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(Some of these symptoms may have noncancerous causes.) Some parts of the body that may be affected by metastatic melanoma include: Lymph Nodes Symptoms of melanoma that has spread to the lymph nodes may include: Hard lumps under the skin Difficulty swallowing (because of swollen lymph nodes in the neck) Swelling in the neck or face (because of fluid buildup, a condition called lymphedema) Lungs Melanoma that has spread to the lungs can cause the following symptoms: A persistent cough Breathlessness Ongoing chest infections Coughing up blood Fluid buildup between the chest wall and the lung Liver Metastatic melanoma in the liver can cause: Discomfort or pain on the right side of the abdomen Poor appetite and weight loss Abdominal swelling Yellowing of the skin and eyes (jaundice) Itchy skin Bone The following symptoms may indicate metastatic melanoma: Gnawing pain (caused by the breakdown of bone) Worsening backache Weaker bones that break more easily Raised blood calcium, which can cause dehydration, confusion, abdominal pain, and constipation Low levels of blood cells (which are produced in healthy bone but crowded out by cancer cells), which can cause bruising, bleeding, and an increased risk of infection Brain Melanoma that has spread to the brain can cause: Headaches Muscle weakness Seizures Personality or mood changes Eyesight changes Confusion (6) Diagnosis of Metastatic Melanoma During a physical exam, a doctor will examine any suspicious moles or areas of the skin for signs of melanoma, and will ask about possible risk factors

The Phase 2 data proves it: fast escalation to 8 mg doubled GI adverse event rates compared to gradual titration

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