Melanoma survival rates

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Chances of Survival from Melanoma (Prognosis)

Most patients diagnosed with melanoma are cured by surgery to remove the original skin tumour. However melanoma is a type of cancer where there is a risk of recurrence or incurable spread to other parts of the body for all patients. Your melanoma prognosis is the most likely course of your melanoma, or the risk that it will spread or affect how long you live. This risk is very, very low for patients who have had treatment for a thin melanoma, and is higher for patients diagnosed with a thicker melanoma or where there has been spread to nearby lymph nodes. If melanoma spreads elsewhere round the body, it is usually incurable and can affect how long you live. However there have been many new innovations in the treatment of advanced melanomas in recent years which have significantly improved the chances of recovery for many patients.

Nurse caring for patient

What is a prognosis?

Prognosis is a word that is sometimes used medically to mean the likely course of your melanoma, and your chances of recovery. Doctors and scientists use other similar cases to make a prediction of what might happen and the recovery rate for you. However, since everyone’s body is different, and reacts in a unique way to melanoma and its treatment, it can never be entirely accurate and is an estimated guess. Some people are keen to have this information from their medical team. Others find the information too general, as it is a kind of ‘average’ and may not apply to them.

If you would like this information, it is best to ask a doctor who is responsible for your care on your melanoma medical team. They are in the best position to know about your individual health and help explain your prognosis.

What things can affect a prognosis?

There are several things that can affect your chances of recovery or prognosis. Some of the key things are:

  • The type of melanoma and where it is located on your body
  • The stage of the melanoma (which includes the extent to which it is has spread)
  • Your overall health and fitness
  • Treatment is coordinated by a specialist skin cancer multidisciplinary team 
  • The type of treatment that is chosen
  • How well your melanoma responds to treatment

It is really hard to predict how the course of your melanoma and your cancer treatment is likely to go. It is important to know that your prognosis can change and is only an estimation of what could happen. A prognosis can improve if you have a good response to a treatment that shrinks a melanoma, and stops it from growing or spreading elsewhere. On the other hand, a prognosis can worsen if there is spread of the melanoma to a vital organ like the brain.   

What are survival rates for melanoma?

You may have come across the term survival rates. These figures show how many people live after being diagnosed with melanoma. 

Often these figures show a 5-year or 10-year survival rate, and group them by the stage of melanoma. The number includes an average of thousands of people. Some of them may be living with melanoma without treatment, some of them may be entirely melanoma-free or cured. It is important to know that these figures are averages of large groups of people, over multiple years. 

Survival rates describe what happens to a group of people diagnosed with a similar condition and do not predict your own survival and exactly what will happen in your case. Melanoma is very treatable and multiple advances in treatment continue to improve survival rates.

Survival rates by melanoma stage

Survival rates for melanoma often use statistics from the American Joint Committee on Cancer (AJCC) Melanoma Staging Database. The most recent of these was published in 20171. These rates have been grouped by stage, see left. 

Since these figures were published, there have been significant advances in adjuvant therapy. This type of treatment can lower the risk of recurrence above for Stage 3 melanoma for some people. This is particularly the case with Stage 3C (IIIC) and Stage 3D (IIID).

See here for more information on adjuvant therapy and the potential benefit of adjuvant therapy.

 

More information to help you understand melanoma staging

Stage 4 melanoma

Not everyone diagnosed with Stage 4 melanoma will feel ready to discuss their prognosis at the same time. Your medical team will work with you to make sure you have enough information to make informed decisions about your own care. However if you would like more or less information at any stage, then it is completely acceptable to let your medical team know.  

There are ‘clues’ which can help your medical team talk to you about your likely prognosis – these ‘clues’ may include where your melanoma is growing, how quickly it is changing, how much it is affecting your body and how you are getting on with your treatment. Remember that your medical team can only use information from other people to estimate what might happen to you, and there can be very great variety in how melanoma behaves. In addition, recent advances in the treatment of melanoma means that much of the information currently available is already out-of-date which is why these are not being quoted and information on the long-term effects of our newer treatments does not yet exist. This means that even if you feel ready for a conversation about your prognosis, there may be relatively little published data to base this discussion on.

Holding hands for support

Recent treatment advances mean that it is possible to live alongside Stage 4 melanoma for a very long time, and there are patients alive and well many years after their diagnosis with Stage 4 melanoma, who may have very little evidence of melanoma left on their scans and we hope will never have further problems from their melanoma. Although most medical teams don’t use the word ‘cure’, it is possible for some patients diagnosed with stage 4 melanoma to eventually stop treatment for their melanoma and live full lives.  Having said that, a diagnosis of Stage 4 melanoma is a time of great uncertainty and unfortunately not everyone will benefit from the treatments currently available. In this case, patients may become less well over a much shorter time.

Relevant References:

[1] Gershenwald JE, et al; for members of the American Joint Committee on Cancer Melanoma Expert Panel and the International Melanoma Database and Discovery Platform. Melanoma staging: Evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin. 2017 Nov;67(6):472-492. doi: 10.3322/caac.21409. Epub 2017 Oct 13. PMID: 29028110; PMCID: PMC5978683.

[2] Larkin J, et al. Five-Year Survival with Combined Nivolumab and Ipilimumab in Advanced Melanoma. N Engl J Med 2019 [Internet]. 2019 Oct 17 [cited 2020 June 24]; 381:1535-1546. DOI: 10.1056/NEJMoa1910836

[3] Robert C, et al. Five-Year Outcomes with Dabrafenib plus Trametinib in Metastatic Melanoma. N Engl J Med 2019 [Internet]. 2019 Aug 15 [cited 2020 June 24]; 381:626-636. DOI: 10.1056/NEJMoa1904059