Signs of advanced melanoma go beyond the skin.
You probably know that skin cancer usually appears as a mole-like growth on the skin. This is true for melanoma as well, which is the rarest yet most dangerous form of skin cancer.
However, if melanoma spreads to other parts of the body (a process known as metastasis), the cancer may affect you beyond skin growths. “One of the challenges of melanoma is that unless you’re detecting any change, it may escape beyond this initial stage and become metastatic,” says Kaveh Alizadeh, MD, plastic and reconstructive surgeon in New York City.
How to Identify Melanoma on the Skin
Not any freckle or mole indicates melanoma—or even other types of skin cancer. While most benign skin spots are simple, round, and reddish brown, melanoma growths are “uglier.”
“You yourself can be vigilant in watching for any changes in your skin,” says Dr. Alizadeh. To help recognize melanoma, you can use the acronym ABCDE.
A is for asymmetry. Most benign moles tend to be symmetrical, meaning one half matches the other (like a perfect circle). Melanoma growths are usually asymmetrical with irregular shapes.
B is for border. The edges of a melanoma growth are often jagged and irregular, and “the border tends to change over time,” says Dr. Alizadeh.
C is for color. Melanoma growths can have uneven colors. Often, it includes black and brown shades.
D is for diameter. If the mole is getting bigger in a short period of time, that may indicate melanoma.
E is for evolving. If the mole changes in size, shape, or color within the course of weeks or months, it might be melanoma.
If melanoma has advanced and is metastatic, the growth is more likely to be ulcerated, meaning it looks like an open sore and is bleeding. Metastatic melanoma growths are also more likely to be deeper—more than four millimeters thick. However, melanoma can metastasize without causing ulceration or a deeper melanoma growth.
Other Symptoms Related to Metastatic Melanoma
Metastatic melanoma means that melanoma has spread to lymph nodes and potentially other organs. Because the cancer is forming tumors in other parts of the body, it can cause a variety of symptoms.
The most likely symptom of metastatic melanoma is swollen lymph nodes. Nearby lymph nodes are the first thing to be impacted when melanoma metastasizes. You might be able to feel the swollen lymph nodes yourself, depending on where they are located in the body.
Other possible symptoms depend on where the melanoma may have spread. Common symptoms of metastatic melanoma include aches or poor function of the lungs, liver, bones, head, or digestive system, as these are the organs most commonly affected by metastatic melanoma.
“It’s really those first five years [after a melanoma diagnosis] that are critical to make sure there’s no evidence of metastasis,” says Dr. Alizadeh. “If these tumors have escaped detection early on, unfortunately they can become very aggressive.”
If you notice any signs of melanoma or metastatic melanoma, seeing a doctor as soon as possible can be life-saving. Find out here how metastatic melanoma is diagnosed, and learn more here about treatment options for metastatic melanoma.
Dr. Alizadeh is a board-certified plastic surgeon and the chief of plastic and reconstructive surgery at Westchester Medical Center and New York Medical College.
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One of the challenges of a melanoma is
that unless you're detecting any change,
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it may escape beyond its initial stage and
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And that's why it's really important to
see a team of dedicated professionals.
00:00:16,186 --> 00:00:24,636
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You yourself can be vigilant in watching
for any changes in your skin, and
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we call that the ABCDEs, essentially.
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Looking for any kind of asymmetry.
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So a mole is usually very circumscribed or
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Whereas a melanoma tends to be asymmetric,
the borders tend to change over time.
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you may have actually different colors.
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It could be reds, browns, or blacks
within the same lesion, that's important.
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And then the diameter's important.
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Once the lesion goes beyond around
0.6 centimeters or 6 millimeters and
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then as it becomes larger, especially
over time, as you're looking at it.
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It's important to relay
that change to your doctor.
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The evolution of it.
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Evolution means, is it getting ulcerated?
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Is there changes in sort of
the actual character of this lesion?
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As we discussed, it's really those
first five years that are critical,
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to make sure that there's
no evidence in metastasis.
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Because if these tumors have escaped
detection early on, unfortunately,
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they can become very aggressive.
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They're going beyond the border
of the skin membrane,
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the border of the skin
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Once they do that,
then it depends on where it is.
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If it's in your arm,
you could potentially have infiltration.
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Let's say if it's in your arm or
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it could infiltrate into the chest area.
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If it's in your legs it could
potentially go to the groin area.
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Where you have infiltration of
that area you may have swelling,
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it can manifest itself as swelling,
it can manifest as well as pain.
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There's a number of different things.
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But really the most important is to
constantly be vigilant about it.
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And seek your medical doctor who
did the diagnosis to continue with
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Because they know what to look for
in terms of the symptoms.
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Guide to staging—melanoma. New York, NY: Skin Cancer Foundation. (Accessed on December 16, 2021 at https://www.skincancer.org/skin-cancer-information/melanoma/the-stages-of-melanoma/guide-to-staging-melanoma.)
Lymph node involvement. New York, NY: Skin Cancer Foundation. (Accessed on December 16, 2021 at https://www.skincancer.org/skin-cancer-information/melanoma/the-stages-of-melanoma/lymph-node-involvement.)
Melanoma. New York, NY: Skin Cancer Foundation. (Accessed on December 16, 2021 at https://www.skincancer.org/skin-cancer-information/melanoma.)
Melanoma. Washington, DC: MedlinePlus, U.S. National Library of Medicine. (Accessed on December 16, 2021 at https://medlineplus.gov/melanoma.html.)
Melanoma: clinical features and diagnosis. Waltham, MA: UpToDate, 2019. (Accessed on December 16, 2021 at https://www.uptodate.com/contents/melanoma-clinical-features-and-diagnosis.)
Melanoma skin cancer. Atlanta, GA: Centers for Disease Control and Prevention. (Accessed on December 16, 2021 at https://www.cancer.org/cancer/melanoma-skin-cancer.html.)Skin cancer (including melanoma)--patient version. Bethesda, MD: National Cancer Institute. (Accessed on December 16, 2021 at https://www.cancer.gov/types/skin.)