Stage 3 Melanoma - Melanoma Research Alliance (2023)

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Stage 3 Melanoma - Melanoma Research Alliance (1)

Stage III melanoma, also known as regional melanoma, has metastasized (spread) to nearby lymph nodes, lymph vessels, or skin. Lymph nodes are an important part of the lymphatic system, which is a vast network of tissues and organs that helps rid the body of waste, toxins, and other unwanted materials. The lymphatic system also helps support the immune system by transporting infection-fighting white blood cells throughout the body.

Stage III melanoma is divided into four subgroups based on ulceration of the primary tumor and the extent of growth into the lymph nodes, lymph vessels, and nearby skin:

Note: The full criteria for each Stage 3 subtype are included below. While thisinformation is dense, it is included so that patients and their loved ones have all available information about their condition.

  • 3A

    Stage IIIA Melanoma:
    The melanoma tumor is up to 1.0 millimeter thick (the size of a sharpened pencil point) with or without broken skin (ulceration) when looked at under a microscope or more than 1.0 millimeter and less than 2.0 millimeters (the size of a new crayon point) without ulceration (broken skin) when looked at under a microscope. The melanoma has spread to up to three nearby lymph nodes–detected by biopsy of the sentinel lymph node–but has not yet spread to distant sites.

  • 3B

    Stage IIIB Melanoma:
    The melanoma tumor is up to 1.0 millimeter thick (the size of a sharpened pencil point) with or without broken skin (ulceration) or more than 1.0 millimeter and less than 2.0 millimeters (the size of a new crayon point) without broken skin (ulceration) when looked at under a microscope;AND:

      • The melanoma has spread to one lymph node detected clinically; OR
      • The melanoma has spread to very small areas of skin near the primary tumor, sometimes called “satellite tumors” or has begun to travel through lymph channels toward lymph nodes but has not yet reached them; OR
      • The melanoma has spread to up to three lymph nodes detected clinically; AND
      • The melanoma has not yet spread to distant sites.

    OR
    The melanoma tumor is more than 1.0 millimeter and less than 2.0 millimeters thick (the size of a new crayon point) with broken skin (ulceration) or more than 2.0 to 4.0 millimeters thick without broken skin (ulceration) when looked at under a microscope; AND:

      • The melanoma has spread to one lymph node detected by biopsy of the sentinel lymph node; OR
      • The melanoma has spread to one lymph node detected clinically; OR
      • The melanoma has spread to very small areas of skin near the primary tumor, sometimes called “satellite tumors” or has begun to travel through lymph channels toward lymph nodes but has not yet reached them; OR
      • The melanoma has spread to two or three lymph nodes detected by biopsy of the sentinel lymph node; OR
      • The melanoma has spread to two or three lymph nodes, of which one was detected clinically; AND
      • The melanoma has not yet spread to distant sites.

    OR
    There is no sign of the primary tumor; AND:

      • The melanoma has spread to one lymph node detected clinically; OR
      • The melanoma has spread to very small areas of skin near the primary tumor, sometimes called “satellite tumors” or has begun to travel through lymph channels toward lymph nodes but has not yet reached them; AND:
      • The melanoma has not yet spread to distant sites.
    (Video) Treatment options for stage III melanoma patients
  • 3C

    Stage IIIC Melanoma:
    The melanoma tumor is up to 2.0 millimeters thick (the size of a new crayon point) with or without broken skin (ulceration) or more than 2.0 millimeters and less than 4.0 millimeters thick without broken skin (ulceration) when looked at under a microscope; AND:

      • The melanoma has spread to one lymph node detected clinically or by biopsy of the sentinel lymph node; AND the melanoma has spread to very small areas of skin near the primary tumor, sometimes called “satellite tumors” or has begun to travel through lymph channels toward lymph nodes but has not yet reached them;

    OR

    (Video) Improving Survival in Stage III Melanoma

      • The melanoma has spread to four or more lymph nodes detected by biopsy of the sentinel lymph node; OR
      • The melanoma has spread to four or more lymph nodes, at least one of which was detected clinically, or the presence of any number of nodes that are clumped together; OR
      • The melanoma has spread to two or more lymph nodes detected clinically or by biopsy of the sentinel lymph node, and/or the presence of any number of nodes that are clumped together; AND
      • The melanoma has not yet spread to distant sites.

