Where Melanoma Can Spread

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If you have melanoma, one of the most important things to know is whether it has spread. The medical word for cancer that has spread is "metastasis." Melanoma is more likely to spread than other types of skin cancers. Over the past decade, the number of new melanoma cases per year continues to grow, yet overall survivorship has not changed. When caught before it spreads, melanoma is almost 100% survivable. 

How Melanoma Spreads

Melanoma starts when melanocytes—or pigment cells—near the surface of the skin begin to grow uncontrollably. Damage from the sun is the usual cause. Doctors grade melanoma in stages from 0 to 4. The stage you have depends on the thickness, depth and spread of the cancer. Stage 3 or 4 melanoma is cancer that has spread. 

If you have stage 3 melanoma, you have cancer cells that have reached one or more of your lymph nodes. Lymph nodes are part of your body’s lymphatic system, which collects fluid from your tissues and returns it to your blood. 

Melanoma can spread three ways: 

  • Direct spread to nearby tissues and areas, including the lymph nodes
  • Through the lymph system to other parts of the body
  • Through the bloodstream to other parts of the body

Regional and Distant Spread of Melanoma

Whether your melanoma has spread will affect the type of treatment you will need. Your doctor may refer to your melanoma based on the spread of the cancer. There are three basic ways of explaining it:

  • Localized disease is melanoma that has not spread to any lymph nodes. 
  • Regional disease is melanoma that has spread to one or more lymph nodes close to your cancer. 
  • Distant disease is melanoma that has spread beyond the lymph nodes close to your cancer to other parts of the body. 

Whether your melanoma has spread will also affect the likelihood of survival. Doctors often use five years as a measure of how well people survive cancer. For melanoma, the five-year survival based on cancer spread breaks out like this: 

  • Localized disease has a five-year survival rate of about 98%.
  • Regional disease has a five-year survival rate of almost 63%.
  • Distant disease has a five-year survival rate of just over 16%.

Distant Disease: Stage 4 Melanoma

Stage 4 melanoma is cancer that has spread to distant parts of the body. Another name for this is metastatic melanoma. It may have spread by growing into other areas of the body, or lymph fluid or blood may have carried it to other areas.

The cancer that forms in another part of the body will be made up of melanoma cancer cells. They will be similar to the ones that started on the surface of your skin. Stage 4 melanoma can involve almost any part of the body. The areas where melanoma most often spreads include: 

  • Bones
  • Brain
  • Liver
  • Lungs

Melanoma that has spread is much harder to treat and the five-year survival is much lower than earlier stages. That’s why it is so important to find it early, when melanoma is almost always curable.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Sep 13
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. SEER Stat Fact Sheets: Melanoma of the Skin. National Institutes of Health. National Cancer Institute. http://seer.cancer.gov/statfacts/html/melan.html
  2. Metastatic Melanoma. Melanoma Research Foundation. https://www.melanoma.org/understand-melanoma/what-is-melanoma/metastatic-melanoma
  3. Skin Cancer Facts & Statistics. Skin Cancer Foundation. http://www.skincancer.org/skin-cancer-information/skin-cancer-facts
  4. What Is Melanoma? Skin Cancer Foundation. http://www.skincancer.org/skin-cancer-information/melanoma
  5. Melanoma Treatment (PDQ®)–Patient Version. National Cancer Institute. https://www.cancer.gov/types/skin/patient/melanoma-treatment-pdq#section/all
  6. Mrazek AA, Chao C. Surviving cutaneous melanoma: a clinical review of follow-up practices, surveillance, and management of recurrence. Surg Clin North Am. 2014 Oct;94(5):989-1002, vii-viii.