If you have melanoma, your doctor will monitor you closely to determine how you are responding to treatment and whether the cancer has spread, or metastasized. However, you should know the signs and symptoms that melanoma has spread and report any you notice to your doctor. The signs and symptoms described in this article can also be caused by many other health conditions, so don’t assume that your melanoma has metastasized if you notice any of them. But it’s important to be proactive and vigilant, since these changes may be signals that your current treatment regimen isn’t controlling your cancer. In that case, your doctor may be able to prescribe a new or additional treatment. Or, he or she may recommend that you enroll in a clinical trial of a new therapy for treating melanoma that’s being evaluated for approval by the U.S. Food and Drug Administration or other regulatory agency.

Your doctor has likely told you what “stage” your cancer is, so before learning about the various signs and symptoms of melanoma that has spread, it’s important to understand what the different stages signify. It’s also important to learn where cancer cells may migrate to in your body, since the location has a direct effect on the signs and symptoms of melanoma that has spread.

The Stages of Melanoma

Doctors use a system called staging to describe a tumor’s prognosis, or outlook. For melanoma, doctors use roman numerals from 0 to IV to describe a tumor’s stage—the higher the number, the more concerning the cancer’s outlook. Staging of melanoma is based on three criteria:

The thickness and appearance of the tumor; those that appear as sores, or ulcers, have a worse prognosis.
Whether the cancer has spread to nearby lymph nodes.
Whether the cancer has spread to distant sites in the body.

The stages of melanoma are as follows:

Stage 0: Cancer cells are found only in the outer layer of skin and have not penetrated deeper layers. The cancer has not spread. Also called melanoma in situ.
Stage I: The tumor is no more than 2 millimeters thick, and the skin may or may not be ulcerated. The cancer has not spread.
Stage II: The tumor is somewhat larger and thicker than in stage I, and may or may not be ulcerated, but it has not spread.
Stage III: These cancers are called regional melanoma, meaning that they have spread to nearby lymph nodes, skin, or other tissues, but not distantly throughout the body.
Stage IV: The cancer has spread to distant lymph nodes or other tissues far from the original tumor.

Common Places for Melanoma To Spread

Melanoma may spread to lymph nodes near the site of the original tumor. As it advances, the cancer can spread to distant lymph nodes or other tissues. In the latter case, it’s identified as stage IV cancer and often called metastatic melanoma. Common sites of melanoma metastasis are bone, brain, liver, lungs, other parts of the skin, and muscle. The following signs and symptoms are potential evidence that melanoma has advanced and should be reported to your healthcare team immediately.

Swollen Lymph Nodes

In stage III melanoma, cancer spreads to lymph nodes near the original tumor. In stage IV melanoma, the disease can migrate to lymph nodes far from the tumor. In either case, this can cause the lymph nodes to become swollen. You have lymph nodes throughout your body, but you are most likely to notice swelling in the neck, under your chin, your armpits, or your groin. Swelling is often visible and lymph nodes become tender and painful. Swollen lymph nodes in the neck may make it hard to swallow.

Abdominal Pain and Tenderness

Pain and tenderness in the mid-section could be a sign that melanoma has spread to the liver. Melanoma cells can travel in the blood, which passes through the liver by way of the portal vein and hepatic artery. After the lymph nodes, the liver is the most common site for cancer metastases to occur.

Headaches, Cognitive Changes, Visual Changes

The brain is another common site for melanoma metastasis. A patient may not notice any symptoms initially, but over time cancer that spreads to the brain can cause variety of changes, such as a persistent headache, memory problems or distraction, and vision problems. Some people even develop personality changes.

Chest Pain and Trouble Breathing

When melanoma or any other cancer travels to the lungs, patients may feel chronic chest pain that can’t be explained by other causes. Some develop shortness of breath or a cough that just won’t go away; in some cases, the cough may produce bloody sputum.

Unexplained Weight Loss and Loss of Appetite

Because cancer patients undergoing treatment often develop nausea, vomiting, and other gastrointestinal side effects, it’s not unusual for them to have no appetite and lose weight. However, unexplained weight loss and loss of appetite are also common symptoms of metastasis to the lungs.

Bone Pain or Fractures

When melanoma metastasizes to the bone, it can cause severe and hard-to-treat pain, which is sometimes accompanied by fever. In people who have thin skin and little body fat, a metastasis may be palpable, or capable of being felt. Bone metastases often occur at a late stage of advancing melanoma.

Flu-like Symptoms

In some patients, spreading melanoma can produce nonspecific flu-like symptoms, such as fever and chills.

If your melanoma has spread, enrolling in a clinical trials may be an option for you. In clinical trials, researchers evaluate promising new therapies that can offer life-changing, and even lifesaving, benefits, often with fewer side effects than standard-of-care treatments. Massive Bio specializes in finding clinical trials for patients with melanoma and other forms of cancer. Patients who choose to enroll in clinical trials can receive cutting-edge treatment and high-quality care under the direction of top oncologists at leading cancer clinics. Enrolling in a clinical trial also gives patients access to innovative treatments long before they’re made available to the public. If you think a clinical trial is right for you, contact Massive Bio today.

7 Signs Your Melanoma Has Spread