Clark Level 4
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Clark Level 4

› Forums › General Melanoma Community › Clark Level 4

  • Post
    • April 22, 2020 at 10:50 pm
    Butterfly74
    Participant
    Hi I have recently been diagnosed as Stage 1a with depth of 0.7mm, no ulceration and zero mitosis. But my Clark Level is 4 which I am so worried about. From everything I have read this is a high risk factor for it spreading at some stage. I probably shouldn’t read so much on the internet as it makes me so anxious and I am really struggling to deal with everything. There seems to be a lot of people who were stage one and are now stage 3 and 4. I’m hoping some people can help me please.
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  • Replies
      • April 22, 2020 at 11:20 pm
      chrispl1974
      Participant
      Hi , I am sorry to hear that you have been diagnosed with Melanoma. I am sure others, more knowledgable than I , will respond to your message, but I can put your mind at ease. Clark Level is pretty insignificant and not really a risk factor. You had no ulceration and zero proliferation. That ,combined with a very shallow melanoma, I would say chances of it spreading are in the low single digits if at all.

      Besides, clark level is very hard to define and often pathologists differ on the classification. Changes are ,if another lab had analyzed your tissue, they might have classified you as Clark Level III.

      Put it behind you and life your life. If you continue to worry, I would say chances of getting a heart attack are exponentially higher than a recurrence of your melanoma. 🙂

      Keep well.

      Chris

      • April 22, 2020 at 11:22 pm
      Bubbles
      Participant
      I believe folks have given you a fairly large response below.

      Here is a very clear explanation of Stage I melanoma: https://www.aimatmelanoma.org/stages-of-melanoma/stage-i-melanoma/

      It notes:
      “Stage 1A
      Tumor is less than 0.8mm thick, with no ulceration.
      No spread to nearby lymph nodes.
      No evidence of metastasis to distant sites.”

      Your report meets this criteria perfectly.

      Regarding Clark Level – there is this: https://www.curemelanoma.org/about-melanoma/melanoma-staging/breslow-depth-and-clark-level/

      It notes: “The current staging system adopted by the American Joint Committee on Cancer (AJCC) no longer considers the Clark Level. This is because the Clark level has been found to be less prognostic and more subjective than other alternatives.”

        • April 23, 2020 at 5:47 am
        Butterfly74
        Participant
        Thank you both so much for replying. I know I need to try and sort my anxiety out, does it ever feel like it isn’t such a weight and feeling of dread on your shoulders?
        With regard to the link you gave me regarding the two diagrams and from reading other info I can’t understand how the measurement of 0.7 can be so deep down, my doctor said it was thin but the level 4 area does go deep down into quite a lot of layers of skin. Hope that makes sense? Anyway I suppose I really should stop googling as it really stresses me out. Hopefully I will get my worry and anxiety under control and not think the worst.
        Victoria
        • April 24, 2020 at 1:21 am
        doragsda
        Participant
        Even a Clark level 4 is still completely contained within the skin itself, which is encouraging. Your Breslow thickness of 0.7mm is very positive for a good outcome. Thicker, ulcerated primaries are the ones that generally spread, and your primary is neither of those, so that’s all good news.
        • April 24, 2020 at 6:48 am
        Butterfly74
        Participant
        Thank you so much for replying. It’s just so overwhelming and worrying. It’s nice to get support from people here so I don’t feel so alone.
      • April 24, 2020 at 4:07 pm
      ed williams
      Participant
      Hi Victoria, pg.12 of new staging guide 8th edition has graphs of survival curves and stage 1a has 99% for five year survival and 98% for 10 years. Here is link! https://cancerstaging.org/CSE/Physician/Documents/Melanoma%202.2.18.pdf
        • April 24, 2020 at 10:45 pm
        Butterfly74
        Participant
        Thank you so much for replying. I need to focus on those statistics and not the stories I read on the internet. I will get more clarity regarding the Clark level system when I see my dermatologist next.
        • April 24, 2020 at 10:57 pm
        Butterfly74
        Participant
        Can I ask though – in the older staging system a Clark level 4 would have made me a 1b so shouldn’t I be looking at those statistics for me over 1, 5 and 10 years?
        • April 28, 2020 at 4:02 pm
        becky15
        Participant
        Hi Victoria. I was in the exactly the same position as you just over 8 years ago. I had a stage 1a melanoma, 0.7mm deep and Clark level 4 on my leg. Like you, I fretted over the Clark level 4 aspect as it seemed to be contrary to the relatively shallow depth. and, to a far lesser extent, it still preys I’m my mind even now. However, I ‘m glad to say that I’ve had no further problems to date and I hope that reassures you. Lynne
        • April 29, 2020 at 1:59 am
        Butterfly74
        Participant
        Hi Lynne
        Thank you so much for replying. It is reassuring to hear from someone who was similar to me, I am really happy for you that everything is going well. How did you deal with the anxiety of it all and did you have regular follow ups? I am feeling very overwhelmed.
        Thanks
        Victoria
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