Skin cancer can develop in any part of the body, but most often it is developed on skin that is more exposed to the UV radiation. Skin cancer occurs to people of all skin tones. Read more about skin cancer here.

How is skin cancer staged?

Staging standardizes the process of describing how much the cancer has spread in the body. Staging of cancer helps the doctors figure out how much the cancer has spread and determine its best treatment and also helps calculate survival statistics. The lower the number of the stage, the less is the cancer has spread, with early stages being 1 and the most advanced stage being 4. Read about stages of skin cancer here.

TNM method:

Most cancers that have tumours are staged using a staging system called TNM system and the same is used for skin cancers. The size of the primary tumour (T), the presence of cancerous lymph nodes (N) and how far the skin cancer has spread to a different part of the body (M) can be described using the TNM system.

Skin High risk features:

The following are the high risk factors of skin cancer:

  • The cancer is more than 2 mm thick in diameter
  • It has grown into the lower dermis
  • It has grown into the space around a nerve
  • It started to spread to the ear or lip
  • The cells are poorly differentiated or undifferentiated when seen in a microscope

Read more about risk factors of skin cancer here.

Stage III non melanomas:

Basal cell carcinoma is rarely staged as these are almost always cured before they spread to other parts of the body, however in the cases where it needs to be staged, TNM method of staging is used. Squamous cell carcinomas are staged similarly.
In stage III, cancer has grown into into the bones in the face, like the jaw bone or the bone around the eye or it has spread to a nearby lymph node than it less than 3 cm in size.

Treatment of stage III basal cell carcinomas:

Surgery is the preferred treatment method for skin cancers, however if the cancer has spread beyond the primary location, below are the treatment methods available for treating localized basal cell carcinomas:

  • Simple excision
  • Mohs micrographic surgery
  • Targeted therapy with a signal transduction inhibitor
  • A clinical trial of a new treatment

Treatment of stage III squamous cell carcinomas:

Surgery is the preferred treatment method for skin cancers, however if the cancer has spread beyond the primary location, below are the treatment methods available for treating localized squamous cell carcinomas:

  • Chemotherapy
  • Retinoid therapy
  • Immunotherapy
  • A clinical trial of a new treatment

Stage III melanoma:

Stage III is divided into three sub stages:

Stage IIIA:

In this stage, upto three lymph nodes contain cancer, though the lymph nodes are not enlarged and the cells can be recognised to be cancerous only under the microscope. The skin is not ulcerated and has not spread to other areas of the body.

Stage IIIB:

The melanoma is ulcerated and has spread to one to three lymph nodes but they are not enlarged, or the skin is not ulcerated and it has spread to one to three lymph nodes but the lymph nodes are enlarged, or the melanoma has spread to other areas of the skin but has not spread to nearby lymph nodes.

Stage IIIC:

The melanoma is ulcerated and has spread to 1 to 3 lymph nodes, or it may or may not be ulcerated and has spread to 4 or more lymph nodes.

Treatment options:

  • Surgery to remove the cancer and the surrounding issue, lymph node mapping and sentinel lymph node biopsy can be done to check if the cancer has spread to the lymph nodes and then be removed if there are cancerous cells.
  • Surgery followed by immunotherapy
  • Surgery followed by targeted therapy
  • Clinical trial with or without vaccine therapy

For melanoma that cannot be removed by surgery or is recurrent, the following are the treatment methods preferred:

  • Immunotherapy
  • Targeted therapy
  • Clinical trials of immunotherapy with or without vaccine therapy.

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