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Nonmelanoma Skin Cancer: Stages

The stage of a cancer is how much and how far the cancer has spread in your body. Your healthcare provider uses exams and tests to find out the size of the cancer and where it is. He or she can also see if the cancer has grown into nearby areas, and if it has spread to other parts of your body. The stage of a cancer is one of the most important things to know when deciding how to treat the cancer.

In most cases, nonmelanoma skin cancer is confined to the skin and is easily treated and cured.

What are the stages of nonmelanoma skin cancer?

The stage is based on the size of the tumor, how deeply into your skin it has grown, and if the cancer has spread beyond the tumor to the lymph nodes or other parts of your body. If you have squamous cell carcinoma, your doctor may also test lymph nodes near the tumor to see if the cancer has spread to them.

Stages are named using a combination of 0 or the Roman numerals I, II, III, and IV. Cancer with a lower stage will often be easier to treat and cure. The stages include:

  • Stage 0. The cancer is only in the top layer of skin, called the epidermis. This is also called carcinoma in situ. In situ means the cancer has not spread into deeper tissues.

  • Stage I. The tumor is 2 centimeters (cm) wide or smaller and has no more than one high-risk feature (see below). Cancer has not invaded the bone, and has not spread to the lymph nodes or other organs.

  • Stage II. The tumor is larger than 2 cm or is any size and has 2 or more high-risk features (see below). Cancer has not invaded the bone, and has not spread to the lymph nodes or other organs.

  • Stage III. The cancer has spread to facial bones, such as the jaw or bones around the eye. Or it has spread to one nearby lymph node on the same side of the body as the tumor. The lymph node is not larger than 3 cm wide and the cancer has not spread to distant organs. Or, the cancer has spread to 1 lymph node on the same side of the body as the tumor, the lymph node is not larger than 3 cm wide, and 1 of these is true:

    • The tumor is not bigger than 2 cm and may have 1 high-risk feature

    • The tumor is bigger than 2 cm

    • The tumor is any size and has 2 or more high-risk features

  • Stage IV. The cancer can be any size. It has grown into other bones, into more than one lymph node, or into a lymph node larger than 3 cm wide, or is in a lymph node on the other side of the body. Or, it has spread to other parts of the body.

Most nonmelanoma skin cancers are Stage 0 or Stage I. Stage III and IV are fairly rare.

High-risk features for nonmelanoma skin cancer

High-risk features are aspects that can make a skin cancer harder to treat. These features include:

  • The tumor is thicker than 2 millimeters.

  • The tumor has spread into the lower layer of your skin (the dermis), or into the connective tissue beneath the dermis, called the subcutis (Clark level IV or V).

  • The tumor has grown and spread along nerve pathways.

  • The tumor began on an ear or on a part of the lip that has hair on it.

  • The tumor cells look very abnormal under a microscope.

Talking with your healthcare provider

When your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Make sure to ask any questions or talk about your concerns.

Online Medical Reviewer: Cunningham, Louise, RN
Online Medical Reviewer: Stump-Sutliff, Kim, RN, MSN, AOCNS
Last Review Date: 1/1/2017
© 2013 The StayWell Company, LLC. 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare provider's instructions.