Stage 2 Melanoma
Stage II melanoma extends beyond the epidermis (very outer layer of skin) into the thicker dermis layer of the skin. It is thicker than Stage I melanoma and is slightly more likely to metastasize. There is still no evidence that Stage II melanoma has spread to the lymph tissues, lymph nodes, or body organs.
Stage II melanoma is divided into three subgroups:
Stage IIA Melanoma: The melanoma tumor is more than 1.0 millimeter and less than 2.0 millimeters thick (up to the size of a new crayon point) with ulceration (broken skin) or more than 2.0 and less than 4.0 millimeters without broken skin.
Stage IIB Melanoma: The melanoma tumor is more than 2.0 millimeters and less than 4.0 millimeters thick with broken skin (ulceration) or more than 4.0 millimeters without ulceration.
Stage IIC Melanoma: The melanoma tumor is more than 4.0 millimeters thick with broken skin (ulceration).
About Staging: Melanoma staging is based on the American Joint Committee on Cancer (AJCC) staging system. The system assigns a stage based on tumor-node-metastasis (TNM) scores as well as additional prognostic factors. The goal is that melanomas of the same stage will have similar characteristics, treatment options, and outcomes. Learn more about melanoma staging here.
Treatment for Stage 2 Melanoma: Stage II melanoma is treated by removing the tumor surgically. Wide local excision, a minor surgery, usually cures local melanoma. Your doctor may suggest a sentinel lymph node biopsy to determine if the melanoma has spread to the nearest lymph node. If melanoma is detected in this biopsy, your doctor may recommend a complete lymph node dissection (removing all lymph nodes in a specific area of the body surgically); however, this is not recommended in all instances. Learn more about melanoma treatments here.
Adjuvant Therapy: Some melanomas may have certain features that increase the chance of metastasis or recurrence. In these cases, your doctor may suggest the use of adjuvant therapy to help delay or prevent the melanoma from returning. Adjuvant therapy is additional treatment given after the primary treatment for melanoma (usually surgery). The goal of adjuvant therapy is to reduce the risk of melanoma returning. Learn more about adjuvant therapy here.
Neoadjuvant Therapy: In some instances, your doctor may recommend trying to shrink the tumor before surgery. This is referred to as neoadjuvant therapy and is typically offered through clinical trials.
High-risk melanoma usually is defined as melanoma that is deeper or thicker (more than 4.0 millimeters thick) at the primary site or involves nearby lymph nodes. This disease has a high risk of recurrence because some melanoma cells may remain in the body even after the surgery removed the visible melanoma tumors successfully.
Clinical Trials: Clinical trials offer patients access to treatment approaches that may prove more beneficial than those approved by the U.S. Food and Drug Administration (FDA) currently. In addition, clinical trials expand our understanding of melanoma and improve future treatment options for all patients. Learn more about clinical trials here.
Prognosis Stage 2 Melanoma: With appropriate treatment, Stage II melanoma is considered intermediate to high risk for recurrence or metastasis. The 5-year survival rate as of 2018 for local melanoma, including Stage II, is 98.4%. Click here to learn more about melanoma survival rates.
Follow-Up Care for Stage 2 Melanoma:
Stage IIA: After achieving No Evidence of Disease (NED) following treatment for Stage IIA melanoma, you should conduct monthly self exams of your skin and lymph nodes and have an annual, full-body skin exam performed by a trained dermatologist for the rest of your life. You should also undergo a physical exam by your doctor every 6 to 12 months for the first 5 years, and then annually as needed. Imaging tests may be ordered as needed to monitor for recurrence.
Stage IIB: After achieving No Evidence of Disease (NED) following treatment for Stage IIB melanoma, you should conduct monthly self exams of your skin and lymph nodes and have an annual, full-body skin exam performed by a trained dermatologist for the rest of your life. You should also undergo a physical exam by your doctor every 3 to 6 months for the first 2 years, then every 3 to 12 months for the next 3 years, and then annually as needed. Imaging tests may be ordered every 3 to 12 months to monitor for recurrence.
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