Understanding your diagnosis
Your test results provide a lot of information about your melanoma.
This may include:
- the cells it started in (cancer type)
- whether it has spread from where it started (cancer stage)
- whether it is likely to grow quickly or slowly (cancer grade).
Your specialist uses this information to explain how the cancer could affect you in the future (your prognosis), and what your treatment options are. Your specialist may arrange further tests if more information is required.
What you need to know
Types of melanoma
Melanoma is a type of skin cancer. It usually starts in the skin but sometimes it can start in places like the eyes, mouth or vagina.
Melanoma starts in cells called melanocytes. These cells give skin its colour.
There are different types of melanoma:
- superficial spreading
- lentigo maligna
- acral lentiginous
Less common or rare types of melanoma include:
The stage of melanoma describes how large it is and how far it has spread at the time of diagnosis.
Staging a melanoma includes checking:
- the tumour thickness, or how far the melanoma has spread into the skin – sometimes called the Breslow measurement
- the presence of ulceration – melanomas with ulceration tend to be more aggressive
- whether the melanoma has spread to the lymph nodes.
This information is used to give a stage number to the melanoma:
- Stage 0 – The cancer is confined to the epidermis. It has not spread and can be called ‘melanoma in-situ’.
- Stage 1 – The cancer is no more than 2mm thick and may have ulceration. It has not spread to nearby tissue or lymph nodes.
- Stage 2 – The cancer is between 1 and 4mm thick. It may be ulcerated but has not spread to any lymph nodes.
- Stage 3 – The cancer can be any thickness. It can be ulcerated and has spread to nearby lymph nodes or into nearby tissues.
- Stage 4 – The cancer can be any thickness and has spread to other areas of the body. This is also called metastatic cancer or advanced cancer.
The TNM staging system can also be used to describe the extent of the melanoma.
The TNM system measures three categories:
- T (tumour) – how large the tumour (cancer) is
- N (lymph nodes) – whether it has spread into the surrounding lymph nodes
- M (metastases) – whether it has spread to other parts of the body and formed secondary cancers (metastases).
What to ask or talk about
Talking about prognosis
Prognosis means what is likely to happen to you in the future because of your cancer. You may find it hard to talk about prognosis but it can help you make decisions about the treatment and care you want.
Everyone’s cancer is different, and everyone responds differently to treatment. Because of this, doctors can’t tell you exactly what will happen to you. Instead, they can give you the best information they have about what to expect.
Doctors work out prognosis based on statistics. These show what happens in large groups of people with cancer. They cannot predict what will happen to you or any other individual person.
Your specialist will share information about you and your cancer with a multidisciplinary team (MDT) to decide the best treatment options for you.
You may need more than one type of treatment or have a choice of treatments. You may also need to see other specialists during treatment planning.
Dealing with your diagnosis
Getting a cancer diagnosis is very distressing for the person with cancer, and their carers, family and friends. Different people react in different ways. They can be upset and angry or just in shock. Many people find it difficult to take in all the information and understand what it will mean for them.
The situation can be especially difficult for people who get a diagnosis of advanced cancer.
If you need to speak to someone about your diagnosis, you can call the Cancer Council on 13 11 20.