Melanoma Stages

                                              
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Melanoma Symptom Stage 1 Image
Melanoma SymptomStage 2  Image
Melanoma Symptom Stage 3-4
Melanoma Symptom Stage 3-4
Stage 1
Sensitive, Irritated Redness
Stage 2
Sore, Raw,Iritated getting Worse
Stage 3-4
Darkens, Grows, Hard in Areas, Growing at Skin Level and Inward 2+cm.
Stage 4
Reaches 3 cm.+ in siize. Reaches Lymph Nodes

The 4 stages often  progress rapidly,  within weeks.
This is page includes general descriptions as iunderstood by the author not intended for medical diognistic, but general laymans understanding of what your doctors talking about.






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T-Catagories

N-Catagories

M- Catagories

Further Description of Melanoma Stages

 

Actinic Keratoses (AK)                                                      
  • Pre-cancerous: scaly patches or spots 
  • Commen in  fair skined people  and  40 +
  • Caused by excessive sun exposure
  • Most commen on head, neck, hands, and forearms.
  • AK can progress to a dangerous  skin cancer, squamous cell carcinoma (SCC).
Melanoma situ-melanoma cells are in outer layer of skin, epidermis. Mainstream says the  stage of melanoma is unlikely to spread to other parts of the body, which is untrue.  All Melanoma began in this stage.  Its the ideal time to treat the condition before it escalates.

Basal cell carcinoma (BCC)     Stage 1
  •  Whiteish bumps or a pinkish patches of skin. Can be sensitive, itchy or burning sensation.
  • Most commen cause is excessive sun exposure or indoor tanning.
  • Usually found on head, neck, and arms, but can apear elcewhere.
  • Early treatment important, like any cancer , it can become agressive, grow quickly  and be deadly.
  • Most commen skin cancer identified.
  •  The melanoma 1  is still only in the skin and is very thin. It is labeled  IA or IB, depending on the thickness and ulceration seen under a microscope. ( Skin is highly sensitive, irritated, with a buring pulse or pulling sensation under the skin.)

Squamous cell carcinoma (SCC)  Stage 2 
 
 
 
 
 

  • Red firm bump, scaly patch, or a sore that heals and then re-opens.
  • SCC tend to form on skin that gets frequent sun exposure, such as the rim of the ear, face, neck, arms, chest, and back. SCC can grow deep in the skin and cause damage and disfigurement. Early diagnosis and treatment can prevent this and stop SCC from spreading to other areas of the body.
  • The  melanoma that has spread to the lymphatic system, called “in-transit metastasis.” The lymphatic system is part of the immune system and drains fluid from body tissues through a series of tubes or vessels. Stage III is also divided into subgroups—A, B, or C—depending on the size and number of lymph nodes involved with melanoma and whether the primary tumor appears ulcerated under a microscope. The melanoma is growing in size1-2 cm. on the surface and beneath the skin. The surface is raw and has blackened areas, very painful)

   Melanoma                        Stage 3-4                                      
  • Melanoma frequently develops in a mole,not always.
  • It can begin scaley dry spots which change to red sensitive spots and progress to dark spot or begin as the dark spot.
  • When darkest, it's Stage 4 and growing above and beneith the skin
  • It grows hard in areas which are painful
  • Early diagnosis and treatment are crucial, it's an agressive and deadly. Stages 3-4  reaches the lymph nodes where cancer is spread throughout the bloodstream.
  • The melanoma  has spread to the bloodstream to other parts of the body. The original site or other as reached 3 cm. in size.  ( Skin brokenred, soreness, black, hardened tumerous areas, very painful to the touch.)
  • M1a- spread to distant skin and/or soft tissue sites
    M1b, which involves metastasis to the lung
     M1c, which describes distant metastasis at any other location or an elevated serum lactate dehydrogenase (LDH) blood test.




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T Categories



    

Tumor Thickness: The thickness of the melanoma is called the Breslow measurement. Melanomas less than 1 millimeter (mm) thick (about 1/25 of an inch) have a  small chance of frowing. If the melanoma becomes thicker, it has a greater chance of spreading.

Mitotic Rate: The mitotic rate is the portion of cancer cells in the process of dividing (mitosis). A higher mitotic rate (having more cells that are dividing) means that the cancer is more likely to grow and spread. The mitotic rate is used to help stage thin melanomas (T1; see below).

Ulceration: Ulceration is a breakdown of the skin over the melanoma. Melanomas that are ulcerated tend to have a worse outlook.


TX: Primary (main) tumor cannot be assessed.

T0: No evidence of primary tumor.

Tis: Melanoma in situ. (The tumor is only in the epidermis, the outermost layer of skin.)

T1a: The melanoma is less than or equal to 1.0 mm thick (1.0 mm = 1/25 of an inch), without ulceration and with a mitotic rate of less than 1/mm2.

T1b: The melanoma is less than or equal to 1.0 mm thick. It is ulcerated and/or the mitotic rate is equal to or greater than 1/mm2.

T2a: The melanoma is between 1.01 and 2.0 mm thick without ulceration.

T2b: The melanoma is between 1.01 and 2.0 mm thick with ulceration.

T3a: The melanoma is between 2.01 and 4.0 mm thick without ulceration.

T4a: The melanoma is thicker than 4.0 mm without ulceration.

T4b: The melanoma is thicker than 4.0 mm with ulceration.

N-Catagories

The possible values for N depend on whether or not a sentinel lymph node biopsy was done.

