Treatment for melanoma can cause side effects, including weight loss, fatigue, nausea, diarrhea, constipation, low blood counts and an increased risk of infection. These side effects can inhibit your ability to stay nourished and interfere with treatment.
People with melanoma experience pain symptoms differently. This depends largely on the staging of their melanoma and the type of treatment they are receiving. Pain will present itself differently in patients who have advanced melanoma, as it can spread to almost anywhere in the body, but most commonly the lungs, liver, bones, brain, abdomen or lymph nodes. Having advanced cancer doesn’t always mean that you will have pain. But sometimes it can. This can be very hard to cope with. There is a lot that can be done to help control the pain caused by advanced cancer.
Fatigue means extreme tiredness. It can affect you mentally, physically, emotionally and spiritually. Everyday life becomes hard work and you may find yourself not having enough energy to cook, eat, clean, bath, or go shopping. You may even find it hard to talk to your friends and family. Many people with cancer suffer from this symptom.
Lymphedema is the build-up of lymph fluid in the body’s tissues due to damage in the lymphatic system. It occurs when the lymph system cannot remove the fluid it normally does from the tissue. This build-up causes abnormal swelling, often of an arm or leg. Lymphedema can be primary or secondary.
Secondary lymphedema is a complication that can occur after cancer treatments (e.g. surgery, lymph node removal, radiation therapy). Lymphedema is usually seen in the part of the body that had the specific cancer treatment. Secondary lymphedema is the most common type of lymphedema in North America .
With melanoma, the following can increase the risk of developing lymphedema :
- the removal of the lymph nodes in the armpit or the groin
- radiation therapy to the lymph nodes
- limb perfusion or infusion therapy
- spread of cancer to the lymph nodes
To find out more information on lymphedema in melanoma patients and how to manage it, please check out the guide by the Melanoma Network.
Post-surgical limited range of motion and/or axillary web syndrome
Dependent on type and location of the surgery performed, melanoma patients can suffer from a limited range of motion post-surgery. If you are experiencing a limited range of motion, consult with your surgeon or clinician for advice on exercises and therapies you can perform to improve your range of motion.
Axillary web syndrome (AWS), also known as cording, sometimes develops as a side effect of sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Both procedures involve removing just a few (SLNB) or many (ALND) of the axillary, or underarm, lymph nodes. If you develop axillary web syndrome, you’ll often be able to see and/or feel a web of thick, rope-like structures under the skin of your inner arm. Lymphedema therapists often call these “cords.” The cords tend to be painful and tight, making it difficult for you to lift your arm any higher than your shoulder or extend the elbow fully. This pain and limited range of motion can have a major impact on your day-to-day life .
Bowel problems such as diarrhoea and constipation are common in the more advanced stages of cancer. These problems may happen because of the changes your melanoma is causing to your body. Or they may happen because of side effects from cancer treatments and other drugs such as painkillers. Whatever the cause, this can sometimes be difficult to control, but there are things that can be done to help.
Shortness of breath
Shortness of breath may be called dyspnoea (pronounced disp-nee-a) by a clinician or nurse. Shortness of breath happens when your lungs are not taking in enough oxygen. Your heart cannot then pump enough oxygen to your body in your blood. If your melanoma has spread to your lungs you may have problems with breathing.
Signs that you are breathless can include:
- Having difficulty catching your breath
- Noisy breathing
- Taking very fast, shallow breaths
- An increase in your pulse rate
- Chest pain
- Skin looking pale and slightly blue, especially around your mouth
- Cold, clammy skin
- Flaring nostrils when you breathe in
- Using your shoulders and the muscles in your upper chest to help you breathe
While being very short of breath is not usually dangerous or harmful, it can make you feel very anxious and panicky, which often makes it even harder to catch your breath. Being short of breath can have a big impact on how much you can do each day. You may be too breathless to shower, cook, or even eat.
While the list here is not exhaustive, if symptoms from the melanoma or treatment are manifesting themselves be sure to document it and let your clinician know. Cancer is challenging enough as it is, there is no need to endure a symptom in silence that could otherwise be treated.
 “Supportive Care for Melanoma.” Canadian Cancer Society. Canadian Cancer Society, 2015. Web. 20 July 2015.
 “Axillary Web Syndrome (Cording).” Breastcancer.org. Breast Cancer Dot Org, 2015. Web. 20 July 2015.
 “Coping with the Symptoms of Advanced Melanoma.” Cancer Research UK. Cancer Research UK, 2015. Web. 20 July 2015.