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Stage 3

Find out what stage 3 melanoma skin cancer means and about treatment options.

Stage 3 is part of the number staging system. Stage 3 means that cancer cells have spread into skin, lymph vessels, or lymph glands close to the melanoma. It depends on a number of factors including ulceration. Ulceration is when the skin covering the melanoma is broken.

Stage 3 can be divided into 3A, 3B and 3C.

Stage 3A

Stage 3A means all the following:

  • up to 3 nearby lymph nodes contain melanoma cells
  • these nodes are not enlarged and the cells can only be seen under a microscope
  • your melanoma is not ulcerated and has not spread to other areas of the body

Stage 3B

Stage 3B means one of the following:

  • your melanoma is ulcerated and has spread to between 1 and 3 nearby lymph nodes but the nodes are not enlarged and the cells can only be seen under a microscope
  • your melanoma is not ulcerated and it has spread to between 1 and 3 nearby lymph nodes and the lymph nodes are enlarged
  • your melanoma is not ulcerated, has spread to small areas of skin or lymphatic channels, but nearby lymph nodes do not contain melanoma cells

Stage 3C

Stage 3C means one of the following:

  • your lymph nodes contain melanoma cells, and there are melanoma cells in the skin or lymph channels close to the main melanoma
  • your melanoma is ulcerated and has spread to between 1 and 3 lymph nodes nearby which are enlarged
  • your melanoma may or may not be ulcerated and has spread to 4 or more nearby lymph nodes
  • your melanoma may or may not be ulcerated and has spread to lymph nodes that have joined together

TNM stages

The TNM staging system 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

In the TNM staging system stage 3A is the same as one of the following:

  • T1- T4a, N1a, M0
  • T1- T4a, N2a, M0

Stage 3B is the same as one of the following:

  • T1-4b, N1a, M0
  • T1-4b, N2a, M0
  • T1-4a, N1b, M0
  • T1-4a, N2b,M0
  • T1-4a, N2c, M0

Stage 3C is the same as one of the following:

  • T1-4b, N1b, M0
  • T1-4b, N2b, M0
  • T1-4b, N2c, M0
  • Any T, N3, M0

Treatment

The stage of your cancer helps your doctor to decide what treatment you need. Treatment also depends on:

  • where the cancer is
  • other health conditions

You have surgery to remove the melanoma. Then you have a wide local excision to remove more tissue in the area where the melanoma was. 

If your melanoma has spread to the lymph nodes, you might need surgery to remove all of the lymph nodes in the area near the melanoma. This operation is called a lymph node dissection.

For stage 3B or 3C melanoma, your doctor might offer you radiotherapy to the area where the surgeon removed the lymph nodes. The doctor carefully weighs up the benefits of giving radiotherapy against the side effects.

Your doctor might ask you to join a clinical trial looking at biological therapy. Doctors are doing trials to see if biological therapy helps to stop stage 3 melanoma from coming back or spreading. You only have it for stage 3 melanoma as part of a clinical trial.

If you have melanoma between the main melanoma and nearby lymph nodes (in-transit metastases) you usually have surgery. If this is not suitable for you, you might have one of the following:

  • chemotherapy directly into the leg or arm where the melanoma is (known as isolated limb infusion or isolated limb perfusion)
  • radiotherapy
  • chemotherapy combined with an electric current (electrochemotherapy)
  • laser treatment using a carbon dioxide laser
  • cream to put on the skin (such as imiquimod cream)
Last reviewed: 
12 Nov 2015
  • Melanoma assessment and management
    National Institute for Health and Care Excellence, July 2015

  • Cancer: Principles and practice of oncology (10th edition)
    VT De Vita, TS Lawrence and SA Rosenberg
    Lippincott, Williams and Wilkins, 2015  

  • TNM Classification of Malignant Tumours (7th edition)
    International Union Against Cancer   
    L.H. Sobin, M.K. Gospodarowicz, Ch. Wittekind
    John Wiley & Sons, Hoboken, New Jersey, 2009

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