Decorative image

Stage 4

Find out what stage 4 melanoma skin cancer means and about treatment options.

Stage 4 is part of the number staging system. Stage 4 means that your melanoma is advanced.

These melanomas have spread elsewhere in the body, away from where they started (the primary site) and the nearby lymph nodes.

The most common places for melanoma to spread include the:

  • lungs
  • liver
  • bones
  • brain
  • tummy (abdomen)
  • distant lymph nodes

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 4 is the same as any T, any N, M1.


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 might have one or more of the following treatments:

  • biological therapy
  • chemotherapy
  • radiotherapy
  • surgery

You might have your treatment as part of a clinical trial.

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

Information and help

Dangoor sponsorship

About Cancer generously supported by Dangoor Education since 2010.