Stage III Melanoma
What do I need to know?
Stage III melanoma is broken down into Stage IIIA, Stage IIIB and Stage IIIC. A variety of factors are involved in this breakdown, including tumor thickness, ulceration, regional lymph node involvement, in-transit metastases and satellite metastases.
In all cases of a Stage III diagnosis, the tumor may be of any thickness and it may or may not be ulcerated. The melanoma cells have spread either to a few nearby lymph nodes, or to some tissue just outside the tumor, but it has not spread to any distant organs.
You may be intersted in reading through our booklet, Managing a Stage III Melanoma Diagnosis.
Treating Stage III Melanoma
Surgery - Standard surgical treatment is removal of the primary melanoma and a small amount of normal skin around the lesion. Recommended margins range from 1-2 cm and are determined by the size of the primary melanoma. If your doctor cannot completely remove all of the primary melanoma, it is referred to as unresectable. In some cases, unresectable Stage III melanoma may be treated much like Stage IV melanoma.
Close observation - Close observation after surgery may be recommended by your treatment team, especially if your risk for recurrence is low. This type of approach may be the best option for you, or it may make you uncomfortable. Either way, it is important to discuss this option with your treatment team.
Immunotherapy - Immunotherapy is a type of systemic treatment - treating the whole body - and attempts to activate a person's immune system so that it will destroy melanoma cells. It is prescribed and administered by a medical oncologist. There are now a couple of FDA-approved immunotherapies for high-risk Stage III patients to consider as adjuvant therapies.
Targeted therapy - Targeted therapy is a form of treatment designed to interfere with the specific proteins that are driving the growth and spread of the tumor. Because they are "targeted" to the tumor, these therapies may be more effective and associated with fewer side effects compared to some other therapies. A targeted therapy approach allows patients to receive a somewhat personalized treatment since the drugs are based on the unique genetic profile, or subtype, of their tumor.
Clinical trials - Clinical trials offer access to drugs or combinations of drugs that are not yet approved by the FDA. Many experts believe these drugs offer great promise in lower the risk of recurrence for Stage III patients. As with any treatment decision, enrolling in a trial is a personal decision and many factors should be considered.
Some people worry that doctors will be offended if they ask for a second opinion. However, most doctors welcome a second opinion and many health insurance companies will even pay for them. A second opinion may provide you with more information and, perhaps, a greater sense of control.
Managing Side Effects
Side effects are a reality of every melanoma treatment option. Side effects vary by treatment and by individual. Some patients may experience many side effects, while others experience a few, or sometimes no side effects from their treatment.
ALL SIDE EFFECTS SHOULD BE REPORTED TO YOUR DOCTOR IMMEDIATELY. Many patients think that reporting side effects will cause their doctors to take them off that treatment. Reporting all side effects as soon as you begin experiencing them will help in the management of the side effects and, in most cases, will allow you to stay on treatment longer.