Where Melanoma Spreads


Christopher Iliades, MD

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Melanoma is the most dangerous type of skin cancer because it spreads so quickly and so easily. That's why it's important to catch melanoma early. After it starts to spread, melanoma is harder to treat.

Melanoma can spread in three ways: directly through your skin, by getting into your bloodstream, and by getting into your lymphatic system - part of your immune system.

Melanoma can spread to almost any part of the body. It usually spreads on your skin, under your skin, or into your lymph nodes. If melanoma gets into your lymphatic system or your bloodstream, it can also spread to distant parts of your body. This is metastatic melanoma (stage IV). Metastatic melanoma spreads most often to the lungs, brain, liver and bones.

If melanoma spreads, it usually happens within two years of getting a diagnosis. The chance that it will spread is higher if your melanoma was thick or ulcerated (like an open sore), if it was already in your lymph nodes at the time of diagnosis, or if you are older than 50.

When Melanoma Spreads to the Skin and Lymph Nodes

If melanoma spreads, there's a 50/50 chance that it will spread first to other areas of your skin or to the lymph nodes near your original melanoma.

Signs that it has spread to skin or to areas just under your skin can include hard bumps that crack open and bleed. The bumps may be black or red. You may also have firm, painless lumps under your skin. Sometimes they are skin-colored; other times they're bluish in color.

If melanoma spreads to a lymph node, you may notice a firm, hard swelling. If a swollen lymph node presses on a nerve, the lymph node may be painful. If melanoma blocks a lymph vessel, fluid can build up behind that area. This causes swelling, a condition known as lymphedema. You may feel a tight or heavy sensation in the swollen area.

The Distant Spread of Melanoma

When melanoma spreads to distant areas of the body, it can cause general symptoms. You might feel really tired or not feel like eating anything and you could lose weight.

Your other symptoms will depend on where else the cancer spreads:

  • Lungs. About 30% of metastatic melanomas go to the lungs. When that's the case, symptoms may include shortness of breath, a cough that won't go away, or chest pain.

  • Brain. Up to 20% of metastatic spread is to the brain. Symptoms may include headache and nausea, especially in the morning. Weakness, numbness, tingling and seizures also may occur when melanoma spreads to the brain.

  • Liver. Up to 20% of melanomas spread to the liver. A common symptom is swelling and pain in the upper right part of the belly. Other symptoms include nausea and loss of appetite. Fluid may build up in the belly, and skin or eyes could become yellowish.

  • Bones. About 17% of the time, melanoma metastasizes to the bones. Often, the first sign of this is a broken bone from a minor injury. Bone pain is the main symptom.

Catching melanoma early is the key to preventing it from spreading. After having treatment for melanoma, make sure to follow up with your doctor for several years to make sure melanoma has not spread or come back. You will most likely have periodic imaging tests, like a PET scan, to look for signs of cancer.

Key Takeaways

  • Melanoma has the ability to spread near and far in the body.

  • Melanoma most often spreads through the skin and to nearby lymph nodes.

  • The most common areas for distant spread are the lungs, brain, liver and bones.

Patient speaking with doctors

Treatments for Advanced Melanoma

When melanoma reaches an advanced stage and begins to spread, getting the right treatment becomes very important.
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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Sep 24, 2016

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Medical References

  1. SEER Fact Sheets: Melanoma of the Skin. National Cancer Institute. http://seer.cancer.gov/statfacts/html/melan.html
  2. Lymphedema. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/supportivecare/lymphedema/healthprofessional/page1
  3. Melanoma Treatment (PDQ). National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/melanoma/Patient/page2
  4. Metastatic melanoma. DermNet NZ. http://www.dermnetnz.org/lesions/metastatic-melanoma.html
  5. Metastatic Behavior in Melanoma: Timing, Pattern, Survival, and Influencing factors. Journal of Oncology. http://www.hindawi.com/journals/jo/2012/647684/
  6. Symptoms of advanced melanoma. Macmillan Cancer Support. http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Melanoma/Symptomsanddiagnosis/Symptomsofme...
  7. Metastatic Melanoma. Melanoma Research Foundation. http://www.melanoma.org/understand-melanoma/what-is-melanoma/metastatic-melanoma

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