    OR
    The melanoma tumor is more than 2.0 millimeters and less than 4.0 millimeters thick (the size of a new crayon point) with broken skin (ulceration) or more than 4.0 millimeters thick without broken skin (ulceration) when looked at under a microscope, AND

      • The melanoma has spread to one or up to four or more lymph nodes; OR
      • The melanoma has spread to very small areas of skin near the primary tumor, sometimes called “satellite tumors” or has begun to travel through lymph channels toward lymph nodes but has not yet reached them; OR
      • The melanoma has spread to lymph nodes that are clumped together; AND
      • The melanoma has not yet spread to distant sites.

    OR
    The melanoma tumor is more than 4 millimeters thick without broken skin (ulceration) when looked at under a microscope, AND

      • The melanoma has spread to one lymph node detected by biopsy of the sentinel lymph node; OR
      • The melanoma has spread to one lymph node detected clinically; OR
      • The melanoma has spread to very small areas of skin near the primary tumor, sometimes called “satellite tumors” or has begun to travel through lymph channels toward lymph nodes but has not yet reached them; OR
      • The melanoma has spread to two or three lymph nodes detected by biopsy of the sentinel lymph node; OR
      • The melanoma has spread to two or three lymph nodes, at least one of which was detected clinically; OR
      • The melanoma has spread to one lymph node that was detected clinically or by biopsy of the sentinel lymph node, and the melanoma has spread to very small areas of skin near the primary tumor, sometimes called “satellite tumors” or has begun to travel through lymph channels toward lymph nodes but has not yet reached them; AND
      • The melanoma has not yet spread to distant sites.

    OR
    There is no sign of the primary tumor; AND:

      • The melanoma has spread to two or three lymph nodes, at least one of which was detected clinically; OR
      • The melanoma has spread to one lymph node that was detected clinically or by biopsy of the sentinel lymph node, and the melanoma has spread to very small areas of skin near the primary tumor, sometimes called “satellite tumors” or has begun to travel through lymph channels toward lymph nodes but has not yet reached them; OR
      • The melanoma has spread to four or more lymph nodes, at least one of which was detected clinically, or the presence of any number of nodes that are clumped together; OR
      • The melanoma has spread to two or more lymph nodes detected clinically or by biopsy of the sentinel lymph node and/or the presence of any number of nodes that are clumped together; AND
      • The melanoma has not yet spread to distant sites.
  • 3D

    Stage IIID Melanoma:
    The melanoma tumor is more than 4 millimeters thick with broken skin (ulceration) when looked at under a microscope, AND

      • The melanoma has spread to four or more lymph nodes detected by biopsy of the sentinel lymph node; OR
      • The melanoma has spread to four or more lymph nodes, at least one of which was detected clinically, the presence of any number of nodes that are clumped together; OR
      • The melanoma has spread to two or more lymph nodes detected clinically or by the biopsy of the sentinel lymph node and/or the presence of any number of nodes that are clumped together, and the melanoma has spread to very small areas of skin near the primary tumor, sometimes called “satellite tumors” or has begun to travel through lymph channels toward lymph nodes but has not yet reached them, AND
      • The melanoma has not yet spread to distant sites.

About Staging:Melanoma staging is based on theAmerican Joint Committee on Cancer (AJCC)staging system. The system assigns a stage based on tumor-node-metastasis (TNM) scores as well as additional prognostic factors. The goal is that melanomas of the same stage will have similar characteristics, treatment options, and outcomes. Learn more about melanoma staging.

