Advanced Melanoma: Symptoms, Treatment, Expert Care

Understanding Advanced Melanoma

Advanced melanoma is a serious form of skin cancer that occurs when melanoma cells have spread from the primary tumour to other parts of the body, such as the lungs, brain, liver, or soft tissue. This is often referred to as metastatic melanoma or stage IV melanoma.

While advanced melanoma can feel overwhelming, there are more effective treatments than ever before. Thanks to progress in clinical trials, drug treatment, and combination immunotherapy, many melanoma patients are living longer and with a better quality of life.

To learn about risk factors for developing skin cancer, click here. The article is about understanding melanoma.

Definition and Stages of Melanoma

Melanoma begins in the melanocytes—cells that produce pigment in the skin. It can occur as a visible mole or lesion, or as a change in existing skin markings. The melanoma stages range from localised (early melanoma) to widespread disease.

• Stage III melanoma: Spread to nearby lymph nodes

• Stage IV melanoma: Spread to distant lymph nodes, internal organs, or distant areas of the body

The American Joint Committee on Cancer provides the global standard for Melanoma staging, based on tumour thickness, spread, and ulceration.

Types of Melanoma (Cutaneous, Ocular, Mucosal)

The different types of melanoma, depending on where they develop in the body.

• Cutaneous melanoma: The most common type of skin cancer, found on sun-exposed skin

• Ocular melanoma (uveal melanoma): Starts in the eye, particularly the uvea

• Mucosal melanoma: A rare form that develops in the mucous membranes (mouth, anus, vagina)

How Melanoma Spreads (Metastatic Melanoma)

Melanoma spreads through the lymphatic system or bloodstream. It may affect:

• Distant lymph nodes

• Lungs, liver, or brain

• Spinal cord or nervous system

• Soft tissue and internal organs

Early detection and timely treatment are crucial to slow or stop the spread. It is important to remember that if the melanoma has spread to the lungs, this does not mean you have lung cancer. It is a secondary cancer that is in the lung.

You need the best treatment for melanoma that has metastasised (spread) to the lungs. The same applies to any part of the body.

Symptoms and Diagnosis

Recognising Signs of Melanoma

Common symptoms of advanced melanoma include:

• Lumps under the skin

• Weight loss or loss of appetite

• Fatigue

• Persistent pain in areas of the body where melanoma has spread

• Trouble breathing or shortness of breath if the lungs are involved

• Headache

Diagnostic Methods (Skin Biopsy, Imaging, Blood Tests)

To diagnose and stage melanoma, your specialist may recommend:

• Skin biopsy - to differentiate from other skin cancers such as squamous cell carcinoma or basal cell carcinoma

• Sentinel lymph node biopsy

• Imaging scans such as a CT scan or magnetic resonance imaging (MRI)

• Blood tests to monitor your general health and treatment response

Advanced Melanoma Treatment Options

Treatment of metastatic melanoma has progressed significantly in recent years with more patients than ever going on to experience long-term survival with the best treatment. Treatment approaches need to be tailored to your specific situation.

Reports of new treatments for metastatic melanoma are frequently in the cancer news.

Targeted Therapy for Melanoma

Targeted therapies are designed to attack tumours with specific genetic mutations, such as BRAF mutations. These cancer drugs can shrink tumours and delay progression. Two main types that show clinical benefit are:

• BRAF inhibitors e.g. dabrafenib, veumrafenib, encorafenib

• MEK inhibitors e.g. trametinib, binimetinib

Targeted therapy is often part of a combination therapy approach and may be used alongside other cancer treatment strategies.

Patient Eligibility and Benefits

A tissue sample from your tumour, or blood, will be tested for gene mutations. If positive, targeted therapy can offer a rapid reduction in tumour size and relief of symptoms. Side effects can include skin changes, fatigue, and fever.

Immunotherapy for Advanced Melanoma

Immunotherapy drugs help your body's immune system recognise and destroy melanoma cells. Immune checkpoint inhibitors, like nivolumab and pembrolizumab, release the brakes on your immune cells such as T cells, enabling them to target cancer more effectively.

