If Melanoma Skin Cancer Spreads
Cancer cells can spread from the area of skin where the cancer started to other parts of the body. This spread is called metastasis.
Understanding how a type of cancer usually grows and spreads helps your healthcare team plan your treatment and future care. If melanoma skin cancer spreads, it can spread to the following:
- lymph nodes near where the cancer started
- other areas of skin away from where the cancer started
- soft tissue
- American Joint Committee on Cancer. AJCC Cancer Staging Handbook. 7th ed. Chicago: Springer 2010.
- American Society of Clinical Oncology. Melanoma. 2015: .
- Canadian Dermatology Association . Malignant Melanoma . .
- Petrella T, Ernst S, Spatz A, Claveau J, Wong R, Smylie M. Canadian perspective on the clinical management of metastatic melanoma. New Evidence in Oncology. Toronto, ON: New Evidence 2012: .
- Ribas A, Slingluff Cl Jr, Rosenberg SA. Cutaneous melanoma. DeVita VT Jr, Lawrence TS, Rosenberg SA. Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins 2015: 94:1346-1394.
Haematogenous Spread Of Melanoma
Haematogenous spread is spread of melanoma cells in the bloodstream, which can happen either by a tumour invading blood vessels or secondary to lymph node involvement. Once in the bloodstream, melanoma cells can travel to distant sites in the body and deposit. It can proliferate in any tissue but most often grows in the lungs, in or under the skin, the liver and brain. Many patients also develop metastases in bone, gastrointestinal tract, heart, pancreas, adrenal glands, kidneys, spleen and thyroid.
More Pictures Of Basal Cell Carcinoma
While the above pictures show you some common ways that BCC can appear on the skin, this skin cancer can show up in other ways, as the following pictures illustrate.
Scaly patch with a spot of normal-looking skin in the center
On the trunk, BCC may look like a scaly patch with a spot of normal-looking skin in the center and a slightly raised border, as shown here.
Basal cell carcinoma can be lighter in some areas and darker in others
While BCC tends to be one color, it can be lighter in some areas and darker in others, as shown here.
Basal cell carcinoma can be brown in color
Most BCCs are red or pink however, this skin cancer can be brown, as shown here.
Basal cell carcinoma can look like a group of shiny bumps
BCC can look like a group of small, shiny bumps that feel smooth to the touch.
Basal cell carcinoma can look like a wart or a sore
The BCC on this patients lower eyelid looks like a wart* in one area and a sore** in another area.
If you see a spot or growth on your skin that looks like any of the above or one that is growing or changing in any way, see a board-certified dermatologist.
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Complementary And Alternative Treatments
It’s common for people with cancer to seek out complementary or alternative treatments. When used alongside your conventional cancer treatment, some of these therapies can make you feel better and improve your quality of life. Others may not be so helpful and in some cases may be harmful. It is important to tell all your healthcare professionals about any complementary medicines you are taking. Never stop taking your conventional treatment without consulting your doctor first.All treatments can have side effects. These days, new treatments are available that can help to make many side effects much less severe than they were in the past.
Biological Therapies And Melanoma
Biological therapies are treatments using substances made naturally by the body. Some of these treatments are called immunotherapy because they help the immune system fight the cancer, or they occur naturally as part of the immune system. There are many biological therapies being researched and trialled, which in the future may help treat people with melanoma. They include monoclonal antibodies and vaccine therapy.
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More Information About Basal Cell Carcinoma
The following are some English-language resources that may be useful. Please note that THE MANUAL is not responsible for the content of these resources.
See the following sites for comprehensive information about basal cell carcinoma, including detection, prevention, treatment options, and other resources:
Types Of Skin Malignancies:
- Melanoma the least common form of skin cancer, but responsible for more deaths per year than squamous cell and basal cell skin cancers combined. Melanoma is also more likely to spread and may be harder to control.
- Nonmelanoma malignancies:
- Squamous cell cancer the second-most common skin cancer. It’s more aggressive and may require extensive surgery, depending on location and nerve involvement.
- Basal cell cancer the most common form of skin cancer. It is rarely fatal but can be locally aggressive.
These skin malignancies are typically caused by ultraviolet radiation from exposure to the sun and tanning beds.
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Where Does Bcc Develop
As the above pictures show, this skin cancer tends to develop on skin that has had lots of sun exposure, such as the face or ears. Its also common on the bald scalp and hands. Other common areas for BCC include, the shoulders, back, arms, and legs.
While rare, BCC can also form on parts of the body that get little or no sun exposure, such as the genitals.
How Dangerous Is Melanoma Its All A Matter Of Timing
Skin cancer holds the unfortunate distinction of being the worlds most common cancer. Though its prevalence around the globe is disturbing, there is some good news: When caught early, skin cancers are almost always curable.
