The lungs are a common site of metastasis in conjunctival melanoma patients. These are usually picked up by an X-ray or CT scan.
Initially they may be unproblematic to the patient, but if they multiply or increase in size, they can cause symptoms such as coughing, pain in the chest and back, and shortness of breath.
Resection, radiofrequency ablation and stereotactic radiosurgery are all options which the thoracic surgeon and medical/clinical oncologist will consider.
Brain metastases can cause weakness, difficulty walking, headaches, nausea, and blurred vision. More serious symptoms include seizures and changes in the patient’s alertness, mental capacity, speech or personality.
Brain tumours can be treated with stereotactic radiosurgery and stereotactic resection, depending on what the neurosurgeon and medical/clinical oncologist decides is appropriate.
Liver surgery is best for patients with small numbers of tumours and easiest if only one side of the liver is involved, however even very large lesions may be removed if there is enough clear and healthy liver that can be left behind.
Liver surgery can be done as “open” surgery or “keyhole” surgery, depending on the individual case. The results are the same for the two types of surgery, but recovery is usually faster with keyhole surgery.
There are other liver-directed therapies which could be useful, such as radiofrequency ablation (RFA) or micro wave ablation (MWA) and chemoembolisation (TACE).
The liver surgeon and interventional radiologist will work with the medical/clinical oncologist on the best treatment plan.
Skin metastases generally develop as non-painful nodules that can be firm or mobile, rubbery or hard. They can form in any size and may be skin-coloured, red, blue or black.
Skin metastases can be treated regionally if appropriate. They can be removed surgically, frozen with cryotherapy, or killed with lasers.
Bone metastases can cause considerable pain if left untreated. Radiating the tumours will not kill them, but can halt the pain they cause, so this is often a good alternative to painkilling drugs.
If patients need more aggressive therapy, cryoablation and embolisation are available
Metastases can appear anywhere in the gastro-intestinal tract, but are most common in the small intestine. The symptoms patients experience will depend on the location of the tumours, but include; pain, diarrhoea, bleeding (including tarry stools), anaemia and vomiting.
GI metastases can often be successfully removed with surgery.