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- Melanoma can involve so many parts of the body that any new symptom should be reported to the doctor.
- • Since the liver and the lung are common sites for tumor cells to lodge and grow after traveling through the
- bloodstream, these organs should be watched carefully at three-month intervals after removal of the primary
- melanoma and more often during treatment of disseminated disease.
- • Liver function tests (especially LDH and alkaline phosphatase) should be done.
- • CT scans of the abdomen with contrast material injected to show the liver should be done every six months.
- MRI or ultrasound examinations of the abdomen are good alternatives. MRI is better than CT for evaluating
- the pelvis.
- • A chest CT scan is preferable to a chest x-ray and can be performed at the same time as an abdominal scan, but
- a chest x-ray can suffice as a screening tool in patients with no known lung metastases. Expense and exposure
- to radiation are major problems with frequent CT scans, even though the scans' ability to detect lesions is far
- better than with routine x-rays.
- • Lumps under the skin, usually colorless or reddish-purple and occasionally black if in the skin, can be felt and
- seen by patients, often during a bath. Lymph nodes under the arms or in the groin can also be felt and/or seen.
- • Brain involvement causing neurologic symptoms is becoming more common as therapy improves for disease
- elsewhere in the body and patients live long enough to allow the slow-growing brain metastases to enlarge.
- Early, single brain metastases can be effectively controlled by surgery or stereotactic radiation. Therefore MRI
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