Advanced melanoma
Melanoma skin cancer can spread almost anywhere in the body. Depending on how far it has spread, doctors may call it:
regional melanoma
advanced melanoma
The melanoma may have already spread when it was first diagnosed. Or it may have come back in another part of the body after your first diagnosis and treatment. Doctors call this recurrent cancer.
Regional melanoma skin cancer means it has spread to either:
an area between the melanoma and the nearby
the lymph nodes close to where the melanoma started
Cancer cells found between the melanoma and the nearby lymph nodes are called either:
micro satellite metastases - tiny amounts of cancer cells found next to the melanoma. They can only be seen through a microscope
satellite metastases - cancer cells found within 2cm of the melanoma
in-transit metastases - cancer cells that have spread more than 2cm away from the melanoma but not as far as the nearest lymph node
Regional melanoma is also called locoregional melanoma skin cancer. This is the same as stage 3 melanoma. It can usually be treated with surgery, targeted cancer drugs and immunotherapy.
If your surgeon can’t remove the melanoma, then you may have the same treatment as someone with advanced melanoma.
Read more about stage 3 melanoma skin cancer
Advanced melanoma is also called metastatic or stage 4 melanoma.
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 further away from the melanoma – which ones depends where the melanoma is
lungs
liver
bones
brain
small bowel
The aim of treatment for advanced melanoma is to control the cancer and help any symptoms. It may control the melanoma for a long time. And in a small number of people this can be for a number of years.
Some people may not have any symptoms at all. They may only know the melanoma has spread when it is found on a follow up scan.
Other people may get symptoms. These depend on where the cancer has spread to. If it has spread to the lungs you may have shortness of breath. A secondary cancer in the liver may cause discomfort or pain on the right side of your tummy (abdomen).
If the cancer has spread to the stomach or bowel you may have pain or notice blood in your poo. Sometimes this can make your poo look black.
Find out more about secondary cancer
To help you decide on the best treatment you need to talk very carefully to your specialist. This will help you understand:
what your diagnosis means
what’s likely to happen
what treatments are available
how treatment can help you
It’s a good idea to find out:
whether treatments have side effects that may affect your quality of life
what the treatment involves, such as travelling back and forth to the hospital
if there is a clinical trial you can take part in
what happens if you decide not to have treatment
You may want to talk things over with a close friend or family member. Or there may be a counsellor you can discuss your feelings with.
Find out more about counselling and cancer
Sometimes the melanoma may have already spread when you are first diagnosed. Your surgeon may recommend removing the original (primary) melanoma. But it depends on how many areas of the body it has spread to.
If the melanoma has only spread to one other part of the body, your doctor may also recommend you have surgery to remove the secondary cancer. Your doctor may refer you to a specialist surgeon for this operation.
Other treatments you might have for advanced melanoma skin cancer include:
immunotherapy
targeted cancer drugs
radiotherapy to specific sites of melanoma, for example the bone or brain
injecting treatment directly into the melanoma (intralesional therapy), for example talimogene laherparepvec (T-VEC)
chemotherapy – usually you only have chemotherapy if you can’t have targeted or immunotherapy drugs
chemotherapy directly into the arm or leg where the melanoma is (isolated limb infusion or isolated limb perfusion)
chemotherapy combined with an electric current (electrochemotherapy)
imiquimod cream
taking part in a clinical trial
Find out more about treatment for melanoma skin cancer
Finding out you have advanced melanoma can be a shock. It’s common to feel uncertain and anxious and not be able to think about anything else. There is lots of information and support available to you and your family and friends.
It can help to find out more about your cancer and the different treatments you can have. Many people find that knowing more about their situation can make it easier to cope. But some days you might want lots of information and on others it might be too much for you.
Last reviewed: 30 Jan 2025
Next review due: 30 Jan 2028
The stage of a melanoma skin cancer tells you how deeply it has grown down into the skin. It also tells you if it has spread elsewhere in your body and how far.
There are general symptoms you may get. But other symptoms can depend on where the cancer has spread to. And some people may not get any symptoms at all.
Treatments include targeted cancer drugs, immunotherapy and chemotherapy. They aim to control the cancer, any symptoms you have and improve your quality of life.
Get support to cope with emotional, practical and physical issues when you have advanced melanoma skin cancer.
Survival for melanoma skin cancer depends on many factors including the stage of the cancer when it was diagnosed, the treatment you have and your general health.
Melanoma develops in cells called melanocytes. You have these in your skin and other parts of your body. Melanoma that starts in the skin is called melanoma skin cancer.
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