(Video) Las Vegas woman raises skin cancer awareness after battle with Stage 3 Melanoma

Treatment for Stage 3 Melanoma: Stage III melanoma treatment varies greatly depending on whether the melanoma is completely resectable. When melanoma is completely resected, it has been removed entirely surgically. Melanoma that is unresectable cannot be removed completely through surgery alone.Learn more about melanoma treatment options.

Resectable Stage III Melanoma:Treatment for resectable Stage III melanoma includes surgical removal of the melanoma with wide excision, and a sentinel node biopsy may be recommended to determine if the melanoma has spread to the nearest lymph node. If melanoma is detected in this biopsy, your doctor may recommend a complete lymph node dissection (removing all lymph nodes in a specific area of the body surgically); however, this is not recommended in all instances.

Adjuvant Therapy:Patients with high-risk melanoma may choose to help delay or prevent the recurrence of melanoma through adjuvant therapy.Adjuvant therapyis additional treatment given after the primary treatment for melanoma (usually surgery). The goal of adjuvant therapy is to reduce the risk of melanoma returning.Learn more about adjuvant therapy.

Neoadjuvant Therapy:In some instances, your doctor may recommend trying to shrink the tumor before surgery. This is referred to as neoadjuvant therapy and is typically offered throughclinical trials.

High-risk melanoma usually is defined as melanoma that is deeper or thicker (more than 4 millimeters thick) at the primary site or involves nearby lymph nodes. This disease has a high risk of recurrence because some melanoma cells may remain in the body even after the surgery removed the visible melanoma tumors successfully.

Unresectable Stage III Melanoma: Treatment options for unresectable Stage III melanoma have expanded greatly in the last 10 years and frequently combine surgery with immunotherapy or targeted therapy.Learn more about melanoma treatment options

(Video) Melanoma Research Alliance Presents: The Promise of Immunotherapy

Clinical Trials: Clinical trials offer patients access to treatment approaches that may prove more beneficial than those approved by the U.S. Food and Drug Administration (FDA) currently. In addition, clinical trials expand our understanding of melanoma and improve future treatment options for all patients.Given the very rapid development of new agents and combinations, patients and their physicians are highly encouraged to consider treatment in a clinical trial for initial treatment and at the time of disease progression. Learn more about clinical trials.

Prognosis for Stage 3 Melanoma: With appropriate treatment, Stage III melanoma is considered intermediate to high risk for recurrence or metastasis. With all melanoma, the earlier it is detected and treated, the better.The 5-year survival rate as of 2018 for regional melanoma (Stage III) is 63.6%. Learn more about melanoma survival rates.

Follow-Up Care for Stage 3 Melanoma:After achieving No Evidence of Disease (NED) following treatment for Stage III melanoma, you should conduct monthly self exams of your skin and lymph nodes and have an annual, full-body skin exam performed by a trained dermatologist for the rest of your life. You should also undergo a physical exam by your doctor every 3 to 6 months for the first 2 years, then every 3 to 12 months for the next 3 years, and then annually as needed. Imaging tests may be ordered every 3 to 12 months or as needed to monitor for recurrence.

Just Diagnosed? If you've been recently diagnosed with melanoma, you are not alone. TheMelanoma > Exchangeis a free online melanoma treatment and research focused discussion group and support community. Through the Melanoma > Exchange, anyone touched by Melanoma can find support, ask questions, and build community among people who share a similar experience. Join the Community.

Melanoma Staging:

  • Stage 0 or Melanoma In Situ
  • Stage 1
  • Stage 2
  • Stage 3
  • Stage 4
  • Breslow Depth andClark Level
  • Understanding Melanoma Staging
  • Melanoma Survival Rates

Were you or a loved one just diagnosed with melanoma?We have the resources to help.

(Video) What are the stages of melanoma?