If the sentinel node biopsy is not done, doctors use the clinical stage of the lymph nodes, which is listed below.

NX: Nearby (regional) lymph nodes cannot be assessed.

N0: No spread to nearby lymph nodes.

N1: Spread to 1 nearby lymph node.

N2: Spread to 2 or 3 nearby lymph nodes, OR spread of melanoma to nearby skin (known as satellite tumors) or toward a nearby lymph node area (known as in-transit tumors) without reaching the lymph nodes.

N3: Spread to 4 or more lymph nodes, OR spread to lymph nodes that are clumped together, OR spread of melanoma to nearby skin (satellite tumors) or toward a lymph node area and into the lymph node(s).

If a lymph node biopsy is done, the pathologic stage can be determined, in which small letters may be added in some cases:

 Na -N1a - N2a : melanoma is in the lymph node(s), but only seen under the microscope (also known as microscopic spread).
 Nb -N1b - N2b : melanoma is in the lymph node(s), seen on imaging tests or felt by the doctor before it was removed (also known as macroscopic spread).

N2c : melanoma has spread to nearby skin (satellite tumors) or has spread to skin lymphatic channels around the tumor (without reaching the lymph nodes).

M-Catagories

M0: No distant metastasis.

M1a: Metastasis to skin, subcutaneous (below the skin) tissue, or lymph nodes in distant parts of the body, with a normal blood LDH level.

M1b: Metastasis to the lungs, with a normal blood LDH level.

M1c: Metastasis to any other organs, OR distant spread to any site along with an elevated blood LDH level.


Further Descriptions / Stages of Melanoma

Once the T, N, and M groups have been determined, they are combined to give an overall stage,
  using 0 and the Roman numerals I to IV (1 to 4). Some stages are further divided using capital letters.

In general, people with lower stage cancers have a better outlook for a cure or long-term survival, but other factors can also come into play. The staging of melanoma can be complex, so be sure to ask your doctor if you have any questions about the stage of your melanoma.

Tis, N0, M0  :The melanoma is still only in the epidermis (in situ) but has not spread to deeper skin layers.

T1a, N0, M0
The melanoma is less than 1.0 mm thick. It is not ulcerated and has a mitotic rate of less than 1/mm2. It has not been found in lymph nodes or distant organs.

IA-  T1b or T2a, N0, M0
The melanoma is less than 1.0 mm thick and is ulcerated or has a mitotic rate of at least 1/mm2, OR it is between 1.01 and 2.0 mm and is not ulcerated. It has not been found in lymph nodes or distant organs.


IIA- T2b or T3a, N0, M0
The melanoma is between 1.01 mm and 2.0 mm thick and is ulcerated, OR it is between 2.01 and 4.0 mm thick and is not ulcerated. It has not been found in lymph nodes or distant organs.

IIB - T3b or T4a, N0, M0
The melanoma is between 2.01 mm and 4.0 mm thick and is ulcerated, OR it is thicker than 4.0 mm and is not ulcerated. It has not been found in lymph nodes or distant organs.

IIC-  T4b, N0, M0
The melanoma is thicker than 4.0 mm and is ulcerated. It has not been found in lymph nodes or distant organs.
IIIA T1a to T4a, N1a or N2a, M0
The melanoma can be any thickness, but it is not ulcerated. It has spread to 1 to 3 lymph nodes near the affected skin area, but the nodes are not enlarged and the melanoma is found only when they are viewed under the microscope. There is no distant spread.
IIIB T1b to T4b, N1a or N2a, M0
The melanoma can be any thickness and is ulcerated. It has spread to 1 to 3 lymph nodes near the affected skin area, but the nodes are not enlarged and the melanoma is found only when they are viewed under the microscope. There is no distant spread.

OR
T1a to T4a, N1b or N2b, M0
The melanoma can be any thickness, but it is not ulcerated. It has spread to 1 to 3 lymph nodes near the affected skin area. The nodes are enlarged because of the melanoma. There is no distant spread.


OR
T1a to T4a, N2c, M0
The melanoma can be any thickness, but it is not ulcerated. It has spread to small areas of nearby skin (satellite tumors) or lymphatic channels (in-transit tumors) around the original tumor, but the nodes do not contain melanoma. There is no distant spread.

IIIC -T1b to T4b, N1b or N2b, M0
The melanoma can be any thickness and is ulcerated. It has spread to 1 to 3 lymph nodes near the affected skin area. The nodes are enlarged because of the melanoma. There is no distant spread.

OR
T1b to T4b, N2c, M0
The melanoma can be any thickness and is ulcerated. It has spread to small areas of nearby skin (satellite tumors) or lymphatic channels (in-transit tumors) around the original tumor, but the nodes do not contain melanoma. There is no distant spread.

OR
  T, N3, M0
The melanoma can be any thickness and may or may not be ulcerated. It has spread to 4 or more nearby lymph nodes, OR to nearby lymph nodes that are clumped together, OR it has spread to nearby skin (satellite tumors) or lymphatic channels (in transit tumors) around the original tumor and to nearby lymph nodes. The nodes are enlarged because of the melanoma. There is no distant spread.

IV- T, N, M1(a, b, or c)
The melanoma has spread beyond the original area of skin and nearby lymph nodes to other organs such as the lung, liver, or brain, or to distant areas of the skin, subcutaneous tissue, or distant lymph nodes. Neither thickness nor spread to nearby lymph nodes is considered in this stage, but typically the melanoma is thick and has also spread to the lymph nodes.