7 Things to Know About Advanced Melanoma

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Chris Illiades, MD on November 21, 2022
  • measuring mole, skin mole, skin, mole
    7 Things to Know About Advanced Melanoma
    Skin cancer is the most common cancer, and melanoma is the most dangerous type of skin cancer. About 2 of every 10 skin cancers are melanoma, but that number has been going up. When it's caught early, melanoma can almost always be cured. When it's not caught early, it can spread beyond your skin. Once is has spread it is called advanced melanoma. This type of skin cancer is harder to treat. Here are seven more things to know about advanced melanoma.
  • Skin Cancer Removal
    How Melanoma Spreads
    Melanoma is the most dangerous type of skin cancer because of its ability to spread. It can grow into your skin and become deeper or wider. It can also spread to other parts of your body through your blood vessels and lymph nodes. Lymph nodes are glands that collect lymph, a fluid that helps the immune system fight infection and disease. Once melanoma spreads into lymph or blood, the cancer can metastasize, which means it can travel to other areas of the body.
  • Dermatologist looking at moles on women's back
    Your Risk of Advanced Melanoma
    Several factors increase your risk of melanoma. They include having a history of skin cancer in your family and having lots of moles, fair skin, or sun-damaged skin. Once you have melanoma, the chance it will progress to advanced melanoma goes up if the melanoma is not found early or if it is not completely removed. Also, your risk is greater if you have a weak immune system.
  • dermatologist-examining-patients-skin
    Signs of Advanced Melanoma
    Melanoma starts as an unusual or changing mole. It may become larger, develop an irregular shape, or change colors. A melanoma that comes back after removal may be an advanced melanoma. Other signs of advanced melanoma include moles that form sores, begin to bleed or itch, red or black nodules that grow quickly or bluish lumps under your skin. Melanoma that has spread to another part of your body may cause fatigue and weight loss.
  • doctor-and-patient
    Staging of Advanced Melanoma
    Staging is an important part of a cancer diagnosis. A cancer stage is an estimate of how advanced the cancer is. This is one of the most important things to know when deciding on treatment. Advanced melanoma is stage IIIC or stage IV. For stage IIIC, the cancer has spread to one or more lymph nodes and has caused them to become enlarged. Stage IIIC melanoma also includes cancer that has spread to areas of skin near the original cancer. Stage IV means it has spread to other areas of the body. This could be the lungs, liver, brain or distant areas of skin.
  • Doctor with Microscope
    Biopsy for Staging Advanced Melanoma
    Your doctor may think you have advanced melanoma based on a physical exam. However, it takes a biopsy to be sure. To do this, the doctor will remove a piece of a mole and check it under a microscope. Your doctor will also check whether the cancer has spread. For this, you might have a sentinel node biopsy, which is a biopsy of the lymph nodes near the melanoma. It will show whether or not the cancer has affected your lymph nodes. An MRI, CT scan, or PET scan will tell if the cancer has spread elsewhere.
  • Medical laser
    Treatment of Advanced Melanoma
    Unlike early melanoma, surgery alone is not enough to treat advanced melanoma. You might need surgery to remove the melanoma and lymph nodes, but you will also need more treatment. Options could include radiation treatment and specialized drugs. Chemotherapy, one type of drug, kills cancer cells. Another type, immunotherapy, boosts your body's immune system to help it fight off the cancer.
  • Nurse Giving Patient Injection Through Tube
    Targeted Immunotherapy for Advanced Melanoma
    Doctors often prescribe the immunotherapy drugs interleukin-2 and interferon to treat advanced melanoma. Interferon can cause serious side effects and the true benefit of these drugs is not certain. However, there are new drugs that may help you if you test positive for certain gene mutations (BRAF, MEK) that help melanoma grow. Drugs like vemurafenib, dabrafenib, cobimetinib and trametinib target those specific genes. In early studies, they have had good success when used together. In three-fourths of people who tried them, their tumors became smaller or went away completely. 
7 Things to Know About Advanced Melanoma
  1. Melanoma, American Academy of Dermatology. https://www.aad.org/public/diseases/skin-cancer/melanoma
  2. New therapies giving hope for patients with advanced melanoma. American Academy of Dermatology. https://www.aad.org/media/news-releases/new-therapies-giving-hope-for-patients-with-advanced-melanom...
  3. Melanoma Treatment (PDQ®)–Patient Version. National Institutes of Health. National Cancer Institute. https://www.cancer.gov/types/skin/patient/melanoma-treatment-pdq
  4. Two New Drugs Increase Survival for Patients With Advanced or Metastatic Melanoma. American Society of Clinical Oncology. http://www.cancer.net/two-new-drugs-increase-survival-patients-advanced-or-metastatic-melanoma
  5. Key statistics for melanoma skin cancer. American Cancer Society. http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin-cancer-key-statistics
  6. Melanoma skin cancer stages. American Cancer Society. http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin-cancer-stages
  7. Survival rates for melanoma skin cancer, by stage. American Cancer Society. http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin-cancer-survival-rates-by-stage
  8. Treatment of melanoma skin cancer by stage. American Cancer Society. http://www.cancer.org/cancer/skincancer-melanoma/detailedguide/melanoma-skin-cancer-treating-by-stag...
  9. Metastatic melanoma. DermNet New Zealand. http://www.dermnetnz.org/topics/metastatic-melanoma/
  10. Melanoma. Skin Cancer Foundation. http://www.skincancer.org/skin-cancer-information/melanoma#panel1-1
  11. Lymph Node Involvement. Skin Cancer Foundation. http://www.skincancer.org/skin-cancer-information/melanoma/the-stages-of-melanoma/lymph-node-involve...
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Last Review Date: 2022 Nov 21
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