Advanced melanoma: what it means and what you can do next

Hearing “advanced melanoma” is scary. You probably want clear steps, not medical jargon. This page explains what advanced melanoma means, which tests matter, main treatment paths, and practical actions you can take right away.

Telling the difference and the tests to expect

Advanced melanoma usually means the cancer has spread beyond the original skin spot—often to lymph nodes or other organs. Your oncology team will order imaging (CT or PET scans) and a biopsy to confirm spread and check for mutations. The single most useful lab test is BRAF mutation testing: if your tumor has a BRAF V600 mutation, targeted drugs may work well. You may also get an MRI of the brain if there are symptoms like headaches or balance problems.

Treatment options in plain language

There are three main approaches: immunotherapy, targeted therapy, and local treatments. Immunotherapy drugs (checkpoint inhibitors) help your immune system find and kill cancer cells. Many people with advanced melanoma get medicines such as pembrolizumab or nivolumab. Targeted therapy attacks tumors with specific mutations—if you have a BRAF mutation, combinations like dabrafenib plus trametinib can shrink tumors quickly.

Local treatments—surgery, radiation, or isolated limb perfusion—are used when one or a few spots cause symptoms. For brain metastases, stereotactic radiosurgery is common. Often treatments are combined or sequenced based on how you respond.

Clinical trials are worth asking about. New drug combos and approaches appear regularly, and early-phase trials may be an option if standard treatments aren’t working.

Side effects vary: immunotherapy can cause immune-related inflammation (skin, thyroid, lungs, gut) that needs prompt treatment with steroids. Targeted therapy side effects often include fever, skin changes, and fatigue. Always tell your team about new symptoms early—many side effects are reversible if treated quickly.

Practical tips that help right away:

• Bring a list of medications and allergies to every visit.
• Ask if molecular testing (BRAF, NRAS, others) has been done.
• Request a copy of imaging reports and compare over time.
• Get a second opinion at a melanoma center if you feel unsure.
• Talk to a nurse or navigator about financial help and transportation.

Watch for warning signs that need urgent care: sudden shortness of breath, severe headache with vomiting, sudden weakness, or seizures. These can signal complications like blood clots or brain involvement.

You don’t have to manage this alone. Ask your oncologist about supportive care (pain, nausea, mood), connect with local melanoma support groups, and consider a clinical trial if recommended. Clear communication with your care team helps you get the right tests and the right treatments at the right time.