Melanoma is the most serious form of skin cancer. It affects the skin cells that produce melanin, the pigment that colors your skin. Melanoma can also develop in other organs, such as your eyes and intestines, but this is uncommon.
Stage 3 melanoma, also written as stage III, is an advanced form of skin cancer. Unlike in stages 1 and 2, the cancer in stage 3 melanoma has spread from the skin cells to the lymph nodes. Lymph nodes are small tissues located in your neck, under your arms, and in other areas throughout the body. Your lymph nodes may or may not be swollen in stage 3.
Doctors divide stage 3 melanoma into three categories: 3A, 3B, and 3C. Stage 3A is the least serious, while stage 3C is the most advanced. Staging depends on the location of the cancer, the size of the tumors, and whether they have ulcerated.
Surgery is the first-line treatment for stage 3 melanoma. Your surgeon will remove the tumors, cancerous lymph nodes, and some normal tissue around the tumors. Your surgeon will also take skin from another part of your body (skin graft) to replace the removed skin. After surgery, you may need other treatments, such as immunotherapy, if there’s a high risk of the cancer coming back.
When surgery isn’t the right treatment, there are:
- targeted therapy, or drugs that attack cancer cells with less damage to normal cells
- injections into the tumor
Immunotherapy helps stop or slow tumor growth and boosts the immune system. Immunotherapy is sometimes also called targeted therapy. The U.S. Food and Drug Administration (FDA) approved several immunotherapy drugs for stage 3 melanoma treatment.
Chemotherapy for melanoma has limited success, but your doctors may suggest combining it immunotherapy. This medication-based treatment aims to destroy all the cancer cells in your body. In some cases, you can have regional chemotherapy, which delivers medicine to just an arm or a leg. This way, fewer healthy cells are killed along with the cancerous cells.
In addition to traditional treatments, your doctor will recommend palliative therapy. This may include radiation therapy to help reduce pain. Palliative therapy doesn’t treat the melanoma, but it can help relieve symptoms and improve your overall quality of life.
After your treatment, your doctor will recommend a regular follow-up schedule to monitor your cancer. They’ll be checking to make sure the cancer hasn’t come back or new cancerous lesions haven’t appeared. The types of follow-up include:
A yearly skin check: Skin checks are an important aspect of detecting melanoma in its earliest, most treatable stages. You should also conduct a skin check on yourself once per month. Look everywhere from the bottoms of your feet to behind your neck.
Imaging tests every three months to a year: Imaging studies, such as an X-ray, CT scan, or brain MRI, look for cancer recurrence.
Physical exam as needed: A physical exam to assess your overall health is important when you have had melanoma. For the first two years, you’ll want to get an exam every three to six months. Then for the next three years, the appointments can be every three months to a year. After the fifth year, the exams can be as needed. Do a monthly self-examination of your lymph nodes to check your progress.
Your doctor may recommend a different schedule based on your overall health.
Managing stage 3 melanoma can be challenging. With technological and medical advances, this diagnosis may not be as severe as it once was.
Tips for managing stage 3 melanoma
- Limit sun exposure and learn the warning signs to catch any changes.
- Make sure you see a melanoma specialist and attend your follow-up appointments.
- Stay up to date on melanoma research and treatment so you know your options.
- Know that it’s okay to get a second opinion.
After your surgery or if you’re unable to undergo surgery, you may need adjuvant treatment to prevent the cancer from coming back. There is adjuvant radiation therapy and adjuvant immunotherapy. These therapies help reduce the risk of melanoma returning, but they don’t increase your survival rate.
Complementary and alternative medicine can’t treat melanoma, but they can help manage the side effects from your standard treatment. These therapies include:
- nutrition therapy to help fight infections and reduce fatigue
- herbal medicines to prevent tumors from forming
- acupuncture and acupressure to decrease pain
- hydrotherapy to relieve pain
- meditation to relieve stress and anxiety
The survival rates for stage 3 melanoma vary based on the size of the primary tumor and how far the cancer has spread into the lymph nodes and other organs.
According to the American Cancer Society, the five-year survival rate for the stages are:
- stage 3A: 78 percent
- stage 3B: 59 percent
- stage 3C: 40 percent
The 10-year survival rates are:
- stage 3A: 68 percent
- stage 3B: 43 percent
- stage 3C: 24 percent
It’s possible for melanoma to go into remission after treatment. The chances of stage 3 melanoma coming back are moderate to high. The highest risk for recurrence of melanoma are the first two to three years after treatment. According to the Magazine of European Medical Oncology, five-year recurrence-free survival rates are:
- stage 3A: 95 percent
- stage 3B: 82 percent
- stage 3C: 72 percent
Risk factors for cancer recurrence include if four or more lymph nodes had cancer or if the lymph nodes measured more than three centimeters in size.
With a melanoma diagnosis, it’s important to reach out to those close to you during your treatment. In addition to family and friends, there are many support groups and resources who can help answer questions or provide a listening ear.
Find a melanoma support group. The American Melanoma Foundation maintains a list of support groups throughout the country — find them by clicking here.
Join an online support group. If you feel more comfortable participating in an online support group, the AIM at Melanoma Foundation offers a support community as well as counseling.
Seek financial assistance, if needed. The Melanoma Research Foundation has developed a central resource for patient assistance programs and government entities that offer financial assistance for those with melanoma. For more information, please click here.
Sign up for a mentoring program. Olympic figure skater Scott Hamilton’s charity, 4th Angel, offers a mentoring program for those with cancer. This telephone-based program is designed to provide support and encouragement to those with cancer.
Many organizations provide professional and supportive services when you’ve been diagnosed with melanoma. Other organizations that provide support for those with skin cancer include the:
Your oncologist may also be able to suggest resources in your area.