FAQs

What are the chances of surviving stage 3 melanoma? ›

Five-Year Survival Rate by Melanoma Stage:

Localized melanoma: Stage 0, Stage I, and Stage II: 98.4% Regional melanoma: Stage III: 63.6% Metastatic melanoma: Stage IV: 22.5%

Can I survive stage 3 melanoma? ›

Prognosis for Stage 3 Melanoma: With appropriate treatment, Stage III melanoma is considered intermediate to high risk for recurrence or metastasis. With all melanoma, the earlier it is detected and treated, the better. The 5-year survival rate as of 2018 for regional melanoma (Stage III) is 63.6%.

Is Stage 3 melanoma considered advanced? ›

Considered an advanced form of skin cancer, a stage III melanoma may have spread beyond the original tumor to one or multiple nearby lymph nodes. This stage also includes disease that has travelled from the primary site but not yet reached local lymph nodes.

What is the 10 year survival rate for stage 3 melanoma? ›

The 10-year survival rate is around 43%. Stage IIIC. The 5-year survival rate is around 40%. The 10-year survival rate is around 24%.

How effective is immunotherapy for Stage 3 melanoma? ›

In a phase III study , scientists compared these treatments in people with unresectable stage 3 or stage 4 melanoma. They found that 55 percent of those who received Keytruda survived for at least 2 years. In comparison, 43 percent of those treated with Yervoy survived for 2 years or more.

Do you feel sick with stage 3 melanoma? ›

General symptoms

hard or swollen lymph nodes. hard lump on your skin. unexplained pain. feeling very tired or unwell.

How long does it take for melanoma to spread to organs? ›

How fast does melanoma spread and grow to local lymph nodes and other organs? “Melanoma can grow extremely quickly and can become life-threatening in as little as six weeks,” noted Dr. Duncanson.

At what stage is melanoma not curable? ›

Some people with stage III melanoma might not be cured with current treatments, so they may want to think about taking part in a clinical trial of newer treatments.

What is the longest you can live with melanoma? ›

5-year relative survival rates for melanoma skin cancer
SEER stage5-year relative survival rate
Localized99%
Regional68%
Distant30%
All SEER stages combined93%
1 Mar 2022

Which type of melanoma has worse prognosis? ›

The thicker the tumour, the poorer the prognosis. Melanoma skin cancer that is less than 1 mm thick has a low risk of spreading to other parts of the body. Melanoma skin cancer that is thicker than 4 mm has a higher risk of spreading to other parts of the body and coming back (recurring) after treatment.

Which stage of melanoma have the best prognosis? ›

Melanoma can be treated most effectively in its early stages when it is still confined to the top layer of the skin (epidermis). The more deeply a melanoma grows into the lower layer of the skin (dermis), the greater the risk that it could spread to nearby lymph nodes or other organs.

What does Stage 3 melanoma mean? ›

Stage 3 is part of the number staging system. It generally means that cancer cells have spread to the lymph nodes close to where the melanoma started (the primary tumour). Or it has spread to an area between the primary tumour and the nearby lymph nodes.

Is Stage 3 melanoma small? ›

Metastatic stage 3 melanoma

Stage 3 is broken down into several subcategories. These tumors are no more than 2 mm thick, and small tumors have spread to one to three nearby lymph nodes. The primary tumor may be ulcerated.

What vitamins help with melanoma? ›

Vitamins C, E and A, zinc, selenium, beta carotene (carotenoids), omega-3 fatty acids, lycopene and polyphenols are among the antioxidants many dermatologists recommend including in your diet to help prevent skin cancer.

Do you only live 5 years with melanoma? ›

Survival for all stages of melanoma

around 90 out of every 100 people (around 90%) will survive their melanoma for 5 years or more after diagnosis. more than 85 out of every 100 people (more than 85%) will survive their melanoma for 10 years or more after they are diagnosed.

Can Keytruda cure stage 3 melanoma? ›

KEYTRUDA may help prevent melanoma from coming back after stage 3 melanoma and lymph nodes that contain cancer have been removed by surgery.

What kills melanoma cells? ›

When melanoma cells are heated by laser beams, tiny bubbles form around the pigment proteins inside the cells. As these bubbles rapidly expand, they can physically destroy the cells.

