Caregivers know better than anyone that the biggest challenges are often difficult to prepare for. These can include overwhelming health diagnoses, such as melanoma. If the person you care for is at risk for or has been diagnosed with metastatic melanoma -- stage III or especially IV of the skin cancer -- you no doubt have many questions running through your head, all while trying to remain emotionally intact. Below are answers to five common questions you may have about what to expect when caring for someone with metastatic melanoma.
You may also be interested to read some facts and statistics about metastatic melanoma here.
1. The person I care for is at high risk for melanoma. What can I do to help prevent him from ever being diagnosed with stage IV of the cancer?
The number-one thing you can do to prevent metastatic melanoma is to catch it early, and monthly skin exams are one way to do this. If your loved one is able to perform skin checks, you can remind him to do it every month. Physically help him with hard-to-see places, such as the scalp or soles of the feet. If he is unable to perform a self-check, you can do it for him. Things to look for are abnormalities in or new appearances of moles or blemishes. You can also ensure that a skin exam is part of any routine health exam he receives.
2. If the person I care for is diagnosed with melanoma, how will we know if it has metastasized (spread to other parts of the body)?
After a skin biopsy has come back positive for melanoma, "staging" is the process used to see how far it has progressed (stages 0 to IV). Several different procedures may be done to determine the stage. They include:
- A physical exam
- Lymph node mapping (tracking a radioactive/blue dye injected near the tumor)
- A CT or CAT scan (computed tomography scan)
- A PET scan (positron emission tomography scan)
- An MRI (magenetic resource imaging)
- Blood chemistry studies
3. How will metastatic melanoma physically affect my loved one?
In addition to the emotional effects of receiving a late-stage cancer diagnoses, there are physical symptoms associated with melanoma and its possible treatments. Some of them include:
- Pain (either localized or all over the body)
- Ulceration, or broken and bleeding skin tumors
- Weight loss, as well as possible loss of appetite
- Diarrhea or constipation
- Nausea, often due to bowel issues, dehydration, or a chemical imbalance
- Difficult or noisy breathing, if melanoma has spread to the lungs
4. What are the treatment options for metastatic melanoma?
There are multiple drug therapies available for stage IV melanoma. They include biologic therapy, to boost the immune system's ability to fight cancer cell growth, and targeted therapy, to attack and kill cancer cells directly. Chemotherapy is another drug treatment to kill cancer cells and stop them from replicating, but it can cause more harm to healthy cells than targeted therapy. Radiation therapy and surgery are generally used only as palliative therapy to lessen pain or improve quality of life.
There are also various treatments for metastatic melanoma currently undergoing clinical trial, which may be another option for your loved one. You can search the National Cancer Institute's website for a clinical trials open for enrollment: http://www.cancer.gov/clinicaltrials/search.
5. How can I provide the best care for my loved one if she has metastatic melanoma?
In addition to being familiar with the physical symptoms that may accompany metastatic melanoma, one of the most important things you can do for your loved one is to talk to her about her wishes in preparation for the coming weeks, months, or years. Is she open to certain treatments but not others? Some older adults opt out of treatment altogether, particularly if it would affect where and how they will be cared for, while others want all treatments available.
While this may be one of the most emotionally challenging things to do as a caregiver, it will be even harder if the melanoma progresses to the point where your loved one is no longer capable of logical thought or coherent expression, and you are left to either make the decisions on your own or come to agreement with other family members.