Stage 2 is part of the number staging system. The melanoma is only in the skin and there is no sign that it has spread to lymph nodes or other parts of the body.
Stage 2 is divided into 2A, 2B and 2C.
Stage 2A means one of the following:
- the melanoma is between 1 and 2 mm thick and the outermost layer of skin covering the tumour looks broken under the microscope (it is ulcerated)
- the melanoma is between 2 and 4 mm thick and is not ulcerated
Stage 2B means one of the following:
- the melanoma is between 2 and 4 mm thick and the outermost layer of skin covering the tumour looks broken under the microscope (it is ulcerated)
- the melanoma is thicker than 4 mm and is not ulcerated
Stage 2C means the melanoma is thicker than 4 mm and under the microscope the outermost layer of skin covering the tumour looks broken (it is ulcerated).
Doctors also use another staging system for melanoma called the TNM staging system. It stands for Tumour, Node, Metastasis.
- T describes the size of the tumour
- N describes whether there are any cancer cells in the lymph nodes
- M describes whether the cancer has spread to a different part of the body
The stage of your cancer helps your doctor to decide what treatment you need. Treatment also depends on:
- where the melanoma is
- your general health and level of fitness
Surgery is the main treatment. To diagnose melanoma doctors remove the abnormal area and a small area of surrounding skin.
You usually have a second operation to remove a larger area of healthy tissue around where the melanoma was. This is called a wide local excision.
Your doctor usually offers you a test to see if the cancer has spread to the nearby lymph nodes. The test is called a sentinel lymph node biopsy. Your doctor removes the first lymph node or nodes that the melanoma could have spread to and they are checked for cancer cells.
You have a sentinel lymph node biopsy while you are asleep (general anaesthetic) at the same time as the wide local excision.
If cancer cells are found in the sentinel lymph nodes (positive sentinel lymph node) your stage of cancer changes to stage 3.
Your doctor might suggest having regular ultrasound scans of the lymph nodes to check if the cancer grows (progresses). This is called surveillance.
Or they might suggest having treatment such as targeted cancer drugs or immunotherapy, to reduce the risk of the melanoma coming back. If a trial of new treatments is available, they may suggest you consider taking part in it.
Swollen lymph nodes
If after being diagnosed with melanoma your doctor can feel that the lymph nodes near to the melanoma are swollen (enlarged), you usually have an ultrasound scan and they take a sample of tissue from the lymph nodes (a biopsy).
If cancer is found in the lymph nodes it is a stage 3 melanoma and you usually have surgery to remove the lymph nodes. This is called a completion lymph node dissection.