Key points

  • There are five stages of melanoma ranging from stage 0 to stage 4.
  • Survival rates are just estimates and don’t ultimately determine an individual’s specific prognosis.
  • Early diagnosis greatly increases survival rates.
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Melanoma is a kind of cancer that begins in the skin cells that create the pigment melanin. Melanoma usually starts as a dark mole on the skin. However, it can also form in other tissue, such as the eye or mouth.

It’s important to keep an eye on moles and changes in your skin, as melanoma can be deadly if it spreads.

Data estimates suggest that about 7,650 deaths occurred from melanoma in 2022, with a larger proportion of them males assigned at birth (MAAB) than females assigned at birth (FAAB). One in twenty Americans dies from melanoma annually.

Melanoma stages are assigned using the TNM system.

The stage of the disease indicates how much the cancer has progressed by taking into account the size of the tumor, whether it’s spread to lymph nodes, and whether it’s spread to other parts of the body.

A doctor can identify a possible melanoma during a physical exam and confirm the diagnosis with a biopsy, where the tissue is removed to determine if it’s cancerous.

But more sophisticated technology, such as PET scans and sentinel lymph node biopsies, are necessary to determine the cancer’s stage or how far it’s progressed.

There are five stages of melanoma. The first stage is called stage 0, or melanoma in situ. The last stage is called stage 4. Survival rates decrease with later stages of melanoma.

It’s important to note that survival rates for each stage are just estimates. Each person with melanoma is different, and your outlook can vary based on a number of different factors.

Stage 0 melanoma is also called melanoma in situ. This means that your body has some abnormal melanocytes. Melanocytes are the cells that produce melanin, which is the substance that adds pigment to the skin.

At this point, the cells could become cancerous, but they’re simply abnormal cells in the top layer of your skin.

Melanoma in situ may look like a small mole. Even though they may appear harmless, any new or suspicious-looking marks on your skin should be evaluated by a dermatologist.


  • Incidence: The U.S. rate is 9.5%.
  • Recurrence: Varies according to research between 2.4-20%.
  • Survival rate: 99-100%

In stage, the tumor is up to 2 mm thick. It may or may be ulcerated, which indicates whether the tumor has broken through the skin. The cancer has not spread to nearby lymph nodes or to distant parts of the body.

For stage 0 and stage 1, surgery is the main treatment. For stage 1, a sentinel node biopsy may be recommended in some cases.


  • Incidence: 8,555 diagnoses in 2017
  • Recurrence:
    • 1a: 99% after 5 years
    • 1b: 97% after 5 years
  • Survival rate: 99.4%

Stage 2 melanoma means the tumor is more than 1 mm thick and may be larger or have grown deeper into the skin. It may be ulcerated or not ulcerated. The cancer has not spread to nearby lymph nodes or to distant parts of the body.

Surgery to remove the cancerous tumor is the usual treatment strategy. A doctor may also order a sentinel lymph node biopsy to determine the cancer’s progression.


  • Incidence: There are varied estimates, so a rate range between 2.07-2.36 per 100,000 annually in the U.S. depending on the study and the year it was conducted.
  • Recurrence:
    • 2a: 94% after 5 years
    • 2b: 87% after 5 years
    • 2c: 82% after 5 years
  • Survival rate: 99.4%

At this point, the tumor may be smaller or larger. In stage 3 melanoma, the cancer has spread to the lymph system. It has not spread to distant parts of the body.

Surgery to remove cancerous tissue and lymph nodes is possible. Radiation therapy and treatment with other powerful medications are also common stage 3 treatments.


  • Incidence: There are varied estimates, but a rate somewhere between 1.21-1.64 per 100,000 annually in the U.S. depending on the study and the year it was conducted.
  • Recurrence:
    • 3a: 93% after 5 years
    • 3b: 83% after 5 years
    • 3c: 69% after 5 years
    • 3d: 32% after 5 years
  • Survival rate: 68%

Stage 4 melanoma means the cancer has spread to other parts of the body, such as the lungs, brain, or other organs and tissue.

It may have also spread to lymph nodes that are a good distance from the original tumor. Stage 4 melanoma is often hard to cure with current treatments.

Surgery, radiation, immunotherapy, targeted therapy, and chemotherapy are options for treating stage 4 melanoma. A clinical trial may also be recommended.


  • Incidence: About 25.3 per 100,000 in 2018, which was a 320% increase from 1975.
  • Recurrence: 34-52%, which is higher than the rate ten years ago of 15-20%, which suggests an improvement in management and treatment.
  • Survival rate: 29.8%

The 5-year survival rate for melanoma, according to the American Cancer Society, is based on a different way of classifying melanoma stages as follows:

  • Local (cancer has not spread beyond where it started): 99%
  • Regional (cancer has spread nearby or to the lymph nodes): 71%
  • Distant (cancer has spread to other parts of the body): 32%

The 5-year survival rate reflects patients who lived at least 5 years after being diagnosed.

Factors that could affect survival rates are:

  • new developments in cancer treatment
  • a person’s individual characteristics and overall health
  • a person’s response to treatment

How long can you live with melanoma?

If your cancer is detected and treated before it spreads to your lymph nodes, your outlook is very good and you will likely live for many years. That said, while the overall 5-year survival rate for melanoma in the U.S. is 93.3%, the later your stage is, the less chance you have of living five years past diagnosis.

Is melanoma a fast-spreading cancer?

It’s important to have any new or unusual blemish examined by a dermatologist because melanoma can spread quickly. It can become life-threatening in as little as six weeks.

Here’s what Melanoma can look like on various skin tones.

Is melanoma still fatal?

The later your stage is, the more fatal is the disease. In the fourth stage, the 5-year survival rate is only 29.8%.

What is the 20-year survival rate for melanoma?

An Australian study found that 20 years after diagnosis the survival rate is about 96.0%. That’s likely because the condition was either diagnosed at an early stage or successfully treated to remission.

In its early stages, melanoma is a treatable condition. But the cancer must be identified and treated swiftly.

If you ever see a new mole or a suspicious mark on your skin, promptly have a dermatologist evaluate it. If a condition such as HIV has weakened your immune system, getting checked is especially important.

One of the best ways to avoid developing skin cancer is to wear protective sunscreen all the time. Wearing clothes that protect against the sun, such as sun-block shirts, is also helpful.

It’s important to familiarize yourself with the ABCDE method, which can help you determine whether a mole is potentially cancerous.