Stage 2 melanoma skin cancer
The number stage of a melanoma tells you how thick it is and whether it has spread. It also tells you whether the top layer of the melanoma looks broken (ulcerated) when looked at under a microscope. Knowing this helps your doctor decide which treatment you need.
Surgery is the main treatment for stage 2 melanoma skin cancer. Some people may have immunotherapy after surgery. This is to help stop the melanoma from coming back.
How does your doctor work out the stage?
To diagnose melanoma your doctor removes the abnormal area and a small area of surrounding skin. This is called an excision biopsy. A specialist doctor (pathologist) looks at the biopsy under a microscope. If there are melanoma cells, they will work out the stage of the cancer.
You may have some other tests and scans to help with this.
What is stage 2 melanoma skin cancer?
Stage 2 means the melanoma is only in the skin and there is no sign that it has spread to the nearby lymph nodes or other parts of the body.
Stage 2 melanoma is divided into 2A, 2B and 2C.
Stage 2A
This means the melanoma is either:
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1mm thick up to 2mm and is ulcerated
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2mm thick up to 4mm and is not ulcerated
Stage 2B
This means the melanoma is either:
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2mm thick up to 4mm and is ulcerated
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more than 4mm thick and is not ulcerated
Stage 2C
This means the melanoma is thicker than 4 mm and it is ulcerated.
TNM stages
Doctors also use another staging system for melanoma called the TNM staging system. It stands for Tumour, Node, Metastasis.
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T describes the size of the tumour
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N describes whether there are any cancer cells in the lymph nodes
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M describes whether the cancer has spread to a different part of the body
The TNM staging system describes the cancer in detail. The number staging system puts these details together to give an overall stage. This can be easier to understand.
In the TNM staging system, stage 2 can be:
- T2b, N0, M0
- T3a or T3b, N0, M0
- T4a or T4b, N0, M0
Tests on your lymph nodes
Your doctor will usually recommend a test to see if there are cancer cells in the lymph nodes near the melanoma. This is called a sentinel lymph node biopsy (SLNB). Your doctor removes the first lymph node or nodes that the melanoma could have spread to.
You have a sentinel lymph node biopsy at the same time as a 
.
If you don’t have an SLNB, your doctor might ask you to have regular ultrasound scans of the lymph nodes. Doctors call this surveillance.
Swollen lymph nodes
If your doctor can feel that your lymph nodes near the melanoma are swollen (enlarged), they will take a sample of fluid or tissue to check for cancer cells. This is called a lymph node biopsy. You may have an ultrasound scan first. Or you may have an ultrasound scan while you are having the biopsy. This is to help guide the needle to the abnormal area.
If there are cancer cells in your lymph nodes
If your doctor finds cancer cells in the lymph nodes near the melanoma, the stage changes to stage 3.
Treatment for stage 2 melanoma skin cancer
The stage of the cancer helps your doctor decide what treatment you need. Treatment also depends on:
- where the melanoma is
- your general health and level of fitness
Surgery
Surgery is the main treatment for stage 2 melanoma skin cancer.
You usually have an operation to remove a larger area of skin around where the melanoma was. This is called a wide local excision. Doctors do this to remove any melanoma cells that might be in the surrounding skin.
Treatment after surgery
If you have a stage 2B or 2C melanoma your doctor may recommend you have an immunotherapy drug called pembrolizumab (Keytruda) after surgery. This is to help stop the melanoma coming back. Doctors call this adjuvant treatment.
Clinical trials
Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.
