A diagnosis of metastatic melanoma is devastating news. The 10 year survival rate is less than 10 percent. 1 Recent treatments have given hope, doubling the life expectancy of some patients.  research is ongoing with scientists searching for more answers, more treatments and better outcomes.
And there are survivors. On the AIM for Melanoma site, one such survivor, Deborah Shemesh writes, "I was 26 when I was diagnosed with Stage III. By the time I was 32, it was Stage IV. Last rites were given several times. I am now 58; 32 years since diagnosis, 12 years of spontaneous remission. I encourage others to be inspired through finding success stories. I hope my story is used to inspire others. Sharing brings me great happiness and I know that in order to heal, happiness is a key ingredient. Happiness heals." 
Another 34 + year survivor, Kenneth Shapiro, wrote a blog up until his death in October 2012. His battle with metastatic melanoma began when he was in his 30's. He died of kidney cancer 34 years later. He writes, "There have been many off the wall theories about why I am alive but the only thing that seems to be constant is that no one really knows"I learned early on that the individual has to be involved and totally aware of what is going on and why"I believe that the individual has to be the main focus of the therapy. The medical side cannot do it without the help of the individual and the individual cannot do it without the medical side"Knowledge is the cancer patient's greatest ally and a belief in what you are doing regardless of what anyone else says." 
Being Involved in Your Treatment
When you receive a diagnosis of cancer, your mind spins, you feel like you are out of control, you can't think straight. And yet, you need information and you need to make decisions. While you may need to decide on treatment options quickly, you usually don't need to do so within minutes of hearing your diagnosis.
Set a time to talk with your doctor. Bring your spouse, partner or a trusted family member with you; someone who will be able to help you understand and remember your options. Ask questions about anything you don't understand as well as what to expect - both in increasing life expectancy and side effects. Once you have a list of your doctor's recommended treatment, do your research. Ask your doctor for reputable websites, books and other educational materials to help you understand your cancer and your options.
After you have decided on a course of treatment, keep apprised of what is going on. Continue to ask questions about anything you don't understand and what treatments are available as a secondary course of action.
Eating right during your treatment and in developing a survivorship plan. Some treatments will cause decreased appetite, nausea and abdominal pain may interfere with your ability to eat. Breaking meals down and eating smaller meals throughout the day may help. You may also find that eating with friends, in a more social and enjoyable setting can help increase your appetite. Talk to your doctor about what foods are best to eat both during your treatment and after it has ended.
Getting some exercise may help you feel better, both physically and emotionally. However, due to your treatment, you may not feel like doing any exercise, even taking a walk. It is important to talk with your doctor about what exercises, and how much, you are able to do. Even a small amount of physical activity can help improve your mood and overall feeling of well-being.
A diagnosis of metastatic melanoma is a stressful event. It can affect you physically, mentally and emotionally. The Melanoma Research Foundation states that "It is important that all signs of stress, depression and anxiety be discussed with your doctor."  Some specific signs of stress include:
- Loss of interest in activities
- Trouble sleeping
- Feeling sad or empty most of the time
- Chronic fatigue
- Stomach problems
- Thoughts of suicide
Some of these signs, such as fatigue, stomach problems or dizziness can be associated with certain treatment options. Be aware of the side-effects of your treatments so you know what to expect and whether symptoms are a sign of depression or anxiety or whether you will gain strength and energy as the side-effects wane.
Suggestions for dealing with the stress include exercise, listening to music, writing, talking with a therapist and joining a cancer support group.
Hope is paramount in your fight against metastatic melanoma. Jackie Doss, another survivor, in remission, writes, "Life is a roller coaster. I feel blessed to be here, but I'm always on the lookout for the next turn in the road"I won't give up. I won't give up fighting. I won't give up hope. I won't give in to fear. " 
 "Melanoma and Stress Management," Date Unknown, Staff Writer, Melanoma Research Foundation
 "New Melanoma Drug Doubles Survival Time, Study Shows," 2012, Feb. 22, Ryan Jaslow, CBS News
  "Stage IV," Different Dates, Numerous Reader Submissions, AIM for Melanoma
 "Treatment of Metastatic Melanoma: An Overview," 2009, Shailender Bhatia, M.D. et al, Oncology