Question explored with the scientific record
Conversation so far
- 1 Stage 0 melanoma in a mole vs not in mole + a private exchange
- 2 Stage 0 melanoma in a mole vs not in mole life expectancy difference + a private exchange
- 3 Stage 0 melanoma life expectancy difference + a private exchange
- 4 Stage 0 melanoma life expectancy when from 60 years + a private exchange
- 5 Do people who have Stage 0 melanoma removed typically die from melanoma?
Answered on this page ↓
Do people who have Stage 0 melanoma removed typically die from melanoma?
The short version: stage 0 melanoma is removed before it has any access to blood or lymph, and the records here show no melanoma deaths in that group. Dying of it after clean removal is rare.
Stage 0 means the abnormal cells sit in the top layer of skin. They have not reached the dermis, where blood vessels and lymph channels are. That anatomy is the whole reason the prognosis is good: a cancer cannot spread until it has a route out.
The records that follow in situ lesions bear this out. In a series of ten early melanomas, five were in situ and five were thin invasive (0.2 to 0.8 mm), and every one of the ten was alive with no progression at follow-up [2]. In the two PUVA cases of melanoma in situ, both were treated with wide re-excision, margins came back clear, and no recurrence was reported [1]. Neither record reports a single melanoma death.
| Group | What the record shows |
|---|---|
| In situ, 5 cases [2] | No progression, alive |
| Thin invasive, 5 cases [2] | No progression, alive |
| In situ after PUVA, 2 cases [1] | Clear margins, no recurrence reported |
What these records cannot tell you is the long-run death rate. They are small series with short follow-up, not a registry tracking thousands of stage 0 patients for decades. The five-year surgical survival figures from earlier in this thread are overall survival, mostly other causes at that age, not melanoma-specific death.
My call: after complete removal of stage 0 melanoma, death from melanoma is uncommon, and the mechanism explains why. Confidence: moderate.
Sources used 2
-
Malignant melanoma in situ in two patients treated with psoralens and ultraviolet A
Two psoriasis patients treated with PUVA therapy developed malignant melanoma in situ, suggesting a possible but unproven link between PUVA exposure and cutaneous melanocytic malignancy.
DOI: 10.1016/s0190-9622(83)70207-0 -
Arginine metabolism in tumor-associated macrophages in cutaneous malignant melanoma: evidence from human and experimental tumors
This study investigates the expression of inducible nitric oxide synthase (iNOS) and arginase in tumor-associated macrophages (TAMs) in cutaneous malignant melanoma, revealing that iNOS predominates in early tumor stages and is influenced by melanoma cells, suggesting a complex …
DOI: 10.1016/j.humpath.2007.02.018