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About Melanoma

Melanoma begins as a malignant tumour in the melanocytes, which are the cells that produce melanin or pigment. As a malignant cancer, melanoma can metastasize to other parts of the body. There are several subtypes of melanoma, including cutaneous, acral, mucosal, ocular melanoma, and even amelanotic melanoma.


To read more about melanoma diagnosis and staging, treatment options, patient and caregiver support, questions to ask your doctor, and more, visit our After Diagnosis page.

There are different types of melanoma

There are four different types of Cutaneous Melanoma, which are determined by microscope examination of a biopsy sample. 

  • Superficial Spreading Melanoma counts for approximately 70% of melanomas of the skin. Superficial spreading melanoma usually develops from an atypical mole and can be found anywhere on the body.

  • Nodular melanoma makes up about 10-15% of melanomas. Nodular melanoma starts growing down into the skin and spreading quickly.

  • Lentigo maligna melanoma makes up about 10-15% of melanomas. Lentigo maligna melanoma is most often seen on skin that has been exposed to the sun. These spots are often large.

  • Acral lentiginous melanoma (ALM) is a type of cutaneous melanoma. Its name comes from the Greek word for “extremity” and refers to the fact that ALM is found on the palms of the hands, the soles of the feet, or under the nails. Though not very common in the general population, ALM is the most common type of melanoma in people with darker skin and those of Asian descent. Up to 60 – 75% of melanoma in people of colour occurs on the palms of the hands, soles of the feet and the nail areas.The risk factors for acral melanomas are not fully understood, but sun is less likely to be a factor. Because of the misconceptions that melanomas only occur in sun-exposed areas and that people of color are not at risk for melanoma, these melanomas are often discovered later than other types, which can lead to a worst prognosis.

Understanding your Pathology Report

Webinar Recording Available

To diagnose diseases such as cancer, a sample of tissue called a biopsy is taken from a patient and examined by a pathologist to determine if cancer is present. A pathologist will then examine specimens removed during surgery (resections) for conditions such as cancer, to determine whether the tumour is benign or cancerous, and if cancerous, the exact cell type, grade and stage of the tumour. The pathologist, who is a member of your medical team, writes the pathology report that your treating doctor uses to provide the best care for you as a patient. In this webinar, Dr. Alan Spatz provides insight on understanding your pathology report so that you can play an active role in your treatment.

Melanoma Staging

Staging is commonly used in melanoma diagnosis and treatment to indicate the advancement and severity and cancer in a patient. Melanoma stages range between 0-IV based on the TNM (tumour, nodes, metastasis) system. The TNM system is dictated by the size of the primary (first) tumour, the occurrence of cancer cells in the surrounding lymph nodes, whether the cancer has metastasized (spread to other regions in the body), and whether there is ulceration (if there is ulceration, the skin covering the melanoma cannot clearly be seen). While these figures can be intimidating in the later stages, the staging system is imperative for dictating the treatment process a patient will undergo.

Stage 0 is thin melanoma which has not penetrated (invaded) the deeper layers of the skin (in situ).


Stages I and II are melanomas that are limited to the skin. These melanomas vary in how thick they are and whether the skin covering the melanoma is ulcerated or not. Thicker melanomas and ulcerated melanomas have a higher risk of recurring.

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Stage III is melanoma that has spread from the original site of your melanoma to 1 or more of the nearby lymph nodes or to the nearby skin/tissue in between. Stage III melanoma is divided into 4 groups, A, B, C, and D.

Stage IV is melanoma that has spread farther than regional lymph nodes, to distant sites such as the lung, liver, or brain.


While staging is clearly a complicated process with many variables, it is important to understand why a particular cancer case has been given its stage, and what that means for the future treatment of that patient.


Click here to view additional resources:


Sources - Works Cited Above

Melanoma Staging. NCCN Guidelines for Patients: Melanoma. 2014: National Comprehensive Cancer Network Foundation.

Canadian Cancer Society, Stages of Melanoma“.


Resources with AIM

In collaboration with AIM at Melanoma we develop patient and healthcare provider resources relevant to the Canadian population:


AIM with Immunotherapy Resources for Canadian Health Care Providers - Sequencing of Therapies in Stage IV Melanoma

Decision Making Tools

Decision Support Tool for Stage II Melanoma 

Our friends at AIM at Melanoma launched a new decision-making guide for stage II melanoma in August 2023.
This document, which is an extended interview between oncologists Geoffrey Lim and Jason Luke, discusses staging, outlines the differences between different surgical and adjuvant care options, and offers insight to the kind of factors patients need to weigh when making their care plans.

Please note that this document is written for an American audience, so some content might be less relevant to Canadians.

Options for Stage II Melanoma Cancer: Making the Decision That’s Right for You

Additional Information

An up-to-date list of available treatments can be found on the Canadian Agency for Drugs and Technologies in Health (CADTH) website’s Provincial drug formulary database, which can be accessed here.


Watch our informative video about melanoma here

Click here to view and download the NCCN Guidelines for Patients – Melanoma

Medical News Today: How skin cancer becomes invasive

Source: Canadian Cancer Society, What is Melanoma?




To read the full reports on Canadian Cancer Statistics, produced by Canadian Cancer Society, Statistics Canada, Public Health Agency of Canada, Provincial/Territorial Cancer Registries, click here for past reports.


NOTE: The information on the Save Your Skin website is not intended to replace the medical advice of a doctor or healthcare provider. While we make every effort to ensure that the information on our site is as current as possible, please note that information and statistics are subject to change as new research and studies are published.

Together, we can make a difference. 

Making awareness and education available is crucial. Since 2006, the Foundation has worked to raise awareness of melanoma and non-melanoma skin cancers focusing on education, prevention and the need for improved patient care.

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