Metastatic Cancer: Melanoma
Signs and Symptoms of Metastatic Melanoma
Lyz Boyd and Jennifer Kong
Learning Objectives
At the end of this section, you will be able to:
- Outline the ABCDEs of self skin checks during early detection of melanoma on the skin.
- Briefly explain the pathophysiology behind signs and symptoms of metastatic melanoma.
Melanoma can occur on any part of the skin (or eyes!) – with the more likely spots to develop in areas of sun exposure. Because melanoma is localized to the skin, it is difficult to notice symptoms other than visual changes to skin.
What can melanoma on the skin look like? Well, that’s part of early detection.
Early Detection of Melanoma by Lyz Boyd, licensed under CC BY NC
Other than visually assessing moles, it is difficult to observe signs and symptoms of metastatic melanoma until it has spread to other organs, thus impairing those organ’s functions. In the DHPLC, there is a large collection of melanoma metastatic sites with patient information outlining their signs and symptoms.
| Organ with Melanoma Metastasis | Normal Function of Organ | Sign/Symptom of Metastatic melanoma |
| Lungs | Ventilation and gas exchange | Shortness of breath, poor oxygenation of blood, generalized fatigue |
| Liver | Nutrient storage, detoxification, synthesis of blood proteins, delays venous blood return to heart from abdominal & leg veins. | Enlarged liver, ascites, weight loss with increased abdominal girth |
| Brain | Controls EVERYTHING – both voluntary & involuntary functions of the body | Seizures, difficulties with coordinated movements |
| Intestines | Digestion and absorption of nutrients and elimination of wastes | Indigestion, possible intestinal obstruction if metastasis grows large enough |
| Eye* | Vision | Impaired vision with areas of blind spots in the affected eye |
| Heart | Pumping blood | Heart function was preserved despite several melanoma metastases |
| Kidneys | Filter wastes out of blood to produce urine | Dark brown/black urine |
| * this patient actually had melanoma start in his eye. There are many melanocytes in the retina of the eye to help absorb the light entering.
Figure 4.20 – CLINICAL MANIFESTATIONS OF METASTATIC MELANOMA |
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Section Review
- Identifying melanoma is through regular self skin checks, looking changes in skin moles using the ABCDE mnemonic: asymmetry, border, colour, diameter, and evolving changes in mole appearance.
- Metastatic melanoma can not be seen visibly (as the metastatic sites are not visible) so signs and symptoms are associated with compression of surrounding structures, thus causing a dysfunction in the organ. Alternatively, the production of melanin may be noticed as its presence may impair normal organ function (e.g. vision, urine production).
Review Questions
abnormal collection of fluid in the abdominal cavity
