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Melanoma: Staging

If you have been diagnosed with melanoma, your doctor needs to learn the extent, or stage, of the disease before planning treatment. Staging is a careful attempt to learn how thick the tumor is, how deeply the melanoma has invaded the skin, and whether melanoma cells have spread to nearby lymph nodes or other parts of the body. Your doctor may remove nearby lymph nodes to check for cancer cells. (Such surgery may be considered part of the treatment because removing cancerous lymph nodes may help control the disease.) Your doctor also does a thorough physical exam and, if the tumor is thick, may order chest x-rays, blood tests, and scans of the liver, bones, and brain.

The Following Stages are Used for Melanoma

Stage Information
Stage 0 The melanoma is “in situ,” meaning that it involves the epidermis but has not spread to the dermis. This is also called Clark level I.
Stage IA The melanoma is less than or equal to 1.0 mm or about 1/25 inch in thickness and no ulceration is present. Using the Clark system, this can be level II or III. It appears to be localized in the skin and has not been found in lymph nodes or distant organs.
Stage IB The melanoma is less than or equal to 1.0 mm in thickness and is ulcerated, or Clark IV or V, or it is between 1.01 and 2.0 mm and is not ulcerated. It appears to be localized in the skin and has not been found in lymph nodes or distant organs.
Stage IIA The melanoma is between 1.01 mm and 2.0 mm in thickness and is ulcerated, or it is between 2.01 and 4.0 mm and is not ulcerated. It appears to be localized in the skin and has not been found in lymph nodes or distant organs.
Stage IIB The melanoma is between 2.01 mm and 4.0 mm in thickness and is ulcerated, or it is thicker than 4.0 mm and is not ulcerated. It appears to be localized in the skin and has not been found in lymph nodes or distant organs.
Stage IIC The melanoma is thicker than 4.0 mm and is ulcerated. It appears to be localized in the skin and has not been found in lymph nodes or distant organs.
Stage III The melanoma has spread to the lymph nodes nearest the affected skin area. There is no distant spread.
Stage IV The melanoma has spread beyond the original area of skin and the nearby lymph nodes to other organs, such as the lung, liver or brain, or to distant areas of the skin or lymph nodes.