Stage 1 melanoma is the earliest stage of melanoma skin cancer. While it is less advanced than higher stages, stage 1 melanoma is still considered serious and requires treatment. Understanding the details about stage 1 melanoma can help you recognize the signs early and take appropriate action.
What is Stage 1 Melanoma?
Stage 1 melanoma refers to a melanoma tumor that is less than 1 mm thick, has not spread to nearby lymph nodes, and shows no signs of distant metastasis. Based on the thickness of the tumor and whether ulceration is present, stage 1 melanoma is further divided into:
- Stage 1A – The tumor is less than 1 mm thick with no ulceration
- Stage 1B – The tumor is less than 1 mm thick with ulceration OR between 1-2 mm thick with no ulceration
Stage 1 melanoma has the highest 5-year survival rate of any stage at 92-97%. However, without treatment, stage 1 melanoma can progress to more advanced and dangerous stages. So while the prognosis is good with early treatment, stage 1 melanoma should still be considered potentially serious.
Signs and Symptoms
The most common signs of stage 1 melanoma include:
- A new mole or spot on the skin
- A mole that changes in size, shape, or color
- A spot that looks different from your other moles
- Changes in sensations, itching, pain, bleeding
Stage 1 melanomas are often smaller than 6 mm, or about the size of a pencil eraser. They may be brown, black, pink, red, white, blue, or flesh-colored. Look for moles with an irregular shape, uneven color, or blurred or ragged edges.
Causes and Risk Factors
The exact causes of melanoma are unknown, but risk factors include:
- Fair skin that burns easily
- Blond or red hair
- Blue or green eyes
- Family history of melanoma
- Personal history of melanoma
- Excessive UV light exposure
- Previous severe sunburns
- Use of tanning beds
- Many moles or unusual looking moles
- Weakened immune system
While anyone can develop melanoma, having one or more risk factors increases your chances. Protecting your skin from the sun and avoiding tanning beds can help reduce UV damage that leads to melanoma.
Diagnosis
To diagnose stage 1 melanoma, a dermatologist will first examine any suspicious spots on your skin. They may use a handheld tool called a dermatoscope to see the spot more clearly. If melanoma is suspected, they will take a biopsy of all or part of the abnormal mole or lesion.
A biopsy is necessary to confirm melanoma and determine the stage based on how deeply the cancer has invaded the skin. Common biopsy methods include:
- Shave biopsy – Shaving off the top layers of the skin with a small blade
- Punch biopsy – Using a tool to remove a circular core of skin
- Excisional biopsy – Cutting out the entire suspicious area
The biopsy sample is examined under a microscope by a pathologist who can determine if cancer cells are present. If so, they will assign a stage based on the thickness and other features.
Treatment
Treatment for stage 1 melanoma typically involves surgery to remove the tumor and a surrounding margin of healthy skin. Standard treatments include:
- Excision surgery – Cutting out the tumor with 0.5-1 cm margins for stage 1A, or 1-2 cm margins for 1B. May require a skin graft.
- Mohs surgery – Removing the cancer layer by layer, examining each layer until no cancer cells remain.
- Curettage and electrodesiccation – Scraping away cancer cells with a curette device then burning remaining cells with an electric current.
- Cryosurgery – Freezing and destroying cancer cells with liquid nitrogen.
Lymph node removal is usually not needed for stage 1 unless the nodes feel enlarged during exams. Your doctor may recommend radiation if cancer cells are found at the edges of the removed sample.
Outlook and Survival Rates
When detected and treated early in stage 1, melanoma has an excellent prognosis. According to the American Cancer Society, average 5-year survival rates for stage 1 melanoma are:
- Stage 1A – 97%
- Stage 1B – 92%
This means that about 97% of people with stage 1A melanoma and 92% of those with 1B melanoma live at least 5 years after diagnosis. Survival is slightly lower in older individuals. While stage 1 has the best outlook, melanoma can return after treatment, so regular self-exams and doctor visits are essential.