How long do you stay on immunotherapy for melanoma? ›

People with melanoma are recommended to take an immune checkpoint inhibitor for 12 months, he explained. But in clinical practice, some patients and their doctors decide to stop the therapy a few months earlier if the patient is in remission and has a mild, but bothersome side effect.

When is melanoma too late? ›

What are the signs of late-stage skin cancer? Melanoma is considered stage 4 when it has metastasized to lymph nodes in a part of the body far from the original tumor or if it has metastasized to internal organs like the lungs, liver, brain, bone or gastrointestinal tract.

What organs does melanoma spread to first? ›

Doctors have known for decades that melanoma and many other cancer types tend to spread first into nearby lymph nodes before entering the blood and traveling to distant parts of the body.

How long does melanoma take to spread to brain? ›

Metastatic melanoma 5-year survival is about 15% [12]. In a study presented by Vosoughi, the median time from primary melanoma diagnosis to brain metastasis was 3.2 years and the median overall survival duration from the time of initial brain metastasis was 12.8 months [13].

How do doctors tell if melanoma has spread? ›

For people with more-advanced melanomas, doctors may recommend imaging tests to look for signs that the cancer has spread to other areas of the body. Imaging tests may include X-rays, CT scans and positron emission tomography (PET) scans.

Can you survive melanoma that has spread to lymph nodes? ›

Survival rates at 5 years for people with melanoma that has spread to the nearby lymph nodes is 68%.

Can you have melanoma for 3 years and not know? ›

You could have melanoma for a long time before you realize it, because some types are not so obvious. Some aggressive forms, like nodular melanoma, grow fast, are visible and can hurt or bleed.” While certain groups may be at a higher risk for melanoma, anyone can get the disease.

Does melanoma always come back? ›

Melanoma is most likely to return within the first 5 years of treatment. If you remain melanoma free for 10 years, it's less likely that the melanoma will return. But it's not impossible. Studies show that melanoma can return 10, 15, and even 25 years after the first treatment.

What is the most effective treatment for melanoma? ›

Surgery. Surgery to remove the tumor is the primary treatment of all stages of melanoma. A wide local excision is used to remove the melanoma and some of the normal tissue around it.

How common is death from melanoma? ›

During the same time period, about 9,008 people died from melanoma in the United States each year, including 5,930 men and 3,079 women. The overall death rate of melanoma was 2.5 per 100,000.
...
Mortality.
Race/EthnicitycRateCount
US Population
White4.35,826
White, Hispanic1.0138
White, non-Hispanic4.75,677
23 more rows
27 Jun 2019

What is the most serious form of melanoma? ›

Nodular melanoma

This is the most aggressive form of cutaneous melanoma. Nodular melanoma typically appears as a dark bump—usually black, but lesions may also appear as colorless skin tones. Because it doesn't look like the usual atypical mole, it can escape notice.

How long before melanoma becomes fatal? ›

Melanoma can grow very quickly. It can become life-threatening in as little as 6 weeks and, if untreated, it can spread to other parts of the body. Melanoma can appear on skin not normally exposed to the sun.

What foods to avoid if you have melanoma? ›

Choose a variety of colorful fruits and vegetables to get the greatest benefit. Aim to eat a minimum of 5 servings of whole fruits and vegetables daily. Choose sources of healthy fat. Avoid fried, greasy, and fatty foods, Choose baked, broiled, or grilled foods instead.

What is the strongest risk factor for melanoma? ›

Ultraviolet (UV) light exposure

Exposure to ultraviolet (UV) rays is a major risk factor for most melanomas. Sunlight is the main source of UV rays. Tanning beds and sun lamps are also sources of UV rays.

What bones does melanoma spread to? ›

Studies have shown that 80% of bone metastases from malignant melanoma are found in the axial skeleton (skull, ribs, vertebral column, and pelvis) 27.

What stage of melanoma do you need chemo? ›

Chemotherapy: This is a combination of powerful drugs used to kill cancer cells. It's recommended more often with stage III. Chemo is usually only an option for stage IV if other treatments haven't worked.

