): How deep into your skin has the tumor gone? Has it broken down the skin over it? (That could show that your skin is casting off dead cells and may mean that a tumor is growing fast. You might hear your doctor call this ulceration.)
  • Lymph N(odes): Has the cancer spread to the tiny bean-shaped lymph nodes that are scattered throughout your body? (They hold white blood cells that help you fight off disease.)
  • M(etastasis): Has the cancer spread to your lungs, brain, or other organs? If so, your doctor might say the cancer has metastasized.

    • This means the cancer is in the very top layers of skin and hasn't spread to other areas. Your doctor might call this melanoma in situ.

    This means you have a cancerous tumor that's less than 2 millimeters thick. (The point of a sharp pencil is about 1 millimeter wide, and the eraser on a new pencil is about 5 millimeters wide.)

    Doctors divide stage I into two levels:

    Stage IA -- The tumor is no more than 1 millimeter thick. It might have broken down the skin on top of it.

    Stage IB -- The tumor is 1 to 2 millimeters thick, but it hasn't broken down the skin on top of it.

    If you have stage I melanoma, it hasn't spread beyond the original tumor.

    In this stage, the cancerous tumor is larger.

    Stage IIA -- The cancer is either:

  • 1 to 2 millimeters thick and has broken down the skin on top of it, OR
  • 2 to 4 millimeters thick but hasn't broken down the skin on top of it.

    • Stage IIB -- The cancerous tumor is either:

  • 2 to 4 millimeters thick and has broken down the skin, OR
  • More than 4 millimeters thick but hasn't broken down the skin.

    • Stage IIC -- The tumor is more than 4 millimeters thick, and it has broken down the skin on top of it.

    In this stage, the cancer has started to spread. It's in:

  • More than one lymph node, OR
  • Tiny new tumors (called satellite or microsatellite tumors) near the original cancer, OR
  • The cells between the original cancer and the nearest lymph node (called in-transit tumor spread).

    • Doctors divide stage III into four detailed categories (A, B, C, and D) based on things like size and how far it's spread.

    This means the cancer has spread to your lungs, brain, bones, or other parts of your body. Melanoma also might show up on your skin in parts of your body far from the original tumor.

    Your doctor might talk about stage IV in smaller categories that start with an M. That stands for "metastasis," the term doctors use when cancer spreads.

    M1a -- The cancer is in your skin in a different part of your body from the original tumor.

    M1b -- Cancer is in your lungs.

    M1c -- Cancer is in some other part of your body, but not your central nervous system.

    M1d -- Cancer is in your brain, spinal cord, or another part of your central nervous system.

    Your medical team will help you get a handle on your treatment and how likely you are to get well. In general, the lower the stage, the better your odds.

    But everyone is different. Your chances of recovery can depend on many things, like your overall health and how well your treatment works for you.


    Stage I (Early-Stage) Lung Cancer

    SOURCES:

    Photo Credit: Science Photo Library/Getty Images

    National Cancer Institute: "NCI Dictionary of Cancer Terms."

    Suresh, S. Ramalingam, MD, deputy director, Winship Cancer Institute, Emory University.

    American Cancer Society: "Non-Small Cell Lung Cancer," "Non-Small Cell Lung Cancer Survival Rates," "Cancer Staging," "What Is Small Cell Lung Cancer?" "Non-Small Cell Lung Cancer Signs and Symptoms," "Treatment Choices for Non-Small Cell Lung Cancer, by Stage."

    National Health Service (UK): "Diagnosis: Lung Cancer", "Symptoms: Lung Cancer."

    Mayo Clinic: "Lung Cancer Diagnosis," "Lung Cancer."

    Methods in Molecular Biology: "Epidemiology of Lung Cancer Prognosis: Quantity and Quality of Life."

    Cedars-Sinai: "Lung Cancer."

    UpToDate: "Screening for lung cancer," "Overview of the initial evaluation, diagnosis, and staging of patients with suspected lung cancer."

    Cancer Research UK: "Stage 1 lung cancer," "Survival for lung cancer."

    Cancer.Net: "Just Diagnosed With Lung Cancer: Answers from an Expert."

    Journal of Thoracic Disease:"Hyperfractionated and accelerated radiotherapy in non-small cell lung cancer."


    Poorest Scots Diagnosed With Lung, Breast And Bowel Cancer At Stage 4 In Third Of Cases

    MOST cases of breast, bowel or lung cancer among the poorest Scots are not picked up until the disease has spread to other organs, new figures show.

    Campaigners said the figures were "especially worrying" as patients diagnosed with stage four cancer are much less likely to survive and face more gruelling treatments and side effects.

    Breast, bowel and lung cancer are the most common forms of the disease in Scotland, accounting for 43% of cases, but the latest statistics highlight a gulf in detection rates between the most and least affluent parts of Scotland.

    While four in five cases among the least deprived patients were picked up before stage four in 2016 and 2017 – in most cases at stage two – among the poorest patients, 30.3% were not identified until it was at the most serious, advanced stage.

    Research has shown that people from more deprived background are less likely to take part in routine cancer screening, such as attending mammograms or returning bowel screening kits, but shortages of radiologists have also been blamed for delays in patients receiving the results of key diagnostic cancer tests such as CT and MRI scans.

    It comes as charities warned that progress on improving early detection rates in Scotland "has stalled".

    The Detect Cancer Early (DCE) programme was launched by the Scottish Government in 2012 with a target to increase the proportion of patients diagnosed with breast, lung or bowel cancer at stage one by 25% by the end of 2015.

    That aim has yet to be achieved, however, and there are fears that after what has been described as"glacial progress" the figures are now going in the wrong direction.

    The latest statistics from ISD Scotland - covering 2016 and 2017 - show the percentage of patients diagnosed at stage one has risen by just 8.4% in six years, compared to the equivalent figures for 2010 and 2011. Previous figures, for 2015 and 2016, had shown a 9.1% improvement.

    Janice Preston, who heads up Macmillan Cancer Support in Scotland, said: "We are deeply concerned there hasn't been any improvement in these figures from last year.

    "While the DCE campaign was making slow progress, it was previously going in the right direction.

    "The picture in deprived communities is especially worrying, with over 30% of people diagnosed at the latest stage compared to under 20% of those in the least deprived areas.

    "People diagnosed the latest stage are less likely to survive and more likely to face very challenging treatment and severe side effects if they do."

    Across the health boards, the percentage of patients whose breast, bowel or lung cancer was detected at stage one ranged from 22.7% in NHS Grampian to 29.2% in NHS Forth Valley.

    In Scotland's largest health board, NHS Greater Glasgow and Clyde, it was 24.4%.

    Health Secretary Jeane Freeman stressed that more than a quarter of all breast, lung and bowel cancers are now detected at stage one, and pointed to a 31% increase in stage one diagnoses of lung cancer among the most deprived patients as a sign of progress.

    Ms Freeman added: "Screening remains one of the most effective ways to find cancer early and more than £1 million has been committed to health boards and third sector organisations since 2016, through the Scottish Government's Health Inequalities Fund, to help identify new and innovative ideas to improve screening uptake amongst groups least likely to participate.

    "Later this year we will also be launching a new DCE campaign, targeting those in the most deprived areas, to reduce fear around cancer and encourage people to get checked early.

    "Overall cancer death rates have dropped by 10.6% over the past 10 years and early detection is vitally important to continuing this trend. We are working to beat cancer, investing more than £100 million in our cancer strategy as well as £14 million earlier this year to support health boards reduce waiting times for endoscopies."





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