Powered By
Finding out you have stage 3 melanoma can raise more than a little concern. If your melanoma is in stage 3, it means the skin cancer has spread to nearby lymph nodes and/or nearby areas of skin or tissue, but not to distant parts of the body.
Knowing more about your treatment options and outlook for stage 3 melanoma might help put your mind at ease. Here’s a quick overview of what to expect from stage 3 melanoma treatment based on the details of your melanoma.
Your stage 3 melanoma substage depends on factors such as the thickness of the melanoma, whether it’s ulcerated (the skin over it has broken down), and how far the cancer has spread. The substages are 3A, 3B, 3C, and 3D.
Sign up to view the results!
Continue with Facebook
Continue with Email
Stage 3A melanoma has a thinner primary tumor (the original melanoma) and a small amount of cancer in nearby lymph nodes. Stage 3D melanoma has a tumor more than 0.16 inch (4 millimeters) thick that is ulcerated and has spread more extensively to lymph nodes and/or nearby areas of skin.
If you have resectable stage 3 melanoma, it means that the melanoma can be removed completely with surgery.
Systemic (whole-body) treatments for resectable stage 3 melanoma can include treatment before surgery and treatment after surgery. You may need systemic treatment after surgery to lower the risk of recurrence (cancer coming back).
Immunotherapy for melanoma works by helping your own immune system recognize and destroy cancer cells more effectively. Before surgery for certain stage 3 melanomas, doctors may recommend immune checkpoint inhibitors such as pembrolizumab (Keytruda).
Pembrolizumab and other immune checkpoint inhibitors work by blocking proteins that can keep immune cells from attacking cancer. When given before skin cancer surgery, immunotherapy may help shrink the tumor before it’s removed.
Another treatment option for resectable stage 3 melanoma is surgery to remove the skin cancer lesion along with a margin of healthy skin and tissue around it. If the area of removed skin is large, you may need a skin graft to cover the wound.
Doctors may also check nearby lymph nodes for cancer with a sentinel lymph node biopsy. This involves removing the first lymph node or nodes that the cancer is likely to spread to and checking them for cancer cells.
If your melanoma has a high risk of recurrence, your doctor might recommend immunotherapy after skin cancer surgery. This can involve an immune checkpoint inhibitor such as:
Melanoma with a high risk of recurrence can also be treated with surgery followed by targeted therapy if the melanoma has certain mutations (changes) in the BRAF gene. Together, the targeted therapies dabrafenib (Tafinlar) and trametinib (Mekinist) target proteins that help melanoma cells with certain BRAF gene changes grow.
If you have unresectable stage 3 melanoma, it means that surgery can’t remove all the cancer. Many treatments for unresectable stage 3 melanoma are also used for stage 4 melanoma.
Usually, treatment for unresectable stage 3 melanoma involves at least one type of systemic therapy. Systemic therapies include immunotherapy and targeted therapy.
Immunotherapy for unresectable stage 3 melanoma may involve one or a combination of drugs. The following immunotherapy options may treat stage 3 melanoma that isn’t able to be fully removed with surgery:
For some adults whose melanoma has not responded to certain previous treatments, doctors might also recommend tumor-infiltrating lymphocyte (TIL) therapy with lifileucel. You usually get about one week of chemotherapy before TIL treatment.
This newer treatment option involves removing part of a tumor and collecting TILs, which are immune cells called T cells that have entered the tumor to attack cancer cells. Doctors then multiply the TILs in a lab before giving them to you as an infusion, followed by IL-2. Once they’re back in your body, the TILs can find and destroy melanoma cells.
Targeted therapies for unresectable stage 3 melanoma may be an option if the melanoma has certain BRAF mutations. Common combinations include:
Oncolytic virus therapy is a stage 3 melanoma treatment that is injected directly into the melanoma tumor. Doctors genetically modify viruses in a lab to target and destroy cancer cells.
When the modified viruses are injected into a tumor, they enter cancer cells and cause them to burst and release proteins. This can help the immune system recognize and attack other melanoma cells, similar to how vaccines help the immune system recognize and fight germs.
There may be ongoing clinical trials for stage 3 melanoma. Clinical trials test new treatments or new combinations to learn how well they work. Ask your skin cancer care team whether any clinical trials are accepting new participants and might be a good fit.
Most cases of stage 3 melanoma have a medium to high risk of spreading or recurring, even after they’ve been treated. Generally, the earlier you find stage 3 melanoma and start treatment, the better your prognosis.
The five-year relative survival rate describes how likely people with a certain cancer are to live for at least five years after diagnosis compared with people without that cancer.
Five-year relative survival rates for stage 3 melanoma vary considerably based on factors like your substage, age, overall health, and how well the melanoma responds to treatment. For regional melanoma, which includes melanoma that has spread to nearby structures or lymph nodes, the five-year relative survival rate is about 76 percent based on people diagnosed between 2015 and 2021.
Survival rates are estimates and can’t predict what will happen for any one person. People diagnosed today may also have a better outlook than these numbers suggest because melanoma treatments have improved over time.
Your doctor can give you more information about available treatments, including their common side effects and how to cope with them.
Through shared decision-making, you and your doctor can work together to choose a treatment plan for your melanoma skin cancer that aims to prevent further spread and lower the risk of recurrence.
Get updates directly to your inbox.
Continue with Facebook
Continue with Email
Continue with Facebook
Continue with Email
Become a member to get even more
Join
Your Privacy Choices
This is a member-feature!
Sign up for free to view article comments.
We'd love to hear from you! Please share your name and email to post and read comments.
You'll also get the latest articles directly to your inbox.