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Treatment By Stage

Melanoma Treatment by Stage

If you or someone you love has just been given a melanoma stage, you’re probably searching for what it actually means and what happens next. Melanoma is grouped into stages — from stage 0 (very early, on the skin’s surface) through to stage 4 (spread to other parts of the body) — and the stage helps your medical team choose the right treatment for you. Below, we explain each stage in plain English and the options usually considered at each one. Your own team is always the best guide to your personal situation — but understanding the basics can make it all feel less overwhelming. 💛

What do melanoma stages mean?

Doctors use a staging system to describe how far a melanoma has developed. In simple terms, it looks at how deep the melanoma has grown into the skin, whether it has reached nearby lymph nodes, and whether it has spread to other parts of the body. This is grouped into stages from 0 to 4. Knowing the stage helps your team recommend the most suitable treatment for you.

The treatment information below is based on current UK guidance41,46 — but your own team will always tailor it to your individual situation. For an overview of all the treatments mentioned here, see our main melanoma treatment page.

Stage 0 melanoma (melanoma in situ)

Treatment options for stage 0

  • Surgery (excision biopsy) to remove the melanoma and a small area of surrounding skin is the main treatment.
  • If your doctors are sure they removed enough skin around the melanoma, this is all the treatment you need.
  • As an alternative to surgery — depending on where the melanoma is and your overall health — your doctor might recommend a cream called imiquimod, which you apply to the affected area.

Stage 1 melanoma — including stage 1a vs stage 1b

Treatment options for stage 1

  • Surgery (excision biopsy) to remove the melanoma and a small area of surrounding skin.
  • Sometimes a second operation is recommended to remove a larger area of skin around the melanoma site. This is known as a wide local excision.
  • For stage 1A melanoma, if your doctors are sure they removed enough skin around the melanoma, this is usually all the treatment you need.
  • For stage 1B melanoma, your doctor might discuss the option of a lymph node biopsy with you.

Stage 2 melanoma

Treatment options for stage 2

  • Surgery to remove the abnormal mole and a small area of surrounding skin.
  • Usually a second operation is recommended to remove a larger area of skin around the melanoma site (a wide local excision).
  • Your doctor is likely to discuss the option of a lymph node biopsy with you.

Stage 3 melanoma

Treatment options for stage 3

  • Surgery to remove the abnormal mole and a larger area of surrounding skin (a wide local excision).
  • A lymph node biopsy.
  • Your doctor may advise adjuvant treatment following surgery, to reduce the risk of melanoma returning. This could include targeted therapy (dabrafenib and trametinib combination treatment)47 or radiotherapy (uncommon).
  • Your doctor may also discuss a lymph node dissection (removal of all the lymph nodes in that area), which is carried out under general anaesthetic.

Stage 4 (metastatic) melanoma

Treatment options for stage 4

You might have one or more of the following treatments:

Understanding your prognosis

Being told your stage naturally raises questions about what it means for the future. It’s important to know that a stage is not a fixed prediction — melanoma affects everyone differently, and outcomes depend on many personal factors that only your medical team can weigh up with you. Melanoma is also one of the most treatable cancers when caught early, and treatments have advanced enormously in recent years. If you’re worried about what your stage means for you, the best thing you can do is talk it through with your consultant or clinical nurse specialist, who understand your situation in full. And remember — you don’t have to carry those worries alone. Our melanoma support team and community are here whenever you need us. 💛

Real stories from people who’ve been there

Reading how others have faced the same stage can be reassuring when the clinical facts feel overwhelming. Our patient stories section shares honest, first-hand experiences from people across the UK at every stage of melanoma — from early diagnosis through to living with advanced disease.

Click HERE for a full list of REFERENCES numbers listed throughout the site (nos. 1–58)

Available Treatments

Treatment By Stage

The treatment your team recommends depends heavily on the stage of your melanoma, from stage 0 through to stage 4. Our stage-by-stage guide explains what each one means and the options usually considered at each.
Treatment By Stage

Targeted Therapies

Targeted therapies work on specific genetic changes inside melanoma cells — most commonly in a gene called BRAF — which is why you may be offered a BRAF test. They're an option for people whose melanoma carries these changes.
Targeted Therapies

Surgery for Melanoma

For most people with melanoma, surgery is the first and main treatment — and often the only one needed when the melanoma is found early. It involves removing the melanoma along with a margin of surrounding skin, and sometimes checking nearby lymph nodes.
Surgery for Melanoma
Stage IV Melanoma Treatment Options Decision Guide

Stage IV Melanoma Guide

This booklet is for anyone diagnosed with — or being evaluated for — stage 4 melanoma, the most advanced stage, where the melanoma has spread beyond where it started. It's designed to help you understand and weigh up your treatment options.
Stage IV Melanoma Guide
Second opinion from DR or Melanoma

Second Opinion

It's completely normal to want reassurance about your diagnosis or treatment plan, and you have every right to ask for a second opinion. It won't offend your medical team — it's a recognised part of your care.
Second Opinion
radiotherapy treatment for melanoma

Radiotherapy for Melanoma

Radiotherapy uses carefully targeted radiation to treat melanoma. It isn't used as often as surgery or drug treatments, but it can play a role in certain situations, such as treating melanoma that has spread.
Radiotherapy for Melanoma

Other Therapies

Some less common treatments, such as isolated limb infusion (ILI) and isolated limb perfusion (ILP), may be recommended when melanoma is confined to one area, such as an arm or leg. These deliver treatment directly to the affected limb.
Other Therapies

Learn about BRAF – watch our video

Around half of people diagnosed with melanoma have a change in their cancer cells called a BRAF V600E gene mutation. Watch our short video to understand what BRAF means and why it matters for your treatment options.
Learn about BRAF – watch our video

Immunotherapy

Immunotherapy works by helping your own immune system recognise and attack melanoma cells. It's often used for melanoma that has spread or has a higher risk of returning, and several immunotherapy treatments are now available on the NHS.
Immunotherapy
Removal of Melanoma

Excision

Local excision is where the abnormal mole or area of skin is removed and sent to a laboratory for testing. It's a relatively simple operation and is often the first step in diagnosing and treating melanoma.
Excision

Next Steps

Follow up appointments with your GP after Melanoma

FOLLOW UP APPOINTMENTS

Your follow-up care depends on the stage of the melanoma. Follow-up appointments allow your doctor to monitor for possible recurrence of the melanoma.
FOLLOW UP APPOINTMENTS
Aftercare advice to follow after Melanoma

MELANOMA AFTER CARE

It’s important to regularly check yourself for any signs of melanoma. As you have already been diagnosed with melanoma, you are at a higher than average risk of having another melanoma in the future.
MELANOMA AFTER CARE

MELANOMA FURTHER TESTS

If the initial biopsy shows melanoma, you may need further tests. Understanding the extent of the melanoma can help your doctor decide the best treatment option for you.
MELANOMA FURTHER TESTS

MELANOMA SKIN BIOPSY

If your doctor does find a suspicious mole, a sample of tissue is removed (a biopsy) for examination under a microscope. The doctor first numbs the skin with an injection of a local anaesthetic
MELANOMA SKIN BIOPSY
Getting diagnosed for Melanoma

GETTING DIAGNOSED WITH MELANOMA

See your doctor if you develop a new mole or notice a change in an existing mole or area of your skin (including under your nail). Even if you’re worried about what this might be, you shouldn’t delay seeing them. It might not be cancer.
GETTING DIAGNOSED WITH MELANOMA