Melanoma is a serious malignancy that originates in the melanocytes, the pigment-producing cells found primarily in the skin. This cancer is uniquely dangerous among skin cancers because of its potential to spread rapidly to other parts of the body if not detected early. A primary question often arises for those concerned about this disease: does melanoma cause generalized, non-skin related illness, or a feeling of being “sick”? The answer depends entirely on the cancer’s stage, as systemic sickness is triggered only when the disease progresses beyond a localized skin lesion.
Localized Signs vs. Systemic Effects
In its earliest phases, such as Stage 0 or Stage I, melanoma is typically confined to the top layer of the skin or has invaded only superficially into the dermis. At this localized stage, the disease does not generally trigger systemic symptoms like fever, widespread fatigue, or nausea. The signs of early melanoma are local, usually presenting as a suspicious mole or lesion that follows the “ABCDE” warning signs. When the malignancy is caught at this point, treatment is often straightforward surgical removal, leading to a high five-year survival rate of approximately 99 percent for localized disease.
How Advanced Melanoma Causes General Sickness
A feeling of general illness signals that the melanoma has progressed to an advanced stage, typically Stage III or Stage IV, which is also known as metastatic melanoma. This systemic sickness results from two primary biological processes: the physical disruption caused by cancer spreading to vital organs and the body’s inflammatory response. Metastasis allows melanoma cells to travel through the body and colonize organs such as the lungs, liver, brain, and bones, interfering with their normal functions. The secondary mechanism involves the release of inflammatory molecules, particularly cytokines, which leads to cancer-related fatigue and general malaise.
Specific Systemic Symptoms Related to Metastasis
The physical manifestations of advanced melanoma are diverse and directly correspond to the location of the metastatic tumors. One of the most common and debilitating systemic symptoms is profound fatigue that is not relieved by rest, often referred to as cancer-related fatigue. Unexplained weight loss, sometimes progressing to cachexia, is another frequent sign, often accompanied by loss of appetite.
Site-Specific Symptoms
Site-specific symptoms emerge depending on which distant organ the melanoma has invaded. If the cancer spreads to the lungs, a person may experience a persistent cough, shortness of breath, or chest pain. Metastasis to the brain can cause severe headaches, visual disturbances, or neurological issues such as seizures or weakness in the limbs. When the liver is involved, symptoms can include swelling in the abdomen, jaundice, or an overall feeling of lethargy. Bone metastases can result in pain or an increased risk of pathological fractures.
Differentiating Treatment Side Effects from Cancer Symptoms
For patients undergoing treatment for advanced melanoma, the experience of feeling sick can become complicated, as symptoms may be caused by the disease itself or by the therapies used to fight it. Advanced melanoma is often treated with innovative therapies, such as immunotherapy and targeted therapy, which carry distinct side effect profiles. Immunotherapies work by activating the patient’s immune system to attack the cancer cells, but this necessary activation can inadvertently cause inflammation in healthy organs. This leads to side effects that mimic disease symptoms, such as fatigue, skin rash, or diarrhea.
Targeted therapies, which block specific proteins in the cancer cells, can also cause systemic symptoms, including joint pain, skin rash, and fever. Fatigue is a common side effect across almost all treatment modalities, making it difficult to determine whether it is due to the underlying cancer progression or the therapy. It is important to communicate any new or worsening systemic symptoms to the oncology care team immediately, as accurate symptom reporting is crucial for proper management.