You might already know that catching a cancer early means a more favorable prognosis. But it can be difficult to comprehend just how big a difference early detection makes with melanoma, the most dangerous form of skin cancer. Melanoma should never be underestimated, but treating a tumor early rather than after it is allowed to progress could be lifesaving.
Leland Fay, 46, understands better than most the seriousness of this distinction. When the Monument, Colorado native was diagnosed with melanoma in 2012, he was given a bleak prognosis due to the advanced stage of the tumor it had already reached stage IV.
Leland hadnt thought much of the little black mole on his head a few months earlier, when a dermatologist froze it off during a routine exam. But the mole resurfaced, bigger than it had been originally. After a biopsy and imaging tests, doctors told Leland it was melanoma, and that it had already spread. He could have as few as six weeks to live.
To fully comprehend the significance of timing, it can be helpful to understand exactly what happens to a melanoma when it advances to a later stage, and what it means when a melanoma spreads beyond the original tumor site.
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Stem Cell Or Bone Marrow Transplant
A stem cell transplant, sometimes called bone marrow transplant, replaces damaged blood-forming cells with healthy ones. The procedure takes place following large-dose chemotherapy or radiation therapy to kill cancer cells and to stop your stem cells from producing cancerous cells.
Stem cell transplants can be used for several types of cancer, including multiple myeloma and some kinds of leukemia.
Other Cancers On The Face
A few other rare skin cancers that might happen on the face:
- Lymphoma of the skin is an uncommon type of white blood cell cancer.
- Kaposi’s sarcoma is cancer caused by a herpes virus in immunosuppressed patients that causes skin lesions on the face. They look like painless purplish spots.
- Skin adnexal tumors is a rare cancer type that starts in hair follicles or skin glands.
- Sarcomas are tumors of the connective tissuesspecifically the fat, nerves, bone, skin, and muscles 80% of which occur in the face, head, or neck.
- Cutaneous leiomyosarcoma is an uncommon soft-tissue sarcoma that can happen on the face.
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Taking Care Of Yourself
Hearing that your cancer has spread is scary, but a lot of research is underway to find new treatments. And there are treatments available to try to stop the disease from spreading, so you can live longer.
It’s important to have support and to talk about your fears and feelings, too. Your doctor can help you find a cancer support group.
These tips may help you feel better during melanoma treatment:
- If you lose your appetite, eat small amounts of food every 2 to 3 hours instead of bigger meals. A dietitian can give you other tips on nutrition and eating during your cancer treatment. Ask your doctor for a referral.
- Exercise can help you feel better overall and fight fatigue. But listen to your body, and balance rest and activity.
- Get the kind of emotional support that’s right for you. It could be from family, friends, your cancer support group, or a religious group.
Causes Of Skin Cancer
One of the main causes of skin cancer is being exposed to UV rays. UV rays are invisible, and are produced by the sun, and tanning equipment.
UV rays cause skin cancer by creating changes in the cells of your skin. In some cases, the UV rays cause direct damage to your cells. Tans and sunburns, for example, are both signs that UV rays have damaged your skin. In other cases, UV rays cause skin cancer indirectly, by weakening the immune system.
Many studies on skin cancer show that people who have suffered many severe sunburns in childhood are at greater risk of developing skin cancer. Family history, some chemical exposures, and immune dysfunction conditions can also create a greater risk of developing skin cancer.
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What Makes Yale Medicines Approach To Squamous Cell Carcinoma Unique
Simple, small cancers can often be treated very well by a local dermatologist, according to Dr. Leffell. We rarely see the small cancers. We get referred to the cases that need special attention.
Dr. Leffell emphasizes that at Yale Medicine, the patient always comes first. We like to have a discussion with the patient about what happens after the skin cancer is removed, he says. We talk about what’s involved with plastic surgery and what’s involved with letting the area heal naturally. We prefer to take a minimalist approach and let the patient decide what they want us to do and how they want to let their skin heal.
If the decision is made to repair the wound using plastic surgery, we do that immediately in the office setting, Dr. Leffell says. Alternatively, allowing the wound to heal naturally is often a great option, and does not rule out doing plastic surgery down the road if needed, though that is very rarely the case.
What Stages Have To Do With Cancer Spread
Cancers are staged according to tumor size and how far it has spread at the time of diagnosis. Stages help doctors decide which treatments are most likely to work and give a general outlook.
There are different types of staging systems and some are specific to certain types of cancer. The following are the basic stages of cancer:
- In situ. Precancerous cells have been found, but they havent spread to surrounding tissue.
- Localized. Cancerous cells havent spread beyond where they started.
- Regional. Cancer has spread to nearby lymph nodes, tissues, or organs.
- Distant. Cancer has reached distant organs or tissues.
- Unknown. Theres not enough information to determine the stage.
- Stage 0 or CIS. Abnormal cells have been found but have not spread into surrounding tissue. This is also called precancer.
