Stage IV melanoma has metastasized (spread) to other places throughout the body, such as the brain, lungs, liver, or gastrointestinal (GI) tract. Melanoma may also have spread to distant points in the skin. Stage IV melanoma is considered distant metastatic or advanced melanoma.
The relative 5-year survival rate drops from 99% in stages 1 and 2 to 66.2% in stage 3 to only 27.3% in stage 4. 2 Stage 4 melanoma is very difficult to treat and has a low survival rate because it has metastasized, but a small population of people with this stage of melanoma respond well to treatment.
Prognosis for Stage 3 Melanoma: With appropriate treatment, Stage III melanoma is considered intermediate to high risk for recurrence or metastasis. With all melanoma, the earlier it is detected and treated, the better. The 5-year survival rate as of 2018 for regional melanoma (Stage III) is 63.6%.
According to the American Cancer Society , the 5-year survival rate for stage 4 melanoma is 15–20 percent. This means that an estimated 15–20 percent of people with stage 4 melanoma will be alive 5 years after diagnosis. Many different factors influence an individual's chance of survival.
Once a tumor has spread to distant body sites such as organs, it is considered a stage IV melanoma, with an estimated five-year survival rate of only 18 percent in the U.S. These survival figures are improving every year because of new treatments (some therapies are keeping as much as 40 percent of stage IV patients ...
Melanoma can grow very quickly. It can become life-threatening in as little as 6 weeks and, if untreated, it can spread to other parts of the body. Melanoma can appear on skin not normally exposed to the sun.
How fast does melanoma spread and grow to local lymph nodes and other organs? “Melanoma can grow extremely quickly and can become life-threatening in as little as six weeks,” noted Dr. Duncanson. “If left untreated, melanoma begins to spread, advancing its stage and worsening the prognosis.”
Doctors have known for decades that melanoma and many other cancer types tend to spread first into nearby lymph nodes before entering the blood and traveling to distant parts of the body.
Melanoma begins on the skin where it is easy to see and treat. However, it can grow into the skin, reaching the blood vessels and lymphatics, and can spread within the body to various organs when it can be fatal. If it is recognized and treated early, chances of recovery are very good.
Stage 4 is also called advanced melanoma. It means the melanoma has spread elsewhere in the body, away from where it started (the primary site) and the nearby lymph nodes. The most common places for melanoma to spread include the: lungs.
If the cancer has spread to nearby lymph nodes, the prognosis is poorer. The larger the number of lymph nodes that contain cancer, the poorer the prognosis. People with cancer in 4 or more nearby lymph nodes have a poorer prognosis than people with 1 to 3 cancerous lymph nodes.
Nodular melanoma had the poorest five-year and ten-year prognosis among histological subtypes (51.67 and 38.75%, respectively). Acral lentiginous melanoma had five-year melanoma-specific survival of 72.34%, and ten-year survival of 48.54%.
There are patients who survive Stage IV melanoma long-term. The survival prognosis is better if the melanoma has spread only to distant parts of the skin or distant lymph nodes rather than to other organs, and if the lactate dehydrogenase (LDH) level is normal.
Clinical analyses of in situ melanoma cells — from melanoma in its highly treatable stage — showed that adipocytes, or fat cells, which usually reside in the deeper layers of the skin, had risen to the upper dermis layer, close to melanoma cells. This event correlated with the aggressiveness of the disease.
Melanoma is the deadliest type of skin cancer. However, a melanoma diagnosis is not a death sentence.
Melanoma that has spread to the brain may cause headaches and sickness. These can be worse first thing in the morning. Other symptoms depend on the area of the brain affected. They may include numbness or weakness in a limb, or having a seizure (fit).
Wolchok explained that when he first started treating patients with melanoma in the year 2000, the average survival for someone with stage 4 disease was about seven months. Now that there are Food and Drug Administration-approved immune checkpoint inhibitors, average survival has increased to over six years.
Melanoma most often appears on the face or the trunk of affected men. In women, this type of cancer most often develops on the lower legs.
In the United States, the 5-year relative survival rates for melanoma that has spread to the nearby lymph nodes is 71%.
Melanoma usually spreads through the body's blood vessels to the liver. Liver metastases are sometimes present when the original (primary) cancer is diagnosed, or it may occur months or years after the primary tumor is removed. After the lymph nodes, the liver is the most common site of metastatic spread.
The median time from primary melanoma diagnosis to brain metastasis was 3.2 years (range, 0–29.8 years), and the median time from stage IV diagnosis to brain metastasis was 2 months (range, 0–103 months).