Stage 4 melanoma has metastasized (spread) to other places in the body, such as the brain, lungs, liver, bone, or gastrointestinal (GI) tract. Melanoma may also have spread to distant points in the skin.
Treatment options for stage 4 melanoma have expanded greatly in the last 10 years. For patients who have a limited number of metastases, surgery could be possible, or stereotactic radiation therapy that delivers the radiation more specifically to the tumor, or injections of T-VEC (Imlygic™) directly into accessible tumors. These treatments are usually followed by the use of immunotherapies or targeted therapies. For metastases that are more widely spread and are not eligible for surgical removal, systemic therapies including immunotherapies and targeted therapies (for melanomas with the BRAFV600 tumor biomarker) as well as a new cell-based therapy (lifileucel (Amtagvi®)) can be used. Learn more about available melanoma treatment options.
Clinical trials offer patients access to treatment approaches that may be more beneficial than those currently approved by the FDA. In addition, clinical trials increase our understanding of melanoma, improving future treatment options for all patients. Given the very rapid development of new agents and combinations, patients are highly encouraged to talk to their physicians about the option of enrolling in a clinical trial for initial treatment and at the time of disease progression. Learn more about melanoma clinical trials.
Stage 4 melanoma is difficult to cure as it has already spread to other parts of the body. However, a growing number of people respond well to treatment, achieve No Evidence of Disease or NED (meaning that cancer cannot be detected in your body), and survive for many years. Researchers are also working every day to increase the amount of time a patient responds to treatment and increase the number of people who benefit from treatment.
Stage 4 melanomas are considered “distant”, meaning the cancer has spread to distant parts of the body. For Stage 4 melanoma, depending on the treatment, overall survival rates at 5 years of 52% and 34% have been reported.
Prognostic tests can be used to estimate the severity of your melanoma and help inform your treatment decision-making. This is an extremely active area of research and includes a variety of institution-specific tests as well as commercially available tests used across multiple institutions. Learn more about prognostic tests for advanced melanoma.
After achieving NED following treatment for stage 4 melanoma, you may receive adjuvant therapy or other follow-up care. If cancer remains detectable in your body after treatment, you may continue to receive systemic treatment. You will likely have imaging tests to monitor how well treatment is working. You should conduct monthly self exams of your skin and lymph nodes and have a regular, full-body skin exam performed by a trained dermatologist for the rest of your life.
If you've been recently diagnosed with melanoma, you are not alone. The Melanoma > Exchange is a free online melanoma treatment and research-focused discussion group and support community.
