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How Fast Does Melanoma Spread? Common Sites of Metastasis

Medically reviewed by Leonora Valdez Rojas, M.D.
Posted on May 7, 2024

You may have heard that melanoma is considered the most dangerous type of skin cancer because it tends to metastasize (spread) to other parts of the body. Most types of melanoma can be successfully treated when they’re caught early. However, melanoma is a fast-growing form of skin cancer and can quickly become life-threatening. When melanoma spreads to another part of the body, it’s known as metastatic melanoma.

Continue reading to learn more about metastatic melanoma and where it commonly spreads.

What Is Metastatic Melanoma?

Metastatic melanoma — also known as advanced melanoma — means that melanoma skin cancer has spread to another part of the body from where it started, known as the primary tumor. Cancer that develops in a distant organ from the primary tumor may be referred to as “secondary cancer” or “metastasis.” Metastatic melanoma can occur in stage 3 (when the cancer spreads to lymph nodes or surrounding skin) or stage 4 melanoma (when it spreads to other organs).

More than 4 out of 5 people are diagnosed with melanoma before it spreads to other parts of the body.

How Does Melanoma Spread?

Melanoma starts in the pigment-producing cells of your skin and eyes, called melanocytes. A tumor that starts in one of these cells is known as a melanoma. If cancerous cells from the primary tumor break away, they can spread to other parts of your body through your blood or lymph fluid (clear fluid containing immune system cells). This process is known as metastasis.

Most often, melanoma first spreads regionally — to the skin and lymph nodes around the primary tumor — before spreading to distant sites and organs farther away. Lymph nodes are small, bean-shaped organs found throughout the body that play a role in the immune system.

Risk Factors for Melanoma Spreading

Research has found that some groups have a higher risk of metastatic melanoma, including:

  • Males and people assigned male at birth
  • People with thicker primary tumors — a tumor thickness greater than 4 millimeters
  • People with nodular melanoma, a subtype of melanoma
  • People who have ulceration (open wounds or sores) on the primary tumor

When Does Melanoma Spread?

Between 15 percent and 26 percent of people who are initially diagnosed with early-stage melanoma will later see their cancer spread. If metastasis occurs, it usually does so in the first one to three years after treatment.

Where Does Melanoma Spread?

While melanoma can theoretically spread to any part of your body, some organs are more likely to be affected than others. In people with advanced melanoma, cancer cells often affect multiple organs.

Skin

Melanoma can spread to other parts of your skin or under it to tissue closer to your muscle.

Superficial spreading melanoma — the most common type of melanoma — often spreads to other parts of the skin. As its name suggests, this type of melanoma spreads across the surface of the skin. It’s usually slow-growing and can continue spreading across the same layer of skin for years before it starts to invade other parts of the body. People with lentigo maligna melanoma may also have this type of melanoma for many years before it becomes invasive.

Other types of melanoma can start to invade deeper layers of the skin more quickly, including nodular melanoma and acral lentiginous melanoma.

Lymph Nodes

In people with metastatic melanoma, between 50 percent and 75 percent have melanoma cells in their lymph nodes, according to research cited in Maedica.

Lymph nodes are small organs that help to filter waste from lymph fluid. You have hundreds of lymph nodes all over your body. If tumor cells break off the primary tumor, they can be carried to another location by your blood or lymph fluid. Like other types of cancer, melanoma tends to spread to nearby lymph nodes before it goes to other parts of the body. The regional lymph nodes, those near the original tumor, are the most common site of melanoma metastasis.

The most common symptom of cancer that’s spread to your lymph nodes is swollen or hard lymph nodes, especially in the area close to the primary tumor.

Lungs

Between 70 percent and 87 percent of people with metastatic melanoma experience melanoma spreading to their lungs or the area between their lungs, according to Maedica. Melanoma spread to the lungs has been known to occur more than 10 years after the original melanoma diagnosis.

