Melanoma

Symptoms & side effects

A melanoma diagnosis is likely to lead to many changes in your daily life. Once treatment starts, this may include not only an adjustment to your schedule but also the prevention or management of disease-related symptoms and treatment-related side effects.

Managing side effects

The possibility of pain is often one of the leading fears for many people with cancer. However, melanoma patients do not usually have pain related to the disease and if they do, there are ways to manage it effectively. Pain may occur temporarily after surgery or can result from metastatic melanoma after it has spread to other tissues or organs. If you experience pain, don’t hesitate to talk to your doctor or another member of your treatment team about how it can be managed and any fears you may have about pain medication.

Mild pain can usually be managed with over-the-counter pain relievers, and more severe pain is often treated and controlled with prescription drugs, such as opioids (narcotics). It’s important to take pain-relieving drugs exactly as your doctor prescribes, including at the intervals suggested rather than on an “as needed” basis. Pain medication is more effective when taken this way because it can help stop pain before it develops or worsens.

People with cancer may also fear the side effects related to treatment. However, it’s now possible to prevent or manage most of the common side effects associated with melanoma treatment. This is extremely important because when side effects are managed well, patients feel better and are generally more likely to finish their treatment regimen.

Not all people will have the same side effects or any side effects at all, even when taking the same medications or receiving similar treatments. Side effects also vary in severity and differ according to the type of treatment (see Table 1).

Some of the common side effects associated with melanoma and its treatments include:

  • Lymphedema: The most common side effect of surgery for melanoma is lymphedema, a buildup of fluid in body tissues that causes some enlargement of an arm or leg. Lymphedema is most likely to occur after the removal of certain lymph nodes. Without the nodes, lymph fluid may not flow normally, causing the fluid to build up. The amount of swelling can range from mild to extreme, and many patients have no swelling.

    Management of lymphedema focuses on ways to reduce swelling and control discomfort. Your doctor may suggest wearing a compression stocking or sleeve, or elevating the limb to a point higher than your heart to help increase the flow of lymph fluid to decrease swelling. Your doctor may also suggest treatment by a certified therapist or other professional with special training in lymphedema.
  • Nausea and vomiting: Nausea and vomiting are the most common side effects of traditional chemotherapy, and they can also result from immunotherapy and targeted therapy treatments, although less often. Because nausea and vomiting are easier to prevent than to manage once they occur, your doctor may prescribe medication that you take before the start of each treatment.

  • Low blood cell counts: Cancer treatments such as chemotherapy and immunotherapy are known to lower the number of certain blood cells in your body. Low white blood cell counts can increase the risk of infection; low red blood cell counts can make you feel tired and weak; and low platelet counts can increase your risk of bleeding and cause you to bruise easily. Your doctor will monitor your blood counts during treatment to make sure levels are well-maintained. If the counts are too low, your doctor may prescribe medication to stimulate blood cell growth or delay cancer treatment until your blood cell counts increase. Be sure to talk to your doctor about when to notify your treatment team about symptoms related to these side effects.

Table 1. Most common side effects for treatment of metastatic melanoma

Type of treatment Side effects
Surgery
Surgical removal Pain, swelling, scar
Lymph node dissection Lymphedema, numbness, restricted movement of limb
Systemic therapy
Immunotherapy
Fever, chills, aches; fatigue; injection-site reaction; low blood pressure; heart and liver damage (interleukin-2); skin, liver, colon and glandular inflammation
Chemotherapy
Nausea and vomiting, hair loss, mouth sores, increased risk of infection and bleeding, easy bruising, fatigue, loss of appetite
Targeted therapy
Rash, joint pain, liver-function abnormalities, sensitivity to the sun, cutaneous squamous cell carcinoma (skin cancer)
Radiation therapy Swelling, skin changes (similar to a sunburn), fatigue

 

Learn more about side effects of cancer treatment.

 

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