All cancer treatments have the potential to cause side effects. Which side effects you experience will depend on the type of melanoma treatment you receive. Your oncologist (cancer specialist) will do their best to balance the benefits of treatment with any potential side effects you may experience.

This article will explain nine of the most common side effects you may experience from certain melanoma treatments. Be sure to discuss any side effects with your cancer care team. They can help you find ways to feel better.

1. Headache

People with melanoma may experience headaches for several reasons. Some types of melanoma treatment — including immunotherapy, chemotherapy (chemo), and targeted therapy — are known to cause headaches.

For example, one type of targeted therapy called BRAF inhibitors may cause headaches as a potential side effect. This includes dabrafenib (Tafinlar), encorafenib (Braftovi), and vemurafenib (Zelboraf). Chemotherapy, immunotherapy, and radiation therapy given for stage 4 melanoma that has spread to the brain may also give you headaches.

Other causes of headaches in people living with cancer include:

• Lack of sleep
• Increased stress levels
• Infections
• Other medications used to treat cancer-related symptoms

2. Skin Reactions

Several melanoma treatments are known to cause skin-related side effects.

Targeted therapies like the BRAF inhibitor vemurafenib can cause:

• Increased sensitivity to sunlight
• Rashes on the upper body and face
• New skin growths, including nonaggressive skin cancers
• Rough or bumpy rashes on the arms and thighs
• Skin changes on the palms of your hands and soles of your feet, including peeling, cracking, burning, or blistering

Immunotherapies can also cause skin-related side effects, although they’re less common compared to other melanoma treatments. Examples include:

• Cracked, peeling, or painful skin
• Rashes
• Blisters
• Skin discoloration
• Purpura (purple, red, or brown spots)

Radiation therapy uses intense beams of radiation to kill melanoma cells. While the radiation is mainly targeted at the melanoma lesion (tumor), it can also damage the skin cells around it. Side effects of radiation therapy can include skin itching, peeling, blistering, and dryness around the treated area. These side effects usually go away within a few weeks after your final treatment.

3. Infusion-Related Reactions

Immunotherapy drugs are lab-engineered proteins that activate your immune system to fight cancer cells. Immunotherapy is given intravenously (through a vein), via IV infusion. Some people experience infusion-related reactions shortly after or during their infusion with an immunotherapy. This is because the immune system can overreact to the drug and try to fight it as if it’s an invading bacteria or virus.

Infusion-related reactions can look similar to allergic reactions and may cause:

• Chills
• Fever
• Dizziness
• Itchy skin or a rash
• Shortness of breath or wheezing
• Flushing

Some people experience infusion-related reactions immediately, while others may develop a reaction days or weeks later. If you begin experiencing signs of an infusion-related reaction, make sure to let your nurse or a member of your cancer care team know.

4. Gastrointestinal Side Effects

Melanoma treatments can also cause a host of gastrointestinal (GI) side effects. Some treatments — like chemo — target rapidly dividing cells in the body. Chemo is very effective at killing cancer cells, but it also harms the cells lining your digestive tract. This is why many people undergoing chemo experience symptoms like:

• Nausea
• Vomiting
• Loss of appetite
• Constipation or diarrhea

Immune checkpoint inhibitor (ICI) drugs like nivolumab (Opdivo) and ipilimumab (Yervoy) can cause GI symptoms — including nausea, vomiting, and abdominal pain. These therapies are also known to sometimes cause colitis or inflammation along the lining of the colon. As a result, you may experience diarrhea while taking an ICI.

If you’re experiencing any GI side effects, it’s important to let your cancer care team know. If they’re left untreated, you may not get enough nutrients or become dehydrated.

5. Hair Loss

Many people undergoing cancer treatment experience hair loss. Hair follicles grow and divide quickly — meaning many cancer treatments will negatively affect them. It’s important to note that hair loss varies from person to person, even if you have the same melanoma treatment as someone else.

Hair loss tends to occur on the scalp for people treated with chemotherapy and targeted therapies. You may notice your hair start to fall out within two or four weeks of starting chemotherapy. On the other hand, targeted therapies like BRAF and MEK inhibitors may cause hair loss within three to 15 weeks of treatment.

Chemo and radiation therapy can also make your hair thinner and more brittle than it was before treatment. People undergoing chemo also note that their scalp tends to be more sensitive or painful.

Radiation therapy can also cause hair loss. However, it usually occurs only around the area of treated skin. You’ll only lose hair from your scalp if you’re receiving radiation therapy to your head.

In most cases, hair grows back after you finish treatment. However, some people may experience permanent hair loss. You can take steps during treatment — like using a scalp cooling cap during chemo — to help prevent hair loss during your melanoma treatment.

6. Fatigue

Fatigue associated with advanced melanoma and cancer treatment is worse than simply feeling tired. The American Society of Clinical Oncology (ASCO) describes cancer-related fatigue as “a feeling of physical, emotional, and mental exhaustion, even after getting enough rest and sleep.”

Cancer-related fatigue may be caused by your melanoma or its treatments. Fatigue affects everyone differently, and you may experience different symptoms compared to another person. The timing of your fatigue can also vary depending on your treatment. According to ASCO, fatigue can start:

• A few days after treatment with chemotherapy
• A few weeks after radiation therapy
• A few months after immunotherapy treatment

Fatigue can also come from the physical effects of treatment. For example, chemotherapy can drop your red blood cell levels, causing a condition known as anemia. People with anemia can feel extremely fatigued because they’re not getting enough oxygen to meet the body’s needs.

7. Eye Problems

The tissues in your eyes can be very sensitive to cancer treatment, including radiation therapy, chemotherapy, and immunotherapy.

If you’re receiving radiation therapy to treat a brain tumor from melanoma or uveal melanoma in the eye, you may experience eye problems. These can include dry, gritty, or watery eyes, blurry vision, and even vision loss.

Melanoma medications like chemotherapy and immunotherapy can also cause:

• Painful inflammation of the eyelids
• Dry or watery eyes
• Spots or floaters in your vision
• Cloudy vision from cataracts

8. Joint and Muscle Pain

Some melanoma treatments can also cause uncomfortable side effects like joint and muscle pain.

Joint pain affects the connections between your bones. In addition to pain, you may also experience swelling and stiffness that make it difficult to move your joints. Commonly affected areas include your knees, hips, hands, and feet. Certain types of chemotherapy and immunotherapy are known to cause joint pain.

Some people experience muscle aches during treatment with chemotherapy, radiation therapy, or immunotherapy. Others don’t experience this side effect until months or years after their treatment ends.

9. Lymphedema

Some people with melanoma have surgery to remove the lymph nodes near their tumor. Lymph nodes are small, bean-shaped lumps found throughout the body that contain immune cells. When doctors remove lymph nodes near melanomas, it helps stop the cancer from spreading.

However, lymph node removal can also lead to a long-term complication known as lymphedema. Lymphedema is swelling that occurs when fluid and fat build up where the node is removed. Some people develop lymphedema after radiation therapy.

The location of lymphedema depends on where the lymph node sample was biopsied (removed). For example, lymph nodes removed from the groin can lead to lymphedema in the legs. Those removed from the underarm (armpit) can cause symptoms in the arms.

Symptoms of lymphedema to look out for include:

• New swelling
• Numbness or tingling
• Heaviness in the arms or legs

Talk With Others Who Understand

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.

What side effects have you experienced during your melanoma treatment? Have you found effective ways to manage them? Share your experience in the comments below, or start a conversation by posting on your Activities page.