Melanoma is a deadly type of skin cancer that is often more severe than other types due to its ability to metastasize, leading to advanced disease and even death. It occurs when melanoma has metastasized, or spread, beyond the initial site of the tumor and to distant lymph nodes or organs within the body. Stage 4 is the most advanced stage of melanoma. Melanoma is a type of skin cancer which develops in melanocytes, which are the cells of the skin that produce melanin (the pigment that gives skin its color). 

Skin cancer is the most common type of cancer. It accounts for over 76% of cancer deaths each year. The American Cancer Society estimates that in 2015, about 73,870 new cases of melanoma will be diagnosed in the United States. For melanoma, there are more than 75,000 people diagnosed with melanoma every year. While only 4 percent of skin cancers are melanoma, the disease makes up about 75 percent of all deaths caused by skin cancer. 

As melanoma grows and spreads throughout the body, itbecomes more and more deadly. The melanoma tumors within the skin grow larger as cancer becomes more advanced. However, the reason this type of cancer is so dangerous is because of what happens elsewhere in the body. 

When melanoma has reached stage 4, the cancer has spread to the lymph nodes, internal organs, and other areas of the body. It is often difficult and sometimes impossibly to treat melanoma at this stage without surgery, chemotherapy, radiation, or biotherapies.

Once melanoma has developed past stage 2, the tumor is no longer contained to its initial location. Once the cancer advances to stage 3, the melanoma has spread to nearby lymph nodes. And once the cancer has progressed to stage 4, the melanoma has spread beyond the lymph nodes to other distant areas of the body. 

The most common location in the body that melanoma spreads to is the lungs. It is also common for melanoma to spread to other areas within the body such as the liver, brain, gastrointestinal tract, and bones.

Stage 4 melanoma is diagnosed when it has been determined that the cancer has spread beyond the original area of skin in which the tumor was located. Therefore, a diagnosis cannot be made based on how the tumor looks on the outside of the skin. This is why symptoms for stage 4 melanoma are not always the same for each case. Symptoms include tumor size, ulceration, and tumor matting. 

Stage 4 melanoma tumors are identified as being thicker than 4 millimeters deep. However, the size of the tumor varies because stage 4 melanoma is only diagnosed once the tumor has spread to distant lymph nodes or to other organs within the body. While treatment can help reduce the size of the tumor, the cancer can still metastasize, or spread. Therefore, the size of the tumor is not the best factor in determining the stage of the skin cancer. 

Skin cancer tumors can develop an ulceration. An ulceration is a break in the skin. Ulcerations can develop in stage 1 melanoma and can persist during the development of more advanced stages. People with stage 4 melanoma may have a tumor on their skin that is broken and bleeding. This does not always occur. It is important to note that melanomas that have ulcerations usually have a worse prognosis.

Tumor matting is another symptoms of stage 4 melanoma. When melanoma metastasizes or spreads to nearby lymph nodes, the nodes can become matted, or joined together. These matted lymph nodes are easier to feel then they are to see. When you push down on matted lymph nodes, you will feel a lumpy and hard surface. Most often, the doctor will identify matted lymph nodes when assessing a patient for advanced melanoma. 

Fortunately, stage 4 melanoma can be treated if it is caught in time and aggressively treated. The earlier the cancer is identified, the earlier it can be treated and removed. And the earlier it is treated and removed, the higher the survival rate andchances for recovery are. The type of treatment a patient receives for stage 4 melanoma depends on where in the body the cancer is, how advanced the cancer is, and the patient’s overall  health and whether they have other health conditions that may get in the way of treatment. Regardless of how advanced the cancer may be, getting treatment is better than not getting treatment because without any treatment, the cancer can quickly progress from treatable to untreatable and deadly.