How Stage IV is Diagnosed
Step 1: Physical Examination
The patient should get a physical examination of the entire skin, lymph node areas, and organs.
For more information on the Doctor's Examination click here
Step 2: Tests to Make Certain
The doctor may order various other tests to confirm a diagnosis of melanoma and/or determine if or where the disease has spread:
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X-ray. An x-ray is a picture of the inside of the body. For instance, a chest x-ray can help doctors determine if the cancer has spread to the lungs.
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Blood tests. Blood levels of LDH may be tested to help determine if the cancer has spread.
Step 3: Additional Tests
Sometimes the following special scanning tests (similar to x-rays in that they provide special images of the inside of the body and require no surgery) may also be performed:
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Ultrasound. An ultrasound uses sound waves to create pictures of the internal parts of the body, including collections of lymph nodes (called basins) and soft tissue.
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Computed tomography (CT or CAT) scan. A CT scan creates a 3-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed view that shows any abnormalities or tumors.
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Magnetic resonance imaging (MRI). An MRI is done with a special scanning machine that uses magnetic fields, not x-rays, to produce detailed images of the body.
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Positron emission tomography (PET) scan. In a PET scan, a special fluid made of sugar is injected into the body, which can be seen by a special scanner. Cancer cells usually absorb sugar more quickly than normal cells, so they may light up on the PET scan. PET scans are often used in addition to a CT scan, MRI, and physical examination.
For more on the Diagnosis of Melanoma click here
For more on the Staging of Melanoma click here
FAST FACTS
- In stage IV, the melanoma has spread to distant sites (metastasized).
- Because of this, doctors are not looking at thickness or lymph node involvement to make a diagnosis or prognosis.
- Instead, they're looking at the location, number, and size of the metastases and the serum LDH level.

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