Metastatic uveal melanoma: what to know

Uveal melanoma begins in pigment-producing cells within the uveal tract, which includes the iris, ciliary body and choroid. Metastatic disease means cells have travelled from the eye to another organ. The liver is a common site of concern, although spread can occur elsewhere. Imaging and blood tests help the team assess the location, number and size of deposits, while the original tumour and overall health inform treatment planning. The eye may have already been treated, or local eye treatment may still be part of the plan.

Local treatments such as Brachytherapy or Radiotherapy may be considered for selected areas. The oncology team may combine local control with medicines or monitoring, depending on the pattern of spread.

Keep appointments with both ocular oncology and medical oncology when both teams are involved. Ask which scans are planned, whether tissue or molecular testing is useful, and whether the treatment aim is to control visible disease, relieve symptoms or protect organ function. Report changes in vision, abdominal discomfort, yellowing of the skin, persistent nausea, unexplained weight change or new pain. A written plan can help coordinate medicines, scan dates and contact numbers.

Seek urgent help for sudden loss of vision, severe eye pain, new weakness, confusion, severe abdominal pain, repeated vomiting, fainting or breathing difficulty. Contact your cancer team promptly for yellow skin or eyes, dark urine, rapidly increasing abdominal swelling, fever or symptoms that worsen quickly.

Where has the melanoma spread? Which scan will assess each area? What is the aim of the proposed treatment? How will eye function be monitored? Which symptoms need an urgent call? Should an ocular oncology, liver or palliative care specialist join my care?