Immune Checkpoint Inhibitors

Checkpoint inhibitors have changed the outlook for melanoma patients. These treatments can provide long-lasting remission (long-term survival) for some people and are now a standard part of clinical practice for advanced stage disease.

Managing Treatment Side Effects

Common side effects of immunotherapy treatment include:

• Fatigue

• Skin rash

• Inflammation of the lungs, liver, or intestines

Your multidisciplinary team will help monitor and manage these effects to ensure treatment remains safe. The potential benefits of treatment will always be discussed in the context of the potential risks of treatment.

Chemotherapy in Melanoma Care

Though less commonly used today, chemotherapy can still play a role, particularly when other treatments have not been successful. Chemotherapy drugs used in melanoma treatment include dacarbazine and temozolomide.

Radiation Therapy for Melanoma

Radiation therapy (radiotherapy) may be used to control pain or symptoms, especially in metastatic melanoma that has spread to the brain or bones. It is also used after surgery in certain cases.

Advanced techniques like stereotactic radiotherapy can deliver precise doses to reduce the impact on surrounding tissues and offer a high likelihood of eliminating the metastatic deposit.

Surgical Treatments

Surgery is a key part of melanoma in the early stages (primary melanoma) and increasingly in advanced melanoma cancer care. Procedures include:

• Wide local excision

• Sentinel lymph node biopsy

• Lymph node dissection

• Limb perfusion or limb infusion for advanced limb tumours

Surgical options depend on the location and treatment plan.

Clinical Trials and Emerging Therapies

Accessing New Treatments

Dr. Wilson offers access to clinical trials evaluating new treatments for advanced melanoma, including:

• Novel checkpoint inhibitors

• Combination therapy options

• Personalised vaccines

Innovative Therapies in Development

Promising areas include:

• T cell therapy

• Oncolytic virus therapy

• New combinations of immunotherapy drugs and cancer drugs

Studies from institutions like Royal Marsden NHS Foundation Trust, Melanoma Institute Australia, and publications in the New England Journal of Medicine are shaping the future of cancer care.

Living with Advanced Melanoma

Managing Side Effects

Side effects may be physical (skin issues, fatigue) or emotional (anxiety, depression). Proactive support from health professionals and your care team makes a big difference.

Supportive Care Strategies

• Regular contact with your healthcare professionals

• Access to support services and support groups

• Help managing everyday activities

Emotional and Psychological Support

Cancer patients often benefit from counselling, mindfulness therapy, and peer networks.

• Look for help through your hospital or local Online Community

• Charities such as Cancer Research UK provide reliable cancer information

Coping Resources and Support Groups

• Macmillan Cancer Support

• Melanoma UK

• Maggie’s Centres

Nutrition and Lifestyle Tips

While no diet cures cancer, good nutrition supports recovery. Tips include:

• Eating small, nutrient-rich meals if experiencing loss of appetite

• Light exercise to maintain strength and reduce fatigue

• Avoiding sunbeds and excessive sun exposure

How Dr James Wilson Can Help

Personalised Melanoma Treatment

Dr. Wilson is a UK-based Consultant Medical Oncologist and specialist in melanoma care. He develops tailored treatment plans for every patient, based on their disease stage, genetics, and goals.

Multidisciplinary Care Team

Working with surgical oncologists, dermatologists, and radiologists, Dr. Wilson offers coordinated care at leading clinics. This ensures the best possible outcomes for melanoma patients.

Access to Innovation

Patients benefit from:

• Entry into clinical trials

• Access to new treatments

• The latest data from global research and real-world evidence

Dr. Wilson combines compassion with cutting-edge knowledge to help patients navigate their treatment with confidence.

Book a Consultation with Dr James Wilson Today

If you’ve been diagnosed with advanced melanoma or are exploring your treatment options, expert guidance can make all the difference.

Contact Dr. Wilson’s clinic to arrange a consultation and discuss your personalised melanoma treatment plan.

Call +44 (0)20 7993 6716 or email info@drjameswilson.co.uk.

Visit our website to learn more about Dr. Wilson’s approach to melanoma and other cancer types. Click here to arrange an appointment.