Melanoma is a serious form of skin cancer that develops in the pigment-producing melanocytes in the skin. When melanoma spreads (metastasizes) to other parts of the body, it becomes much more dangerous and difficult to treat.
Understanding the symptoms and getting early treatment is critical for improving outcomes in metastatic melanoma. This article will provide an overview of metastatic melanoma, the major symptoms to watch for, current treatments, and frequently asked questions.
Understanding Metastatic Melanoma
Melanoma begins when healthy melanocytes grow out of control and form a cancerous tumor. At first, melanoma is confined to the surface of the skin. But if it grows deeper into the skin and spreads to lymph nodes or other organs, it becomes metastatic melanoma.
Metastatic means the cancer has spread to other parts of the body through the lymph system or bloodstream. Melanoma most often spreads to the lymph nodes, lungs, liver, brain, bones, and gastrointestinal tract.
Metastatic melanoma progresses rapidly and can be deadly if not treated. Around 20% of people with melanoma already have metastases at the time of diagnosis. For those whose cancer has already spread, the 5-year survival rate is about 25%.
Catching melanoma early while it is still localized greatly improves prognosis. However, all patients with a history of melanoma need to be aware of the symptoms of metastatic disease.
Major Metastatic Melanoma Symptoms
Some of the most common symptoms of metastatic melanoma include:
- Enlarged lymph nodes – This is often the first sign that melanoma has spread. Swollen or hardened lymph nodes may appear near the original melanoma tumor or elsewhere.
- New skin lesions – The appearance of new melanotic spots or tumors can indicate melanoma has metastasized to other areas of the skin.
- Shortness of breath – Metastasis in the lungs can cause shortness of breath or wheezing. A persistent cough may also develop.
- Abdominal pain or swelling – The spread of melanoma to the gastrointestinal area may cause pain, nausea, or swelling in the abdomen.
- Headache – Metastases in the brain can lead to persistent headaches or neurological symptoms like dizziness, seizures, or weakness on one side.
- Bone pain – Bone metastases can cause pain in areas such as the back or pelvis. Cracks or breaks in bones may occur more easily.
- Fatigue – Those with metastatic melanoma often feel extremely tired and run down. Unexplained weight loss sometimes occurs as well.
- Elevated LDH levels – A blood test finding high levels of lactate dehydrogenase (LDH) enzyme can indicate melanoma has spread to multiple organs.
Any new symptoms like these in someone with a history of melanoma need prompt medical evaluation. Catching metastasis early allows for quicker treatment to slow cancer growth and improve quality of life.
Treatments For Metastatic Melanoma
Major treatment options for metastatic melanoma include:
- Immunotherapy – Drugs like ipilimumab (Yervoy) and pembrolizumab (Keytruda) help boost the body’s immune response against melanoma cells. They have proven effective in controlling metastases in many patients.
- Targeted therapy – Vemurafenib (Zelboraf) and dabrafenib (Tafinlar) are examples of targeted drugs that block specific mutated genes found in metastatic melanoma. This disrupts tumor growth.
- Chemotherapy – Traditional cytotoxic chemotherapy drugs destroy rapidly dividing cancer cells. They may be used alone or alongside immunotherapy for melanoma that has widely spread.
- Radiation therapy – High energy radiation can shrink melanoma tumors and relieve symptoms when cancer has spread to limited areas like the brain or bones.
- Surgery – Removing isolated metastases surgically may help extend and improve the quality of life in some cases. This is often followed by other treatments like immunotherapy to reduce recurrence risk.
- Palliative care – Managing pain, nutrition, emotional support, and quality of life are also key parts of the treatment plan for metastatic melanoma.
With newer advanced treatments, even metastatic melanoma can often be managed for many months or years. Patients should discuss all their options with a melanoma specialist to determine the ideal treatment plan. Research into new therapies for advanced melanoma is ongoing.
Metastatic melanoma occurs when the initial skin cancer spreads to other organs and becomes life-threatening. Paying attention to potential symptoms like enlarged lymph nodes, headaches, bone pain, or new skin lesions allows for earlier detection and treatment.
While metastatic melanoma remains a challenge to treat, the prognosis is improving with new immunotherapy and targeted drugs. Patients should communicate closely with their oncology team to pursue optimal treatment and symptom management. Continued research provides hope for finding additional effective therapies that prolong survival in metastatic melanoma.
A: The most common sites melanoma spreads to are lymph nodes, lungs, brain, liver, bones, and gastrointestinal tract. Lymph nodes closest to the primary tumor are usually first affected.
A: Doctors may use tests like CT, PET, or MRI scans to detect metastases in lymph nodes, lungs, brain, and other organs. A biopsy of suspicious lesions can confirm melanoma spread. Blood tests for LDH levels may also indicate advanced melanoma.
A: Survival rates for stage 4 metastatic melanoma vary greatly depending on multiple factors. With newer treatments, the 5-year survival rate is estimated around 25%. Catching metastases early and starting aggressive treatment helps improve prognosis.
A: Some patients with metastases can live for years with ongoing treatment. But metastatic melanoma is still considered terminal, with a median survival time of around 8-18 months. Palliative care and managing quality of life are important, even when lifespan is reduced.
A: Yes, stage 4 metastatic melanoma is generally considered terminal though treatment can prolong life for variable periods of time. The goal is to control symptoms and slow cancer progression as much as possible. Participating in clinical trials may offer cutting-edge new therapies as well.