Carolinas HealthCare System

In 2010, the American Joint Commission on Cancer (AJCC) updated the melanoma staging system. Factors considered in determining a patient’s prognosis include tumor characteristics (T) based on thickness; whether the melanoma has broken the skin and how fast the cancer cells are growing; if tumor cells have spread to lymph nodes (N); and metastases/spread to other organs (M)

To determine the stage of a melanoma, your healthcare provider will take a history and perform a physical exam. In certain circumstances, you provider will conduct tests such as lymph node mapping, sentinel lymph node biopsy, CT (computed tomography) scan, PET (positron emission tomography) scan and blood work. The final stage designation is a composite of the T, N and M factors listed above. The system can be complicated, so ask your physician to explain the stage of your cancer.

  • Early stage melanomas are considered to be stages I and II. In these two stages, the melanoma has not spread to the lymph nodes or other organs.
  • Later-stage cancer is considered stages III and IV. By stage III, the tumor has spread to the lymph nodes or to the skin near the primary tumor and lymph nodes; a biopsy can help determine this. In stage IV, the cancer has spread to distant lymph nodes or to other organs, typically the lung. Other common areas for melanoma to spread are the brain, bone, liver and gastrointestinal tract.