What should you know about metastatic malignant melanoma?

Melanoma begins in pigment-producing cells, often in the skin, and can grow into nearby tissue. Metastatic disease means melanoma cells have reached another part of the body through lymphatic channels or the bloodstream. Possible sites include lymph nodes, lung, liver, bone, or the brain; the symptoms depend on the site involved. Brain metastases can cause headache, weakness, confusion, seizures, or changes in vision, although other conditions can cause these symptoms too.

A diagnosis is based on the original melanoma history, examination, tissue testing, and scans chosen by the oncology team. Tests may also examine tumour features that help guide treatment. The care plan depends on the locations involved, previous treatment, overall health, and personal preferences.

Arrange coordinated care with a dermatologist, medical oncologist, and other specialists when needed. Bring your pathology reports, scan results, medication list, and a record of new symptoms. Ask whether further imaging or a biopsy is needed before treatment begins, and whether testing of the melanoma could affect the options offered.

Treatment may include immunotherapy, medicines that act throughout the body, surgery for a particular tumour, radiation, or a combination. Surgery can remove selected deposits or relieve pressure and symptoms, while systemic treatment is used when melanoma is present in several areas. Discuss expected benefits, possible side effects, fertility or pregnancy concerns, and how symptoms will be monitored.

Contact your oncology team promptly for a new or rapidly worsening symptom. Seek emergency help for a seizure, sudden weakness or trouble speaking, severe confusion, difficulty breathing, chest pain, uncontrolled bleeding, or severe abdominal pain. A new severe headache with vomiting or a change in vision also needs urgent assessment, particularly when brain involvement is known or suspected.

During treatment, fever, severe diarrhoea, a widespread rash, yellowing of the skin, or marked breathlessness can signal a serious treatment reaction or infection. Use the emergency contact instructions given by your cancer team rather than waiting for a routine appointment.

Which areas are affected, and what test confirmed each finding? Is a biopsy or additional scan needed? What treatment do you recommend first, and what would make you change the plan? Which side effects should be reported the same day? Who should I contact outside clinic hours?