• Several details factor into your melanoma prognosis (outlook), including your tumor characteristics, age, and sex.
• When all stages are combined, the five-year relative survival rate is 94 percent.
• Melanoma survival rates have improved in recent years, thanks to new treatments.

If you or a loved one was recently diagnosed with melanoma skin cancer, you’re probably wondering what the future is likely to bring — that is, your prognosis. Doctors use your individual cancer characteristics and information collected from large studies to give their best estimate of your outlook.

In this article, we’ll discuss the details that factor into the prognosis of melanoma, along with current survival rates. It’s important to remember that each person’s melanoma prognosis is different. Your oncologist (cancer specialist) can answer any questions you may have about your individual outlook.

Factors in Melanoma Prognosis

When estimating someone’s prognosis with melanoma, doctors look at the person’s age, sex, and tumor characteristics. Altogether, this information can help you better understand the outlook of others with similar melanomas.

Melanoma Stage

Your melanoma stage helps predict your prognosis. The stages range from 0 to 4, with 0 being the least advanced and 4 being the most advanced. You may see the stages of melanoma written in Roman numerals, such as “stage III” instead of “stage 3.”

Your doctor will use the results of your skin biopsy to make a diagnosis and determine your cancer’s stage. Doctors use the TNM staging system, which takes into account the following:

• “T” stands for “tumor” and refers to the size and characteristic of your tumor.
• “N” stands for “node” and refers to the involvement of any nearby lymph nodes
• “M” stands for “metastasis” and looks at whether or not your cancer has spread to other parts of the body.

The higher your melanoma stage, the worse your outlook is. For example, people with stage 4 melanoma have a poorer prognosis compared to those with stage 3.

Details of Your Tumor

Your tumor’s size and thickness play an important role in your prognosis. Tumors that are thinner or less than 1 millimeter deep tend to have a good outlook. They’re less likely to spread away from the primary (main) tumor.

On the other hand, tumors thicker than 4 millimeters are associated with a worse prognosis. This is because thicker melanomas are more likely to spread to the lymph nodes. Your lymph nodes are tiny immune system organs that filter out cancer cells and infections.

Melanoma that reaches the lymph nodes can spread to other parts of the body. As a result, tumors that spread into nearby nodes have a poorer prognosis.

Ulceration

In some people, the skin covering a melanoma tumor breaks down and forms an open sore. This is known as ulceration, and it’s associated with a poorer prognosis. Ulcerated melanomas are more likely to spread to other parts of the body. However, studies also show that melanomas with ulceration respond better to certain treatments — like immunotherapy.

Location of Your Tumor

Where your melanoma tumor is located on your body also influences your prognosis. Melanomas found on the arms or legs tend to have a better outlook compared to tumors on the head, neck, or trunk (chest and back).

Melanoma Subtype

Cutaneous melanoma (melanoma that grows on the skin) is the most common type. Doctors divide cutaneous melanoma into four main subtypes based on how the tumor grows.

Nodular melanoma is an aggressive subtype of melanoma that grows faster and deeper into the skin layers. Studies show that nodular melanoma has a poorer prognosis compared to other subtypes. This is because the tumors are usually thick when they’re diagnosed.

Acral lentiginous melanoma (ALM) — also called acral melanoma — forms on the palms of the hands, the soles of the feet, and underneath the nails. Prognosis with ALM tends to be worse than with cutaneous melanoma because it can go unnoticed for a long time. ALM is more likely to be advanced-stage melanoma at the time of diagnosis.

Age and Sex

Older age with melanoma is generally associated with a poorer prognosis. According to the National Cancer Institute (NCI), the median age of death with melanoma is 72 years old. This means that half of people with melanoma die before age 72, and half die after age 72. Data from the NCI Surveillance, Epidemiology, and End Results (SEER) database also shows that males are almost twice as likely to die from melanoma compared to females.

Rate of Growth

When a doctor looks at your melanoma cells under a microscope, they’ll note how quickly the cells grow and divide. Studies have found that thicker melanomas and those with ulceration have more cancer cells growing and dividing. Overall, faster growth rate is associated with a worse prognosis.

Race and Ethnicity

People with lighter skin are at a higher risk of melanoma. However, people with darker skin can also develop the condition. Melanoma can develop anywhere — including skin that doesn’t get much sunlight. Studies show that people with darker skin tones tend to develop ALM and mucosal melanoma, which affects the moist tissues lining the mouth and genitals.

These melanomas are harder to find and diagnose, meaning they aren’t found until the cancer has progressed. Some people with darker skin are less likely to feel they’re at risk for skin cancer, so they’re less likely to get full-body skin exams. Researchers have found that underlying social factors also may contribute to delayed diagnosis and delayed treatment in non-Hispanic Black people, resulting in worse outcomes. Researchers have found that members of racial minority groups, people without insurance, and individuals with lower incomes have a harder time accessing primary care — which is often needed for referral to a dermatologist.

As a result of these factors, people with melanoma and darker skin tend to have a worse prognosis overall.

Survival Rates and Life Expectancy With Melanoma

Survival rate refers to the number of people with a type of cancer who are still alive after a certain amount of time. Doctors use survival rates to help people with melanoma understand their outlook when compared to others with the same stage of the disease.

The American Cancer Society notes that survival rates are estimates made from large studies of people with melanoma. It’s important to remember that they can’t accurately predict how long you or any one person will live with melanoma.

Every person’s cancer and response to treatment is different, and what may work for someone else may not work for you. The statistics are meant to help you get a better idea of how your melanoma may respond to treatment.

5-Year Relative Survival Rate With Melanoma

A common statistic used to describe prognosis is the five-year relative survival rate. It compares people with a certain melanoma stage to the general population over five years.

The NCI SEER database collects survival information for different cancers. While melanoma is typically divided into stages 0 through 4, the SEER database defines melanoma as:

• Localized — The cancer is contained to the primary tumor and hasn’t spread.
• Regional — The cancer has spread into nearby tissues or lymph nodes.
• Distant — The cancer has spread to other parts of the body.

Five-year relative survival rates are given in percentages. When all stages of melanoma are combined, the relative five-year survival rate is 94 percent. This means that people with melanoma are 94 percent as likely to be alive after five years compared to the general population.

SEER also provides the five-year relative survival rates based on the melanoma stage:

• Localized — Greater than 99 percent
• Regional — 74 percent
• Distant — 35 percent

Remember, these statistics are an estimate of several studies of people diagnosed with melanoma between 2013 and 2019. Since then, the U.S. Food and Drug Administration (FDA) has approved several new melanoma treatment options, including some for advanced melanoma.

The American Society of Clinical Oncology notes that survival rates for people with stage 4 (metastatic) melanoma have doubled in the past 20 years. As we learn more about melanoma and better ways to treat it, survival rates are expected to continue improving.

Talk With Others Who Understand

MyMelanomaTeam is the social network for people with melanoma and their loved ones. On MyMelanomaTeam, members come together to ask questions, give advice, and share their stories with others who understand life with melanoma.

Have you discussed prognosis with your doctor? Do you still have questions about your outlook? Share your experience in the comments below, or start a conversation by posting on your Activities page.