The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Content within the patient forum is user-generated and has not been reviewed by medical professionals. Other sections of the Melanoma Research Foundation website include information that has been reviewed by medical professionals as appropriate. All medical decisions should be made in consultation with your doctor or other qualified medical professional.

Clark Level 4

Forums General Melanoma Community Clark Level 4

  • Post
    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.
    Viewing 2 reply threads
    • Replies
        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

          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.”

              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
                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.
                  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.
                  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
                      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.
                        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?
                          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
                            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
                        Viewing 2 reply threads
                        • You must be logged in to reply to this topic.
                        About the MRF Patient Forum

                        The MRF Patient Forum is the oldest and largest online community of people affected by melanoma. It is designed to provide peer support and information to caregivers, patients, family and friends. There is no better place to discuss different parts of your journey with this cancer and find the friends and support resources to make that journey more bearable.

                        The information on the forum is open and accessible to everyone. To add a new topic or to post a reply, you must be a registered user. Please note that you will be able to post both topics and replies anonymously even though you are logged in. All posts must abide by MRF posting policies.

                        Popular Topics