Symptoms of advanced melanoma skin cancer

Advanced melanoma skin cancer means it has spread to another part of the body such as the liver, lungs or bone.

Some people may not get symptoms when they have advanced cancer. Their doctor may find the cancer has spread during a scan for a follow up appointment. If they do have symptoms, these will depend on where the cancer has spread to.

It might not mean that you have advanced cancer if you have the symptoms described below. They can be caused by other conditions.

Where can melanoma skin cancer spread to?

Melanoma can spread to other areas on the skin or to soft tissue. Soft tissue includes muscles, nerves, fat, and blood vessels. Sometimes it can spread to more than one area.

Other common places for melanoma to spread include your:

• lymph nodes  away from the melanoma 
• lungs
• liver
• bones
• brain
• small bowel

Where a cancer has spread to is called a secondary cancer or metastasis.

General symptoms of advanced melanoma skin cancer

The symptoms of advanced cancer depend on where the cancer is in your body. But general symptoms might include:

• hard or swollen lymph nodes
• a hard lump on your skin
• unexplained pain
• feeling very tired or unwell
• unexplained weight loss

Symptoms if cancer has spread to the lymph nodes

Lymph nodes are part of the lymphatic system. This is a network of thin tubes (vessels) and small pieces of tissue (nodes) that carry a fluid called lymph around the body.

Lymph nodes normally filter out and destroy old or abnormal cells from the lymph. But, when cells break away from the cancer, they can get stuck and start to grow in the lymph nodes. Doctors don’t yet understand why the lymph nodes don’t destroy these cells.

There are lots of lymph nodes in your body. But they can be felt easiest in your groin, armpit and neck.

If the cancer has spread to your lymph nodes they can feel hard or swollen. Swollen lymph nodes in the neck area can make it hard to swallow.

Cancer cells in the lymph nodes can also stop the lymph from draining away. It collects in the body causing swelling. This is called lymphoedema.

Where the lymph can collect depends on which lymph nodes are swollen. If you have swollen lymph nodes in your:

• arm pit - you may get fluid collecting in your arm on the same side as the swollen lymph nodes
• groin - you may get fluid collecting in your leg on the same side as the swollen lymph nodes
• neck - you may get fluid collecting in the neck or face

Symptoms if cancer has spread to the lungs

You may have any of these symptoms if your cancer has spread into the lungs:

• a cough that doesn’t go away
• breathlessness
• ongoing chest infections
• coughing up blood
• a buildup of fluid between the chest wall and the lung (a pleural effusion)

Symptoms if cancer has spread to the liver

You might have any of the following symptoms if your cancer has spread to the liver:

• discomfort or pain on the right side of your tummy (abdomen)
• feeling sick
• poor appetite and weight loss
• a swollen tummy (called ascites)
• yellowing of the skin and whites of the eyes (jaundice)
• itchy skin

Symptoms if cancer has spread to the bone

You might have any of the following symptoms if your cancer has spread to the bones:

• pain from breakdown of the bone – the pain is continuous and people often describe it as gnawing
• backache, which gets worse despite resting
• weaker bones – they can break more easily
• raised blood calcium (hypercalcaemia), which can cause dehydration, confusion, sickness, tummy (abdominal) pain and constipation
• low levels of blood cells – blood cells are made in the bone marrow and can be crowded out by the cancer cells, causing anaemia, increased risk of infection, bruising and bleeding

Cancer in the spinal bones can cause pressure on the spinal cord. If it isn't treated, it can lead to weakness in your legs, numbness, paralysis and loss of bladder and bowel control (incontinence). This is called spinal cord compression. It is an emergency, so if you have these symptoms contact your 24 hour advice line or healthcare team straight away. If you can't get through, contact your GP or go to your nearest accident and emergency department (A&E). 

Symptoms if cancer has spread to the brain

You might have any of the following symptoms if the cancer has spread to your brain:

• memory problems, mood or personality changes
• seizures
• confusion
• severe headaches, often with sickness
• weakness of an arm or leg

Symptoms if cancer has spread to the small bowel

Melanoma skin cancer can spread to the small bowel. This is the part of the bowel between your stomach and large bowel. 

Most people don’t have any symptoms if the melanoma has spread to the small bowel. But if you do they might include:

• pain in the abdomen
• indigestion
• feeling or being sick
• weight loss
• anaemia

The secondary cancer may also press on the small bowel and block or partially block it. This is called bowel obstruction.

Bowel obstruction can cause cramping abdominal pain that comes in waves. You can also be sick, feel bloated and be unable to pass wind or have a poo.

Bowel obstruction is an emergency. You should see your doctor quickly or go to your nearest A&E department if you think you have it.