Controlling symptoms of advanced melanoma skin cancer

Advanced melanoma skin cancer means it has spread from where it started to another part of the body. This can cause symptoms. The symptoms can depend on where in the body the cancer has spread to. 

It is possible to control many of the symptoms.

Treatment to help shrink the cancer

Treatments can sometimes help to shrink the melanoma. This includes:

• targeted cancer drugs
• immunotherapy
• radiotherapy
• chemotherapy

This may reduce symptoms and help you feel better. Other treatments can treat specific symptoms.

Pain

You might have pain in the area of the cancer but not everyone does. Painkillers can usually control pain well. 

There are many different painkillers and ways of taking them. Your doctor and nurse can help you to be pain free most of the time. 

You and your friends or relatives can do things to help reduce the pain. Complementary therapies such as relaxation and massage may help.

Tiredness and feeling unwell

Tiredness (fatigue) is a common symptom of advanced cancer. You may feel that you lack energy, and this can be overwhelming. 

Let your doctor or nurse know if you’re very tired, as they can prescribe medicines or other treatments to help. For example, a blood transfusion can give you more energy if you’re tired due to anaemia (low red blood cell levels).

Resting

It’s important to rest a few times throughout the day. Resting regularly can help you feel less tired and more able to cope. You don't have to sleep during these times. Just sitting or lying down will help. 

Exercise

Exercising can be hard when you feel very tired. But research shows that daily light to moderate exercise can give you more energy. You can try a short walk if you can manage it. Gentle exercises in bed or standing up can help if you can’t move around easily. 

Your hospital physiotherapist might be able to help you plan an exercise programme that suits your needs.  

Sleeping

You might feel more tired if you have trouble sleeping at night. It can help to change a few things about when and where you sleep.

Loss of appetite

You might not feel like eating and may lose weight. There can be different reasons for this. But it is important to drink plenty and try to eat when you can.

Talk to your healthcare team if you have lost your appetite. They might be able to help. For example, they can give you medicine to help stop you feeling sick.

Tips:

• Eating several small meals and snacks throughout the day can be easier to manage.

• Ask your doctor or dietitian to recommend high calorie drinks to boost your calorie intake.

• Eat whatever you feel like eating rather than what you think you should eat.

• Drink plenty even if you can't eat.

• Don't fill your stomach with a large amount of liquid before eating.

• Try to eat high calorie foods to keep your weight up.

Bowel problems

Cancer can cause bowel problems such as diarrhoea or constipation. They can also be caused by cancer treatments or other medicines. For example, painkillers commonly cause constipation. 

Talk to your doctor or nurse if you have bowel problems. They can help by giving you medicine. And they can refer you to a dietitian for advice on what to eat or drink. 

Feeling or being sick

Anti sickness medicines can usually help to control this. There are different types of anti sickness medicine and they work in different ways. 

Tell your doctor or nurse if you still feel sick so they can find a medicine that’s right for you. Tell them what helps and what makes the sickness worse.

Sickness is sometimes caused by fluid building up in the stomach. Putting a tube into the stomach to drain this fluid can ease the sickness and help you feel better.

Tips to reduce sickness

• Eat several small meals and snacks each day if possible.

• Don't drink much just before eating.

• Relaxation techniques help some people control their sickness.

• Ginger can help - try it as crystallised stem ginger, ginger tea or ginger ale.

• Peppermint can help - use a few drops of peppermint oil on a diffuser. You can also try peppermint tea or sucking on mint.

• Try sipping fizzy drinks.

• Drink high calorie drinks if you can't eat.

Breathlessness

You might feel breathless if the cancer has spread to your lungs or if you have low red blood cell levels (anaemia). You can learn breathing techniques that can help. You might need a blood transfusion to give you red blood cells if you have anaemia.

Tell your doctor or nurse if you feel breathless. They can prescribe medicines to make your breathing easier.

Swollen tummy (ascites)

You might have a swollen tummy (abdomen) if your cancer has spread to the liver. The swelling is due to a build up of fluid called ascites. It can make your clothes feel tighter. Your tummy might feel bloated. You might also find it difficult to sit comfortably or to move around. Ascites can make you feel breathless, especially when lying flat.

Your doctor can drain off the fluid by putting a small, flexible tube into the abdomen. This helps you to feel more comfortable.

Other symptoms

You might have other symptoms depending on where the melanoma has spread to.

Help with controlling symptoms

Your doctor or specialist nurse can:

• give you medicines

• help you to get the equipment that you need

• suggest other ways of controlling your symptoms

• refer you to a symptom control team (a palliative care team)

Symptom control team

There are symptom control teams in most cancer units. They can help you to stay as well as possible for as long as possible. They are also in hospices and many general hospitals.

Most symptom control teams have home care services so they can visit you at home.