What are the symptoms of metastatic uveal melanoma?

Uveal melanoma is a type of cancer that begins in the middle layer of the eyeball, called the uvea. It is the most common type of cancer that occurs inside the eye, though overall, it is much less common than other types of cancer. Though it is a type of melanoma, it is a different condition than the melanomas that are skin cancers.

In the early stages, uveal melanoma may not cause noticeable symptoms, and may only be found during an eye examination. As the cancer grows, it can begin to cause various symptoms that affect a person’s vision.

It is common for uveal melanoma to metastasize and spread to other parts of the body. As many as half of people who have this type of cancer will experience metastasis. Metastatic uveal melanoma can cause different symptoms depending on where the cancer has spread.

What are the symptoms of uveal melanoma?

Uveal melanoma can cause changes in vision and changes in the appearance of the eyes. These symptoms can include:

• Blurred vision
• Poor vision in one eye
• Reduced peripheral vision and/or field of vision
• Floaters, which can look like dark specks, cobweb-like structures, or flashes
• A dark spot on the iris (the colored part of the eye) that grows in size
• Changes to the size and/or shape of the pupil
• Changes to the color of the iris
• Eyes that bulge or protrude from the socket
• Pain, pressure, or discomfort in the eye

Many of these symptoms can also be caused by more common eye disorders, but the only way to know what is causing a problem with the eyes or vision is to visit a healthcare provider for an exam and evaluation.

What are the symptoms of metastatic uveal melanoma?

As mentioned above, it is common for uveal melanoma to metastasize. Metastasis occurs when the cancer grows into blood vessels and lymph vessels. From there, cancer cells travel through the blood and lymphatic system and form tumors in other parts of the body.

The most common site for uveal melanoma to metastasize is the liver—up to 90 percent of cases of metastatic uveal melanoma involve the liver. Metastasis to the lungs and bones are also common. Less commonly, uveal melanoma spreads to the lymph nodes and brain.

Symptoms of metastatic uveal melanoma depend on the site in the body where the cancer has spread, but may include:

• Pain, including bone pain, muscle pain, back pain, and abdominal pain
• Fractures (broken bones)
• Persistent fatigue, weakness, or tiredness
• Swelling or fluid retention, such as swelling in the legs or abdomen
• Unexplained and unintentional weight loss
• Loss of appetite or other changes in eating habits
• Difficulty breathing, shortness of breath, coughing, chest pain
• Problems with digestion, including constipation, bowel and/or bladder incontinence, or difficulty urinating
• Jaundice (yellowing of the whites of the eyes and the skin)
• Headaches and/or neurological problems
• Changes in the skin, such as lumps or skin lesions that may be painless
• Fever
• Skin itching

In most cases (but not all), metastasis occurs after a person has been diagnosed with uveal melanoma in the eye. Reducing the risk of metastasis and monitoring for metastasis are important aspects of treatment.