Stage III Melanoma: What You Need to Know

Regarding Stage III Melanoma

Hello, doctor.
My mother had a black mole on the sole of her foot that became infected two months ago.
After a series of biopsies and PET scans, it was found that there was also a lymph node metastasis in the popliteal fossa.
She underwent surgery last week to remove the affected tissue and the lymph node, which was sent for analysis.
During the follow-up appointment, the doctor mentioned that the lymph node tested positive, indicating that it has progressed to "stage III." They only advised close monitoring and did not provide further information.
She was then referred to an oncologist, who only said to return for a check-up in two months.
Throughout this process, the doctors did not thoroughly explain what stage III melanoma is, so I have been researching online and discovered alarming information that stage III patients may only have three years left to live.
If cancer cells metastasize to other organs, it would progress to stage IV, with a life expectancy of just one year.

I have a few questions:
1.
Is the information I found accurate?
2.
What does it mean that it has "spread" to stage III but has not yet invaded any organs?
3.
Does this mean that we can only monitor her condition and wait for it to invade organs and progress to stage IV before any definitive action can be taken? I apologize if my questions are a bit disorganized; our doctors really did not explain what stage III means, and I have had to rely on my own research.

Mr. Wu, 30~39 year old female. Ask Date: 2019/04/08

Dr. Wu Yuxin reply Dermatology

I am hesitant to answer this question.
If Google could answer all questions, there would be no need for specialists; clinical expertise is truly important.
For this question, you should consult your mother's attending physician, as they are the most familiar with her condition.

Reply Date: 2019/04/08

More Info

Understanding Stage III Melanoma: What You Need to Know
Dear patient,
I understand that you are going through a very challenging time with your mother's diagnosis of Stage III melanoma. It is completely normal to feel overwhelmed and confused, especially when dealing with such serious health issues. I will do my best to clarify your questions and provide you with a comprehensive understanding of Stage III melanoma.

1. Is the information I found correct?
The information you found online can be both accurate and misleading. Stage III melanoma indicates that the cancer has spread to nearby lymph nodes but has not yet metastasized to distant organs. The prognosis for Stage III melanoma can vary significantly based on several factors, including the specific characteristics of the melanoma, the number of lymph nodes involved, and the overall health of the patient. While it is true that the five-year survival rate for Stage III melanoma can be lower than for earlier stages, many patients live well beyond three years, especially with appropriate treatment. It is essential to discuss prognosis with your oncologist, who can provide a more personalized assessment based on your mother's specific case.

2. What does "eating out" mean in terms of Stage III?
When your doctor mentioned that the cancer has "eaten out," they likely referred to the fact that the melanoma has invaded the lymph nodes. In melanoma staging, Stage III indicates that the cancer has spread beyond the primary site (in this case, the black mole on the foot) to regional lymph nodes. This does not mean that the cancer has invaded other organs (which would indicate Stage IV), but it does signify that the cancer is more advanced and requires careful monitoring and possibly treatment.

3. What can be done now?
While it may feel like the only option is to wait and see, there are often several treatment options available for Stage III melanoma. These may include:
- Surgical Intervention: If not already done, surgery to remove any remaining melanoma and affected lymph nodes may be necessary.

- Adjuvant Therapy: After surgery, your mother may be eligible for adjuvant therapies, which are treatments given to reduce the risk of cancer recurrence. This can include immunotherapy or targeted therapy, which have shown promising results in treating melanoma.

- Regular Monitoring: Close follow-up with her oncologist is crucial. This typically involves regular physical exams, imaging studies, and blood tests to monitor for any signs of recurrence or progression.

It is understandable to feel anxious about the future, especially with the potential for the cancer to progress to Stage IV. However, many patients with Stage III melanoma can live long, fulfilling lives with appropriate treatment and monitoring. It is crucial to maintain open communication with your healthcare team. If you feel that your mother's doctors have not provided enough information, do not hesitate to ask for a more detailed explanation or seek a second opinion.

In conclusion, while Stage III melanoma is serious, it is not a definitive sentence. With advancements in cancer treatment, many patients are living longer and healthier lives. I encourage you to continue seeking information, but also to rely on your healthcare providers for guidance tailored to your mother's specific situation.
Wishing you and your family strength and clarity during this difficult time.

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