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In most cases, nonmelanoma skin cancer is confined to the skin and is easily treated and cured. If skin cancer has spread, then your doctor will want to know the stage of the cancer. Staging of cancer is a method of noting the extent of the cancer. The stage tells how big the cancer is, and if it has spread. This helps in deciding on the best treatment. Stage is determined when a biopsy (tissue sample) and other tests are done on the cancer.
The stage is based on the size of your 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 to IV. Cancer with 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 it has two 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.
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 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 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 dermis, or into 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.
When your cancer is staged, your health care provider will talk with you about what the stage means for your treatment. Make sure to ask any questions or talk about your concerns.
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