Melanoma is the rarest type of skin cancer, but, according to the Melanoma Center, it is also the most fatal. It develops in skin cells called melanocytes, which make melanin. Melanin gives color to parts of the body such as skin, eyes and hair. Melanoma is not limited to the areas of skin exposed to the sun, as it can also affect the mouth, soles of the feet and genitals. When melanoma is diagnosed, it is categorized into a stage. The stage of the cancer helps distinguish how far along it is in its progression. The stage of the cancer will help the doctor determine what type of treatment to use to fight it.
Stage 0
Stage 0 is the earliest stage of melanoma that can be diagnosed. In stage 0, according to the National Cancer Institute, the cancer is found in the outer layer of skin, but it has not spread to lower layers or surrounding tissues. Treatment for stage 0 melanoma is usually to remove the cancerous cells and a small area of skin surrounding them.
Stage I
In stage I, the cancer can be small, with signs of "scraping," or ulceration at the site, or it can be 1 to 2 mm in size, with no signs of physical changes. Treatment for stage I melanoma is the same as stage 0, which is removal of the melanoma and some of the surrounding skin. The American Cancer Society states that melanoma that is caught in stage I has a five-year survival rate of 92 to 99 percent.
Stage II
Stage II melanoma means the tumor can be between 1 and 2 mm thick, with signs of physical scraping or ulcerations, or it can be more than 2 mm thick, with no signs of ulcerations. Treatment for stage II melanoma is much more detailed. It begins with removal of the melanoma and some of the surrounding "normal" skin, followed by removal of the nearby lymph nodes. The National Cancer Institute reports that after surgery, patients often undergo "biologic therapy," which uses vaccines and antibodies to attempt to restore the immune system so it is better able to fight cancer and infections. The five-year survival rate for stage II melanoma is between 56 and 78 percent, depending upon the thickness of the tumor.
Stage III
In stage III melanoma, the cancerous cells have become more aggressive and have spread beyond the original tumor site and into nearby tissues and possibly to nearby lymph nodes. As the melanoma is now getting more aggressive, so must the treatment, which may come in different stages. First, there is the removal of the tumor and cancerous cells and a small area of healthy skin around it. (If there is a large area removed, the skin may need to be grafted to fill in the area.) The local lymph nodes will be removed, and lymph node biopsies may be taken to see if the cancer has spread to lymph nodes that are farther away in the body. Next, the doctor may choose to proceed with biologic therapy, as mentioned in stage II, to help rebuild the immune system. Chemotherapy and radiation may also be recommended at this stage. The five-year survival rate for stage III melanoma can be anywhere from 27 to 68 percent. The rate is determined by how deep the cancerous cells have spread into neighboring tissues, and by which lymph nodes, and how many of them, it has reached.
Stage IV
Stage IV is the most advanced stage of melanoma. At this point, the cancer has spread to other lymph nodes, areas of skin and bodily organs such as the liver, lungs or kidneys. If there are few cancerous tumors, the doctor may choose to remove them. If there are several, at this stage she may decide that the best course of treatment is to not remove the tumors, but treat the symptoms of the cancer so the patient can be as comfortable as possible. Some of the optional treatments are chemotherapy, biologic therapy and radiation. The American Cancer Society reports that the five-year survival rate for stage IV melanoma is around 18 percent.
