7 Signs Your Melanoma Has Spread
There’s a lot to dislike about cancer, but one thing very high on the list? If it isn’t caught and treated early enough, it can spread throughout your body. That’s especially true for melanoma, a type of skin cancer that develops when the cells that give your skin its tan or brown color (called melanocytes) start to grow out of control. When those cancer cells spread, it’s called metastasis or metastatic melanoma. Ideally, melanoma is discovered and treated before that happens. But if it’s not, you may notice a variety of symptoms depending on exactly where the cancer has spread.
The 4 Stages of Melanoma
Two main things determine the stage of melanoma: The thickness or depth of the tumor and how far it has spread when it’s diagnosed, explains David Polsky, M.D., dermatologist at NYU Langone Medical Center in New York City. In stages 0, 1, and 2, the melanoma is limited to the skin. In stage 3, it’s spread to the lymph nodes, small structures throughout your body that help filter fluids and fight infection. In the most advanced stage, stage 4, melanoma cells have broken away from the original tumor, traveled through the body and formed a new tumor somewhere else.
Common Places for Melanoma to Spread
Melanoma can spread from the original site on your skin and form a tumor in any organ or body tissue, but it’s most likely to metastasize to the lymph nodes, liver, brain, lungs, and less commonly, the bones. “Melanoma really likes the brain and the liver,” says Lisa Zaba, M.D., dermatologic oncologist at Stanford Medical Center in San Jose, CA. If you notice any of the following red flags, it might mean your melanoma has spread and warrants a call to your doctor right away.
Red Flag #1: Swollen Lymph Nodes
“If melanoma spreads, it often goes to the lymph nodes first,” says Melinda L. Yushak, M.D., assistant professor of hematology and medical oncology at Emory University School of Medicine in Atlanta. The cancer cells will first travel to the nodes closest to the original tumor, she says. Lymph nodes are located throughout your entire body, but large clusters are found in the neck, underarms, chest, abdomen, and groin. If the cancer has made its way to the lymph nodes, it usually won’t be painful, but they’ll feel swollen or even hard to the touch, Dr. Zaba says.
Red Flag #2: Abdominal Pain and Tenderness
Early on, there may be no noticeable symptoms that melanoma has spread to the liver. When symptoms do show up, they commonly include an enlarged, hard, or tender liver and pain in the upper right area of your abdomen, just below your ribs. Other signs cancer has spread to the liver are similar to symptoms of liver disease: fluid buildup in the belly (ascites) and yellowing of the skin and eyes (jaundice).
Red Flag #3: Headaches or Visual Changes
Just like the liver, not everyone will notice symptoms of melanoma spreading to the brain. But when symptoms do show up, it’s usually in the form of headaches, problems with eyesight, paralysis on one side of the body, or seizures. “If someone simply has a headache, that doesn’t mean they have advanced stage melanoma,” Dr. Yushak says. “But if it’s a headache that’s not going away after a week, and you never have headaches, then that’s something that definitely needs to be checked out.”
Red Flag #4: Chest Pain and Trouble Breathing
Melanoma is also known to spread to the lungs, though Dr. Zaba notes that most people don’t experience noticeable symptoms in the lungs until a tumor has gotten pretty large. A cough that just won’t quit or recurring chest infections (a.k.a. feeling like you’re always a little sick) can signal that the cancer has traveled to the lungs, Dr. Polsky says. Shortness of breath or trouble breathing can also be a red flag.
Red Flag #5: Bone Pain or Fractures
The bones are considered a late-stage site of melanoma metastases—typically, it doesn’t spread to the bones until it’s already spread to another area of the body first. Melanoma can cause pain in the bones where it’s spread, and some people—those with very little body fat covering their bones—may be able to feel a lump or mass. Metastatic melanoma can also weaken the bones, making them fracture or break very easily. This is most common in the arms, legs, and spine. If you feel any sharp, sudden, or new pains that won’t go away, talk to your doctor.
Red Flag #6: Unexplained Weight Loss and Loss of Appetite
Unintentional weight loss is a common side effect of any cancer. When it comes to melanoma, extreme weight loss usually only happens after the cancer has spread from the skin to other parts of the body. Dr. Zaba says she can sometimes tell if a patient’s melanoma has metastasized because it looks like they have cachexia, a syndrome marked by drastic loss of fat and muscle and increased weakness. Cachexia can also cause loss of appetite, which further contributes to the problem.
Red Flag #7: Flu-Like Symptoms
A handful of general symptoms can be signs your melanoma has spread, though they’re pretty nonspecific—meaning they could be symptoms of many things, from the flu to cancer. If you experience fever, chills, and/or night sweats, tell your doctor so they can figure out if something else is to blame, Dr. Polsky says. If the cause still isn’t clear, they’ll send you for additional tests and scans to figure out what’s going on.
- Melanoma Facts: American Cancer Society. (2019). “What Is Melanoma Skin Cancer?” cancer.org/cancer/melanoma-skin-cancer/about/what-is-melanoma.html
- Metastasis Definition: National Cancer Institute. (n.d.). “NCI Dictionary of Cancer Terms.” cancer.gov/publications/dictionaries/cancer-terms/def/metastasis
- Lymph Nodes Definition: National Cancer Institute. (n.d.). “NCI Dictionary of Cancer Terms.” cancer.gov/publications/dictionaries/cancer-terms/def/lymph-node
- Spreading to the Liver: Merck Manual. (2020). “Metastatic Liver Cancer.” merckmanuals.com/home/liver-and-gallbladder-disorders/tumors-of-the-liver/metastatic-liver-cancer
- Liver Metastases: University of California San Francisco Department of Surgery. (2020). “Liver Metastases.” surgery.ucsf.edu/conditions--procedures/liver-metastases.aspx
- Brain Metastases: American Academy of Dermatology. (n.d.). “What Options Are Available When Melanoma Spreads to the Brain?” aad.org/public/diseases/skin-cancer/types/common/melanoma/brain
- Bone Metastases: American Cancer Society. (2016). “Finding Bone Metastases.” cancer.org/treatment/understanding-your-diagnosis/advanced-cancer/finding-bone-metastases.html
- Melanoma and Bones: Melanoma Research. (2018). “Skeletal muscle and solitary bone metastases from malignant melanoma: multimodality imaging and oncological outcome.” journals.lww.com/melanomaresearch/fulltext/2018/12000/skeletal_muscle_and_solitary_bone_metastases_from.10.aspx
- Extreme Weight Loss: Journal of Oral and Maxillofacial Pathology. (2011). “Cancer cachexia.” ncbi.nlm.nih.gov/pmc/articles/PMC3227249/#!po=6.25000
- Cachexia and Cancer: OncoLink. (2018). “Cachexia in the Cancer Patient.” oncolink.org/support/nutrition-and-cancer/during-and-after-treatment/cachexia-in-the-cancer-patient