Stages and types of melanoma
The number stage of a melanoma tells you how thick it is and if 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.
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 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 4 is the same as:
Any T, Any N, M1
Find out more about TNM staging for melanoma skin cancer
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 normally have some other tests and scans to help with this.
Read more about the tests for melanoma skin cancer
Stage 4 means the melanoma has spread to parts of the body away from the original (primary) cancer and further than the nearby .
Unfortunately this means the melanoma is advanced. Advanced melanoma is also called metastatic melanoma.
Find out more about advanced melanoma skin cancer
Melanoma can spread to other areas on the skin or to soft tissue. Soft tissue includes muscles, nerves, fat, and blood vessels. Sometimes it can spread to more than one area.
Other common places for melanoma to spread include your:
lymph nodes further away from the melanoma – which ones depend on where the melanoma is
lungs
liver
bones
brain
small bowel
Where the melanoma has spread to is called a secondary cancer or metastasis.
Find out more about secondary 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
Treatment for stage 4 melanoma can help control the cancer and help to relieve symptoms. You might have one or more of the following treatments:
surgery
to the secondary melanoma, for example the bone or brain
injecting a drug directly into the melanoma (intralesional therapy), for example talimogene laherparepvec (T-VEC)
directly into the leg or arm where the melanoma is (isolated limb infusion or isolated limb perfusion)
chemotherapy combined with an electric current (electrochemotherapy)
chemotherapy into your bloodstream (intravenously) – usually you would only have this if you’ are not able to have targeted cancer drugs or immunotherapy
Find out more about treatment for advanced melanoma skin cancer
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.
Find out more about clinical trials
Last reviewed: 06 Jan 2025
Next review due: 06 Jan 2028
The stage of a melanoma skin cancer tells you how deeply it has grown down into the skin. It also tells you if it has spread elsewhere in your body and how far.
Advanced cancer has spread to another part of the body. The symptoms and treatment depend on where it has spread to. It may help to find out what support is available if you have advanced cancer.
Treatments include targeted cancer drugs, immunotherapy and chemotherapy. They aim to control the cancer, any symptoms you have and improve your quality of life.
Get support to cope with emotional, practical and physical issues when you have advanced melanoma skin cancer.
Survival for melanoma skin cancer depends on many factors including the stage of the cancer when it was diagnosed, the treatment you have and your general health.
Melanoma develops in cells called melanocytes. You have these in your skin and other parts of your body. Melanoma that starts in the skin is called melanoma skin cancer.
About Cancer generously supported by Dangoor Education since 2010. Learn more about Dangoor Education
Search our clinical trials database for all cancer trials and studies recruiting in the UK.
Connect with other people affected by cancer and share your experiences.
Questions about cancer? Call freephone 0808 800 40 40 from 9 to 5 - Monday to Friday. Alternatively, you can email us.