Can you tell the stage of melanoma from a biopsy? ›

These test results along with the results from your skin biopsy, complete skin exam, and physical are used to determine the stage of the melanoma. When everything that your doctor sees suggests that the cancer may have spread to a lymph node, your doctor may recommend a procedure called a sentinel lymph node biopsy.

Does melanoma spread to lymph nodes first? ›

When melanoma starts to spread, it often travels to a lymph node near the melanoma first. Having a sentinel lymph node biopsy (SLNB) can tell whether cancer cells have spread to a nearby lymph node. If the cancer has spread to a lymph node, you have stage III melanoma.

What size tumor is stage 3? ›

3A: The tumor is smaller than 5 centimeters (cm) but has spread to 4-9 nodes. The tumor is larger than 5cm and has spread to 1 to 9 nodes.

Is lymph node removal necessary for melanoma? ›

If the biopsy reveals melanoma cells in the sentinel nodes, doctors usually recommend immediate removal of the remaining regional lymph nodes.

Does melanoma make you tired? ›

The general symptoms of advanced melanoma can include: weight loss. loss of appetite. feeling very tired (fatigued).

Can turmeric cure melanoma? ›

While many internet sites claim supplements of turmeric can cure skin cancer, there's not enough evidence to support them.

Does vitamin D stop melanoma? ›

High circulating vitamin D concentration has been found to be associated with reduced melanoma progression and improved survival. Furthermore, reduced vitamin D serum levels have been reported in patients with stage IV melanoma compared with those with stage I.

Can vitamin C cure melanoma? ›

In vivo assay suggested that lower dosage (equivalent to 0.5 g/70 kg) of vitamin C administered orally increased the melanoma growth. Therefore, vitamin C may exert pro- or anti-melanoma effect depending on concentration.

What is the best treatment for stage 3 melanoma? ›

The typical treatment approach for stage III melanoma is a wide excision surgery to remove the primary tumor, as well as a dissection to remove the lymph node(s). Following surgery, further treatment may include chemotherapy, immunotherapy, targeted therapies, or radiation therapy.

What stage is melanoma fatal? ›

Once a tumor has spread to distant body sites such as organs, it is considered a stage IV melanoma, with an estimated five-year survival rate of only 18 percent in the U.S. These survival figures are improving every year because of new treatments (some therapies are keeping as much as 40 percent of stage IV patients ...

What are the symptoms of stage 3 melanoma? ›

Metastatic melanoma symptoms and signs may include:
  • Fatigue.
  • Swollen or painful lymph nodes.
  • Weight loss.
  • Loss of appetite.
  • Trouble breathing or a cough that doesn't go away.
  • Bone pain.
  • Headaches.
  • Seizures.
20 Jun 2022

How fast can melanoma spread to the brain? ›

Metastatic melanoma 5-year survival is about 15% [12]. In a study presented by Vosoughi, the median time from primary melanoma diagnosis to brain metastasis was 3.2 years and the median overall survival duration from the time of initial brain metastasis was 12.8 months [13].

Is melanoma always terminal? ›

Melanoma is usually curable when detected and treated early. Once it has spread deeper into the skin or other parts of the body, it becomes more difficult to treat and can be deadly. The estimated five-year survival rate for U.S. patients whose melanoma is detected early is about 99 percent.

Can you live with melanoma for years without knowing? ›

You could have melanoma for a long time before you realize it, because some types are not so obvious. Some aggressive forms, like nodular melanoma, grow fast, are visible and can hurt or bleed.” While certain groups may be at a higher risk for melanoma, anyone can get the disease.

Which stage of melanoma has the best prognosis? ›

Melanoma can be treated most effectively in its early stages when it is still confined to the top layer of the skin (epidermis). The more deeply a melanoma grows into the lower layer of the skin (dermis), the greater the risk that it could spread to nearby lymph nodes or other organs.

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