Melanoma is a dangerous and aggressive form of skin cancer. The staging system ranges from stage 0 to stage 4, with higher stages indicating more advanced disease. A melanoma diagnosis does not automatically mean a poor prognosis. The stage at which melanoma is detected and how quickly it’s treated plays a major role in survival outcomes.

To determine the stage, healthcare providers examine the tissue under a microscope to assess how deeply the cancer has penetrated and whether it has spread to other parts of the body.

Stage 0

Stage 0, or melanoma in situ, is the earliest stage of the disease. “In situ” means the cancer is confined to its place of origin—in this case, the epidermis, the outermost layer of the skin.

treatment

Stage 0 melanoma is usually treated with wide excision surgery. The affected area, typically a mole, is removed along with some surrounding skin to ensure clean margins. In some cases, Mohs surgery or topical treatments like imiquimod cream may be used, especially when surgery isn’t feasible.

survival rate

Because the cancer is still localized, the five-year survival rate for stage 0 melanoma is approximately 98.4%.

Stage 1

In stage 1, melanoma cells have moved beyond the epidermis. The tumor is up to 2 millimeters thick and may be ulcerated, but it has not reached lymph nodes or other organs.

treatment

Treatment typically involves wide excision surgery, removing the tumor with a safety margin of normal skin. Healthcare providers may also test nearby lymph nodes to ensure the melanoma hasn't begun to spread.

survival rate

When detected early and treated appropriately, the five-year survival rate remains high—around 98.4%.

Stage 2

Stage 2 melanoma is more advanced than stage 1, with tumors at least 1 millimeter thick and possibly over 4 millimeters. The tumor may or may not be ulcerated, but the cancer has not yet spread to lymph nodes or distant organs.

treatment

Wide excision surgery remains the main form of treatment. A lymph node biopsy may be recommended to check for potential spread. The size of the excised margin depends on the tumor’s thickness and location.

survival rate

Even at stage 2, melanoma is still considered localized. The five-year survival rate is comparable to earlier stages at around 98.4%, assuming prompt treatment.

Stage 3

At stage 3, melanoma has spread to nearby lymph nodes or surrounding skin. It has extended beyond the original tumor site, though it has not yet reached distant organs.

treatment

Treatment involves surgical removal of the primary tumor and affected lymph nodes. Lymph node biopsy and dissection are common procedures at this stage. Additional treatments such as immunotherapy, radiation, or clinical trials may also be recommended to reduce the risk of recurrence.

survival rate

Stage 3 melanoma has a five-year survival rate of about 63.6%. While more serious, it is still treatable, especially with newer medical therapies.

Stage 4

Stage 4, or metastatic melanoma, occurs when the cancer spreads to distant organs such as the lungs, liver, or brain.

treatment

Though often incurable, treatment focuses on symptom management and slowing the disease. Options may include surgery, radiation, chemotherapy, immunotherapy, targeted therapy, or clinical trial drugs.

survival rate

Stage 4 melanoma has a much lower five-year survival rate of around 22.5%. However, advances in treatments such as immunotherapy have improved outcomes for some patients.

How To Protect Against Melanoma

Although not all melanomas are preventable, early detection greatly increases the chance of successful treatment. Most melanomas caught early are completely curable.

Do Not Ignore Skin Changes

If you notice new moles or changes in existing ones—especially growth, color changes, itching, bleeding, or irregular borders—it’s important to consult a healthcare provider right away. Delaying evaluation can lead to late-stage diagnosis and reduced survival chances.

Act Quickly

Melanoma can progress quickly. Early action is crucial. From the moment you notice something unusual on your skin to the time of diagnosis and treatment, speed matters.

Know Your Risk Factors

common melanoma risk factors include

  • Fair skin, light eyes, and blonde or red hair

  • A family history of melanoma

  • Frequent or severe sunburns during childhood or adolescence

  • Having more than 50 moles or large, atypical moles

  • UV exposure from sunlight or tanning beds

While you can’t change genetic risk factors, you can limit UV exposure by using SPF 30+ sunscreen, avoiding tanning beds, and wearing protective clothing.

Get Regular Skin Checks

Self-monitoring your skin and scheduling annual dermatological exams are essential steps in prevention and early detection. Healthcare providers can spot changes you might miss—especially in hard-to-see areas like your back or scalp.

A Quick Review

Melanoma is categorized into five main stages. Stages 0 to 2 offer high chances of recovery when treated early. New therapies—especially immunotherapy and targeted drugs—are making a significant impact on advanced-stage melanoma outcomes.

Keeping an eye on your skin, acting fast on changes, and getting regular checkups can greatly improve your chances of catching melanoma before it becomes life-threatening.