Diagnosis and Symptoms of Melanoma
Symptoms of Melanoma
General symptoms of advanced melanoma can include one or more of the following3:
- Hard or swollen lymph nodes
- Unexplained pain
- Unexplained weight loss
- Hard lump on the skin
- Extreme tiredness or feeling unwell
- Jaundice (yellowing of eyes and skin)
- Ascites (fluid build-up in the abdomen)
- Abdominal pain
- Cough that doesn’t go away
- Feeling out of breath
Melanoma Diagnosis
Your doctor will arrive at your diagnosis following a physical exam and a biopsy. A biopsy is when your doctor takes cells or tissues to view under a microscope.1
A physical exam includes collecting your health history and examination of your skin to look for signs of melanoma. If your doctor finds something of concern, he may take a sample of your skin for testing (a biopsy). By looking at the cells under a microscope, doctors can tell if it is cancer. If the mole or lesion is cancer, other tests may be done to check for gene changes in the cancer.1 Information from the biopsy can help doctors decide how to treat the cancer.4
Types of biopsy include:1
- Shave biopsy
- Punch biopsy
- Incisional biopsy
- Excisional biopsy
Your doctor can tell you more about these, which one they will perform, and why.
Biopsy
Pathologists then collect a host of information about your skin sample including the thickness of the melanoma, the presence or absence of ulceration, the speed at which the cells are multiplying, presence of other immune cells within the sample, margin status (indicative of whether the cancer cells are seen at the deep/peripheral sides of the sample), and presence or absence of certain marker proteins. All of these parameters help the pathologist identify the type/sub-type of melanoma.5
Sentinel Lymph Node Biopsy
Your doctor may also perform a sentinel lymph node biopsy (SLNB or SNB or lymphatic mapping). This is done during surgery and is used to see if the cancer has spread to 1 or more lymph nodes near the tumor. This information helps your doctor stage the tumor and plan your treatment.1
Other tests
You may be referred to a specialist(s) after an initial diagnosis. Your doctor may also order more tests that can include an ultrasound, computed tomography (CT or CAT) scan, magnetic resonance imaging (MRI), and/or positron emission tomography (PET) or PET-CT scan. All these will be done to further visualize your tumor(s) and check if the cancer has spread to other parts of your body.4
References
- National Cancer Institute. Melanoma Treatment (PDQ)-Patient Version. https://www.cancer.gov/types/skin/patient/melanoma-treatment-pdq#_67
- National Cancer Institute. Melanoma (PDQ)-HCP Version. https://www.cancer.gov/types/skin/hp/melanoma-treatment-pdq
- Cancer Research UK. Symptoms of Advanced Melanoma. Reviewd 01/30/2025. https://www.cancerresearchuk.org/about-cancer/melanoma/advanced-melanoma/symptoms-advanced-melanoma
- Mayo Clinic. Diagnosis and Treatment. December 30, 2023. https://www.mayoclinic.org/diseases-conditions/melanoma/diagnosis-treatment/drc-20374888
- Cancer.Net. Melanoma: Diagnosis. https://www.cancer.net/cancer-types/melanoma/diagnosis
- National Cancer Institute. Sentinel Lymph Node Biopsy. https://www.cancer.gov/about-cancer/diagnosis-staging/staging/sentinel-node-biopsy-fact-sheet
All URLs accessed on May 17, 2025
