The only way to diagnose melanoma is to remove and test all suspicious looking lesions. The dermatologist will anesthetize the area around the lesion and, depending on size and site, remove all or part of it. The biopsy specimen will be sent to a lab for analysis where a pathologist will take thin slices of the lesion and examine the cell structure under a microscope. If melanoma is found, its depth and probability of spreading can be assessed (8).

The most common way to discuss melanoma is the TNM system. The "T" stands for the thickness of the lesion removed, the "N" reflects whether or not the melanoma has spread to the lymph nodes, and the "M" indicates if the melanoma has matastasized. Using TMN system there are different stages of melanoma.

Stage 0: In this stage the melanoma has not spread to the lower levels of the skin and is only in the upper level. The stage is also called Clark level one. For this stage the five year survival rate is almost 100%.

Stage I: The melanoma is a low risk tumor in this stage. The thickness is less than one and a half millimeters. The melanoma appears to be localized in the skin. The Clark level is two or three. The five year survival rate for this stage is over 90%.

Stage II:The melanoma now has a thickness of greater than one and a half millimeters. The melanoma still appears to be localized in the skin. The Clark level is four or five. The five year survival rate of this stage is 80%.

Stage III: The melanoma has now spread to the lymph nodes near the original site. There seems to be no further metastasis. The thickness is not considered anymore but at this stage the original melanoma was usually one and a half millimeters or greater. The five year survival rate for this stage is 50%.

Stage IV: The melanoma has now spread beyond the lymphatic system to other organs such as the lungs, liver, or brain. At this point neither the thickness or lymph node status is considered. The five year survival rate for this stage drops to 13% (2).