- Stages 1, 2, and 3. The diagnosis of cancer is confirmed. The numbers represent how large the primary tumor has grown and how far the cancer has spread.
- Stage 4. Cancer has metastasized to distant parts of the body.
Your pathology report may use the TNM staging system, which provides more detailed information as follows:
T: Size of primary tumor
- TX: primary tumor cant be measured
- T0: primary tumor cant be located
- T1, T2, T3, T4: describes the size of the primary tumor and how far it may have grown into surrounding tissue
N: Number of regional lymph nodes affected by cancer
M: Whether cancer has metastasized or not
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Questions To Ask The Doctor
- Do you know the stage of the cancer?
- If not, how and when will you find out the stage of the cancer?
- Would you explain to me what the stage means in my case?
- What will happen next?
There are many ways to treat skin cancer. The main types of treatment are:
- Surgery
- Immunotherapy
- Chemotherapy
Most basal cell and squamous cell cancers can be cured with surgery or other types of treatments that affect only the spot on the skin.
The treatment plan thats best for you will depend on:
- The stage and grade of the cancer
- The chance that a type of treatment will cure the cancer or help in some way
- Your age and overall health
- Your feelings about the treatment and the side effects that come with it
What Are Biopsies And Why Do I Need One
Biopsies are the most common way that doctors diagnose cancer. During a biopsy, a doctor takes a small piece of tissue, called a sample, from a suspected tumor or area of concern. Then, a pathologist looks at it under a microscope to make a diagnosis. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease, including cancer.
There are many different techniques for collecting a biopsy. For example, in a fine needle aspiration biopsy, the doctor inserts a needle attached to a syringe into the suspicious area to collect a small amount of tissue for diagnosis. In an excisional biopsy, the doctor removes the entire suspicious mass for examination.
Properly performed, biopsies often provide essential information to help diagnose, stage, and inform clinical decision-making for patients with suspected or known cancer. Jeffrey E. Gershenwald, MD, FACS, professor in the Department of Surgical Oncology in the Division of Surgery at the University of Texas MD Anderson Cancer Center in Houston, Texas, and Cancer.Net Editorial Board member.
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Red Flag #: Unexplained Weight Loss And Loss Of Appetite
Unintentional weight loss is a common side effect of any cancer. When it comes to melanoma, extreme weight loss usually only happens after the cancer has spread from the skin to other parts of the body. Dr. Zaba says she can sometimes tell if a patients melanoma has metastasized because it looks like they have cachexia, a syndrome marked by drastic loss of fat and muscle and increased weakness. Cachexia can also cause loss of appetite, which further contributes to the problem.
How Fast Does Skin Cancer Grow
You know that its possible for skin cancer to spread, but how fast does skin cancer grow? Here as well, the answer depends on the type of skin cancer that youre dealing with:
- Melanoma skin cancers can become life-threatening in as little as six weeks. This fast-growing type of skin cancer needs to be addressed as soon as possible.
- Basal cell carcinoma is the slowest-growing variety of common skin cancers, and it is also the least likely to spread. However, over time, this type of skin cancer may spread to surrounding healthy skin cells. From there, it may move into other tissues and organs.
- Squamous cell carcinoma is also slow-growing, but it does tend to grow and spread more quickly than basal cell carcinoma. If it does spread, it may start by moving deeper into the lower, fatty layers of your skin.
Melanoma often looks like a mole with unstable or irregular borders basal cell carcinoma and squamous cell carcinoma may take on a variety of appearances. Talk to your doctor and read more to determine your next steps.
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How Serious Is My Cancer
If you have skin cancer, the doctor will want to find out how far it has spread. This is called staging.
Basal and squamous cell skin cancers don’t spread as often as some other types of cancer, so the exact stage might not be too important. Still, your doctor might want to find out the stage of your cancer to help decide what type of treatment is best for you.
The stage describes the growth or spread of the cancer through the skin. It also tells if the cancer has spread to other parts of your body that are close by or farther away.
Your cancer can be stage 0, 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread beyond the skin. Be sure to ask the doctor about the cancer stage and what it means for you.
Other things can also help you and your doctor decide how to treat your cancer, such as:
- Where the cancer is on your body
- How fast the cancer has been growing
- If the cancer is causing symptoms, such as being painful or itchy
- If the cancer is in a place that was already treated with radiation
- If you have a weakened immune system
The 4 Stages Of Melanoma
Two main things determine the stage of melanoma: The thickness or depth of the tumor and how far it has spread when its diagnosed, explains David Polsky, M.D., dermatologist at NYU Langone Medical Center in New York City. In stages 0, 1, and 2, the melanoma is limited to the skin. In stage 3, its spread to the lymph nodes, small structures throughout your body that help filter fluids and fight infection. In the most advanced stage, stage 4, melanoma cells have broken away from the original tumor, traveled through the body and formed a new tumor somewhere else.
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