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Skin Cancer

Stages of Skin Cancer on the Body

Staging of nonmelanoma skin cancer depends on whether the tumor has certain "high-risk" features and if the tumor is on the eyelid.

Staging for nonmelanoma skin cancer that is on the eyelid is different from staging for nonmelanoma skin cancer that affects other parts of the body.

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Millimeters; drawing shows millimeters (mm) using everyday objects. A sharp pencil point shows 1 mm, a new crayon point shows 2 mm, and a new pencil-top eraser shows 5 mm.
Millimeters (mm). A sharp pencil point is about 1 mm, a new crayon point is about 2 mm, and a new pencil eraser is about 5 mm.

The following are high-risk features for nonmelanoma skin cancer that is not on the eyelid:

  • The tumor is thicker than 2 millimeters.
  • The tumor is described as Clark level IV (has spread into the lower layer of the dermis) or Clark level V (has spread into the layer of fat below the skin).
  • The tumor has grown and spread along nerve pathways.
  • The tumor began on an ear or on a lip that has hair on it.
  • The tumor has cells that look very different from normal cells under a microscope.

The following stages are used for nonmelanoma skin cancer that is not on the eyelid:

Stage 0 (Carcinoma in Situ)

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Stage 0 nonmelanoma skin carcinoma in situ; drawing shows skin anatomy with abnormal cells in the epidermis (outer layer of the skin). Also shown are the dermis (inner layer of the skin) and subcutaneous tissue below the dermis.
Stage 0 nonmelanoma skin carcinoma in situ. Abnormal cells are shown in the epidermis (outer layer of the skin).

In stage 0abnormal cells are found in the squamous cell or basal cell layer of the epidermis (topmost layer of the skin). These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

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Tumor size compared to everyday objects; shows various measurements of a tumor compared to a pea, peanut, walnut, and lime
Pea, peanut, walnut, and lime show tumor sizes.

Stage I

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Stage I nonmelanoma skin cancer; drawing shows a tumor in the epidermis (outer layer of the skin) that is no more than 2 centimeters wide. Also shown are the dermis (inner layer of the skin) and the subcutaneous tissue below the dermis.
Stage I nonmelanoma skin cancer. The tumor is no more than 2 centimeters.

In stage Icancer has formed. The tumor is not larger than 2 centimeters at its widest point and may have one high-risk feature.

Stage II

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Stage II nonmelanoma skin cancer; drawing shows a tumor that is more than 2 centimeters wide that has spread from the epidermis (outer layer of the skin) into the dermis (inner layer of the skin). Also shown is the subcutaneous tissue below the dermis.
Stage II nonmelanoma skin cancer. The tumor is more than 2 centimeters wide.

In stage II, the tumor is either:

  • larger than 2 centimeters at its widest point; or
  • any size and has two or more high-risk features.

Stage III

In stage III:

  • The tumor has spread to the jaw, eye socket, or side of the skullCancer may have spread to one lymph node on the same side of the body as the tumor. The lymph node is not larger than 3 centimeters.
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Stage III nonmelanoma skin cancer (1); drawing shows a primary tumor in one arm and parts of the body where it may spread, including the bones of the jaw, eye socket, or side of the skull.
Stage III nonmelanoma skin cancer (1). Cancer has spread from the primary tumor to bones of the jaw, eye socket, or side of the skull.

or

  • Cancer has spread to one lymph node on the same side of the body as the tumor. The lymph node is not larger than 3 centimeters and one of the following is true:
    • the tumor is not larger than 2 centimeters at its widest point and may have one high-risk feature; or
    • the tumor is larger than 2 centimeters at its widest point; or
    • the tumor is any size and has two or more high-risk features.
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Stage III nonmelanoma skin cancer (2); drawing shows a primary tumor in one arm and cancer in a lymph node on the same side of the body as the primary tumor. Insets show 2 centimeters is about the size of a peanut and 3 centimeters is about the size of a grape.
Stage III nonmelanoma skin cancer (2). Cancer has spread to one lymph node that is 3 centimeters or smaller and is on the same side of the body as the primary tumor. Also, the tumor is 2 centimeters or smaller at its widest point and may have one high-risk feature; OR the tumor is larger than 2 centimeters at its widest point; OR the tumor is any size and has two or more high-risk features. There are five high-risk features: (1) the tumor is thicker than 2 millimeters; (2) the tumor has spread into the lower layer of the skin or into the layer of fat below the skin; (3) the tumor has grown and spread along nerve pathways; (4) the tumor began on an ear or on a lip that has hair on it; and (5) the tumor has cells that look very different from normal cells under a microscope.

Stage IV

In stage IV, one of the following is true:

  • The tumor is any size and may have spread to the jaw, eye socket, or side of the skullCancer has spread to one lymph node on the same side of the body as the tumor and the affected node is larger than 3 centimeters but not larger than 6 centimeters, or cancer has spread to more than one lymph node on one or both sides of the body and the affected nodes are not larger than 6 centimeters; or
  • The tumor is any size and may have spread to the jaw, eye socket, skull, spine, or ribs. Cancer has spread to one lymph node that is larger than 6 centimeters; orEnlarge
    Stage IV nonmelanoma skin cancer (1); drawing shows a primary tumor in one arm with cancer in a lymph node on the same side of the body as the primary tumor. Insets show 3 centimeters is about the size of a grape and 6 centimeters is about the size of an egg.
    Stage IV nonmelanoma skin cancer (1). The tumor is any size. Cancer has spread to one lymph node that is larger than 3 centimeters but not larger than 6 centimeters and is on the same side of the body as the tumor; OR to more than one lymph node 6 centimeters or smaller on one or both sides of the body; OR to one lymph node that is larger than 6 centimeters.
  • The tumor is any size and has spread to the base of the skull, spine, or ribs. Cancer may have spread to the lymph nodes; or
  • Cancer has spread to other parts of the body, such as the lung.Enlarge
    Stage IV nonmelanoma skin cancer (2); drawing shows a primary tumor in one arm and parts of the body where it may spread, such as the ribs, base of skull, spine, or lung. An inset shows cancer spreading through the blood and lymph nodes to other parts of the body.
    Stage IV nonmelanoma skin cancer (2). The tumor is any size and has spread to the base of the skull, spine, ribs, lung, or other parts of the body.

 

 

Adapted from the National Cancer Institute's Physician Data Query (PDQ(r)) Cancer Information Summaries (http://www.cancer.gov/cancertopics/pdq). Date last modified: November 10, 2014

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Last Reviewed: Mar 26, 2015