Melanoma metastasis to the brain: what to know

A brain metastasis is a melanoma deposit that has travelled from its original site to the brain or nearby structures. Symptoms depend on its location and may include a new or worsening headache, seizure, weakness on one side, balance difficulty, speech trouble, confusion, personality change or vision disturbance. These symptoms have many possible causes, but a person with melanoma should report new neurological changes promptly. Doctors use the history, neurological examination and brain imaging to investigate them.

Contact the oncology team urgently about new neurological symptoms or a scan showing a brain lesion. Do not drive if you have had a seizure, fainting episode or sudden visual or coordination change. Treatment depends on the number, size and position of lesions, symptoms, overall health and whether melanoma is present elsewhere. Options may include focused radiation, surgery in selected situations, medicines to reduce swelling, or immunotherapy and other systemic treatment. A multidisciplinary team coordinates the plan.

Call emergency services for a first seizure, a seizure lasting longer than expected, sudden weakness or facial drooping, inability to speak, severe confusion, collapse, repeated vomiting with a severe headache or rapidly worsening drowsiness. Do not wait for a clinic appointment with these warning signs. Keep the person safe from falls and follow emergency instructions.

Ask what the imaging shows, whether more scans or a biopsy are needed, which symptoms suggest swelling or seizure risk, and whether a neurosurgeon, radiation specialist or medical oncologist should be involved. Ask about driving, work, medicines, treatment goals, side effects and how follow-up after cancer treatment will monitor the brain and the rest of the body.