Stage III melanoma means that cancer cells have spread into skin, lymph vessels, or lymph glands close to the melanoma. The melanoma, however, has not spread further to distant sites within your body.

Stage III can be subdivided into stages IIIA, IIIB, IIIC and IIID

Stage IIIA means all the following:

  • The melanoma is no more than 2mm thick and it may or may not be ulcerated
  • up to 3 nearby lymph nodes contain melanoma cells
  • these nodes are not enlarged and the cells can only be seen under a microscope (post sentinel lymph node biopsy)

 

Stage IIIB means one of the following:

There is no sign of the primary melanoma AND:

  • it has spread to only one lymph node OR
  • it has spread to very small areas of nearby skin (satellite sites) or to the lymphatic system between the primary melanoma and the draining lymph node.

OR

The melanoma is no more than 4mm thick. It might or might not be ulcerated AND:

  • has spread to up to 3 lymph nodes OR
  • has spread to very small areas of nearby skin (satellite sites) or to the lymphatic system between the primary melanoma and the draining lymph node.

 

Stage IIIC melanoma – there are additional higher risk features identified such as satellite lesions or more lymph nodes involved or surrounding tissues

Stage IIIC means one of the following:

There is no sign of the primary melanoma AND:

  • it has spread to one or more lymph nodes OR
  • it has spread to very small areas of nearby skin (satellite sites) or to the lymphatic system between the primary melanoma and the draining lymph nodes OR
  • it has spread to any lymph nodes that are clumped together.

OR

The melanoma may or may not be ulcerated AND:

  • it has spread to one or more lymph nodes OR
  • it has spread to very small areas of nearby skin (satellite sites) or to skin lymphatic system between the primary melanoma and the draining lymph nodes OR
  • it has spread to lymph nodes that are clumped together.

 

Stage IIID means the following:

The melanoma is thicker than 4mm and is ulcerated AND:

  • it has spread to 4 or more lymph nodes OR
  • it has spread to very small areas of nearby skin (satellite sites) or to skin lymphatic system between the primary melanoma and the draining lymph nodes OR
  • it has spread to lymph nodes that are clumped together.

 

You should be cared for by a Specialist Skin Multidisciplinary Team (SSMDT), which includes a dermatologist (skin doctor), a plastic surgeon, an oncologist (cancer doctor), a specialist nurse, a pathologist (who reviews the biopsies) and a radiologist (x-ray/scan doctor) and possibly some other types of support staff.

If at the outset the local lymph nodes are known to be involved with melanoma, for example if your doctor can feel them, or after a sentinel lymph node biopsy, then you are likely to have stage IIIA, IIIB, IIIC or IIID melanoma. If the melanoma can be removed with surgery, then adjuvant treatment would be discussed with you. If your melanoma is considered inoperable, you may be considered for immunotherapy or targeted therapy.

Stage III melanoma include where the melanoma has spread to local areas of skin away from the primary tumour. These are called ‘in-transit’ or ‘satellite lesions’. In such cases, if the melanoma can not be easily removed, you could be considered for surgery, electrochemotherapy, isolated limb perfusion/infusion or T-VEC (see ‘other options’ on the above or below tab for further information)

Values you may wish to consider during treatment

    • Is the most important thing to you having treatment that gives you the best chance of curing your melanoma?
    • How prepared are you to have a treatment that has a potential risk of causing serious side effects or complications?
    • How prepared are you to have a year of treatment?
    • Is it important to you whether you have oral treatment or treatment in hospital?
    • How much time are you prepared to spend in hospital having treatment?
    • How much do you want to avoid having a visible scar after treatment?
    • How important is it to you to know everything about your risk of future melanoma?
    • How important is it to you to maintain living an active lifestyle, taking into account your daily activities and hobbies?
click to progress