If melanoma spreads to your lungs, you may notice symptoms such as:

  • New or worsening cough
  • Shortness of breath
  • Coughing up blood
  • Chest pain
  • Fluid around the lungs

Liver

The liver is another common organ that can be affected when melanoma spreads. Between 54 percent and 77 percent of people with metastatic melanoma develop metastasis in their liver, per Maedica. If ocular melanoma (melanoma that affects the eye) spreads to a distant organ, it’s most likely to spread to the liver.

Symptoms of metastatic melanoma that involves the liver include:

  • Loss of appetite and weight loss
  • Stomach pain
  • Extreme tiredness
  • Jaundice (yellowing of the skin or eyes)
  • Swelling of the stomach or legs
  • Itching

Brain

The brain is another organ that melanoma may spread to. Brain metastasis occurs in 36 percent to 54 percent of people with malignant melanoma, according to Maedica. In general, brain tumors due to the spread of melanoma grow quickly.

Possible symptoms of melanoma spreading to the brain include:

  • Headaches
  • Tiredness
  • Memory problems
  • Behavior changes
  • Seizures
  • Hearing or vision changes
  • Trouble swallowing

Bones

Melanoma can also spread to the bones. Between 23 percent and 49 percent of people with metastatic melanoma develop secondary cancer in their bones, according to Maedica. Once melanoma begins to spread, it can invade the bones in a few months.

If you have a bone metastasis, you may have the following symptoms:

  • Aches and pains in your bones
  • Back pain
  • Bones that break easily
  • Changes in your bowel habits
  • Confusion

Other Sites Where Melanoma Can Spread

As previously mentioned, melanoma can theoretically spread to any organ in your body. Other organs that melanoma may spread to include:

  • Digestive tract
  • Heart
  • Adrenal glands
  • Kidneys
  • Spleen

How Do You Know if Melanoma Has Spread?

After you’ve been diagnosed with melanoma, your cancer care team will monitor you for signs and symptoms that may mean your cancer has spread. You may need more frequent monitoring for two to five years following melanoma treatment. As time passes, your cancer care team may recommend monitoring for metastasis less often. Blood tests and imaging tests can help your care team detect malignant melanoma before you feel symptoms.

If you have a high risk of melanoma spreading, you may undergo a procedure called a sentinel lymph node biopsy. This procedure can help to tell whether melanoma has spread to the lymph nodes near your primary tumor. During this procedure, a surgeon will dye and then remove one or more lymph nodes closest to the tumor. You may have this procedure at the same time as melanoma surgery to remove the primary tumor. The removed lymph nodes are sent for testing to see if they have cancer cells.

It’s important to talk to your cancer care team about any new symptoms or symptoms that don’t go away.

Can You Prevent Metastatic Melanoma?

You may not be able to prevent melanoma from spreading to a distant site of your body. However, melanoma treatments are available that can help shrink your tumor or stop or slow your cancer’s growth.

Treatment options for melanoma may include:

  • Surgery
  • Radiation therapy
  • Immunotherapy
  • Targeted therapy
  • Chemotherapy

Once melanoma has spread to other parts of the body, your melanoma treatment options may change. These treatments may be able to control your cancer for months or years.

Talk to your cancer care team about your risk for melanoma spreading and how it can affect your treatment options. You can also ask about joining a clinical trial to try new treatments.

Find Your Team

MyMelanomaTeam is the social network for people with melanoma and their loved ones. On MyMelanomaTeam, members come together to ask questions, give advice, and share their stories with others who understand life with melanoma.

Do you have melanoma that has spread to another part of your body? How did it affect you? Share your experience in the comments below, or start a conversation by posting on your Activities page.

Leonora Valdez Rojas, M.D. received her medical degree from the Autonomous University of Guadalajara before pursuing a fellowship in internal medicine and subsequently in medical oncology at the National Cancer Institute. Learn more about her here.
Amanda Jacot, Pharm.D earned a Bachelor of Science in biology from the University of Texas at Austin in 2009 and a Doctor of Pharmacy from the University of Texas College of Pharmacy in 2014. Learn more about her here.
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