Recurrence Rate
Recurrence rates for stage 1 melanoma depend on the substage:
- Stage 1A – Recurrence rate of about 8-10%
- Stage 1B – Recurrence rate of about 15-20%
Lower thickness and lack of ulceration predict better outcomes. Caught early, recurrent melanoma can often be treated successfully a second time.
Prevention
Preventing stage 1 melanoma begins with limiting UV exposure from the sun or tanning beds. Additional tips include:
- Apply broad spectrum sunscreen daily with SPF 30 or higher
- Wear protective clothing like hats and long sleeves outside
- Seek shade when possible and avoid midday sun
- Examine skin monthly and see a dermatologist annually
- Use extra caution around water, snow, or sand due to reflected UV rays
- Avoid tanning salons and sunburns
Reducing UV skin damage can lower your melanoma risk. Catching a melanoma early in stage 1 gives you the best chance for successful treatment.
Can Stage 1 Melanoma Spread?
Stage 1 melanomas have not spread beyond the outermost skin layer. However, without treatment, stage 1 melanoma can progress and spread:
- Locally – Cancer can grow deeper in the skin and spread to nearby tissue.
- Lymph nodes – Cancer cells can break away, enter lymphatic vessels, and invade nearby lymph nodes.
- Distant sites – Advanced melanoma can metastasize to distant organs like the lungs, liver, or brain.
The risk of spread increases as the tumor thickness increases. Prompt treatment is vital to prevent local recurrence or metastasis to other parts of the body.
5 Year Survival Rates by Stage
| Melanoma Stage | 5 Year Survival Rate |
|---|---|
| Stage 0 | 100% |
| Stage 1A | 97% |
| Stage 1B | 92% |
| Stage 2A | 81% |
| Stage 2B | 70% |
| Stage 3A | 78% |
| Stage 3B | 59% |
| Stage 3C | 40% |
| Stage 4 | 15%-20% |
As the table shows, survival rates decrease significantly with more advanced stage melanoma. Aggressive treatment of stage 1 provides the best chance for long-term survival.
Life Expectancy for Stage 1 Melanoma
With prompt treatment, most people diagnosed with stage 1 melanoma have a normal life expectancy. According to studies, average life expectancy for stage 1 melanoma is:
- Stage 1A – 25+ years
- Stage 1B – 20+ years
This approaches the average life expectancy of someone without melanoma. Regular follow-up is important to monitor for recurrence and allow for early detection and repeat excision if it occurs.
Impact of Age on Life Expectancy
Age is a factor in life expectancy following stage 1 melanoma. Studies show:
- Patients under 50 – Almost 100% 10-year survival rate
- Patients 50-70 years old – Up to 90% 10-year survival
- Patients over 70 – Higher mortality risk
Younger individuals tend to have a better prognosis after stage 1 melanoma treatment. But patients of any age benefit significantly from early detection and treatment.
Follow Up Care
Appropriate follow-up is important after treating stage 1 melanoma to catch any recurrence early. Follow-up care may include:
- Skin exams every 3-12 months for several years
- Regular self-checks of skin and lymph nodes
- Lymph node ultrasound if nodes were enlarged
- Chest x-ray, CT scan, PET scan, or MRI if higher risk
- Blood tests for certain high-risk patients
Make sure you know what follow up schedule your doctor recommends. Alert your doctor right away about any new or changing moles or skin changes. Lifelong sun protection and vigilance are important.
Is Stage 1 Melanoma Serious?
While stage 1 melanoma has the best prognosis and survival rate, it is still considered a serious diagnosis. Without proper treatment, the cancer can advance, spread to lymph nodes, and metastasize to distant high-risk organs.
Treatment is highly effective when stage 1 melanoma is diagnosed early. But melanoma can be unpredictable, so continued follow-up care and monitoring for recurrence is necessary after treatment. Given the risk of progression, stage 1 melanoma warrants being treated seriously.
Conclusion
Overall, stage 1 melanoma has an excellent prognosis when treated promptly. But no melanoma diagnosis should be taken lightly. Being aware of the signs of early melanoma, getting regular skin checks, and avoiding excessive sun exposure are all key to detecting melanoma at an initial stage. This provides the greatest chance for full recovery and long-term survival.
