Spotted a suspicious mole? Noticed a change to your skin? It’s important to get an accurate diagnosis, quickly. Detecting skin cancer early is the best way to prevent it from spreading. Once melanoma spreads, it’s called metastatic melanoma. Here’s everything you need to know about the symptoms, treatment, and outcome for this type of advanced skin cancer.
According to Cancer Australia, melanoma is the third most commonly diagnosed skin cancer. Metastatic melanoma is the spread of melanoma skin cancer cells to other parts of the body. This includes the lymph nodes, lungs, abdomen, liver, brain, and bones. The melanoma cells spread directly through the body tissue , via the lymphatic system and/or the blood.
Once melanoma has spread or metastasised, it may be referred to as advanced melanoma or stage 3 and 4 melanoma.
In most cases, melanoma is caused by overexposure to ultraviolet (UV) light from the sun and other sources. UV rays can damage the DNA of skin cells. This causes the cells to divide uncontrollably and form cancerous tumours.
When these cancerous tumours invade nearby tissue or spread to distant parts of the body, the process is called metastasis. You can’t have metastatic melanoma without first having melanoma. Risk factors for melanoma skin cancer include:
Melanoma gets its bad rap from the fact it can spread. Depending on the type of melanoma, it can be quick to spread. In some cases, it can become life-threatening in as little as six weeks., in other cases it can be present for years and still remain in one place.
The best way to prevent melanoma from spreading is to detect and treat it early.
The first symptom of melanoma is usually a new or abnormal mole. If this is not detected and the melanoma spreads (metastasizes), other symptoms may develop. The symptoms can vary, depending on where in the body the melanoma has spread.
Symptoms of metastatic melanoma in lymph nodes may include:
Symptoms of metastatic melanoma in the brain may include:
Symptoms of metastatic melanoma in the lungs may include:
Symptoms of metastatic melanoma in the bones may include:
Symptoms of metastatic melanoma in the liver may include:
If you haven’t already been diagnosed with melanoma, a skin exam and biopsy will be performed. A biopsy removes some of the tissue and surrounding healthy skin so that it can be tested for melanoma. The diagnosis of melanoma needs to be confirmed and the depth of spread determines the next step in treatment.
Additional tests are needed to see if the melanoma has spread. Tests for metastatic melanoma may include:
Sound waves are used to produce images of the internal organs. This can assist in the early detection of lymph node metastasis.
X-rays take internal images of the body. A chest x-ray may be useful for detecting metastatic melanoma in the lungs. A CT scan is a more detailed and specialised x-ray. It can show if any lymph nodes are enlarged or if any organs such as the lungs or liver have suspicious spots, which may be a sign of melanoma.
MRI scans use magnets and radio waves to create a detailed picture of the inside of the body. They can help show where the melanoma is and if it has spread. MRI scans are particularly useful when looking at the brain.
A PET scan uses a special dye that has radioactive traces. The dye is injected into your arm through a small plastic tube (a cannula). Once it has been absorbed by the body and tissues, a PET scan can show if the cancer has spread to the lymph nodes or other parts of the body.
A small amount of radioactive liquid is injected into a vein. A special camera and computer are then used to see your skeleton. This type of scan may be used to detect melanoma metastases in the bones.
Stage 4 metastatic melanoma cancer is challenging to treat. Yet, newer treatments are showing promising results. In fact, recent clinical trials showed an increase in stage 4 metastatic melanoma life expectancy.
In the past, the five-year survival rate for stage 4 melanoma was around 15-20%. The 10-year survival rate was estimated to be 10-15%. Latest clinical trials of targeted therapy and combination immune therapy have shown five-year survival rates ranging from 34-52%.
In cases of advanced (metastatic) melanoma, there is no “one-size-fits-all” skin cancer treatment. Your doctor will provide you with a personalised treatment plan. Treatment options may include:
If a lymph node biopsy is positive this indicates the cancer may have spread to nearby lymph nodes. It’s likely the lymph nodes involved will be removed. This is called a lymph node dissection. Following the surgery, you may be given adjuvant therapy to target any cancer cells that may have escaped into the body. This is to help prevent melanoma from recurring and improve your survival rate.
Immunotherapy treatment enhances your own immune system. This helps it to detect and destroy cancer cells more effectively. Immunotherapy drugs (AKA checkpoint inhibitors) may be given via intravenous (IV) injection or intravenous infusion (i.e. a drip).
A melanoma tumour may contain different gene mutations. Genetic testing helps to identify mutations and determine the best course of treatment. Once a mutation is found, treatment can be targeted to help slow down the rate of tumour growth. Targeted therapy is administered orally (in the form of a daily pill).
Radiation therapy uses high energy radiation to destroy the cancer cells. It does this by damaging the DNA of cells that are dividing.
Chemotherapy kills the cancer cells by targeting rapidly dividing cells. Yet, it’s not only cancer cells that quickly divide; hair cells and other health cells develop in the same way. Unfortunately, chemotherapy also damages healthy cells. Side effects of this can include hair loss, nausea, fatigue, and bone marrow suppression (reduction in red and white blood cells).
The best way to reduce your risk of skin cancer is to make sun protection an everyday habit. (Yes, you need sun protection in winter too.) The following actions can help you to protect yourself from melanoma:
At MoleMap, we recommend checking your skin for new moles and changes in existing moles every three months. If you notice anything unusual, don’t wait; get it looked at by a professional straight away.
Know you’re at high risk of melanoma? We suggest a Full Body MoleMap for complete peace of mind. This is our most comprehensive skin check. It includes a thorough skin assessment with dermatologist diagnosis, total body photography, additional dermoscopic imaging of moles that may be at risk, and unlimited free spot checks for 12 months.
Noticed a new mole or found a suspicious-looking mole? Book in for a Skin Check. You’ll get a head-to-toe skin examination, plus a dermatologist diagnosis. (No referral needed, unless you’re under the age of 16.)
Keep your skin safe. Compare all MoleMap services and find your nearest MoleMap location.
