# Cancer question **URL:** \ **Category:** Factual Questions\ **Created:** [June 29, 2005, 3:44pm UTC](https://boards.straightdope.com/t/cancer-question/310369 "2005-06-29T15:44:37Z")\ **Posts on this page:** 10\ **Page:** 1
**Author:** ![scr4](https://avatars.discourse-cdn.com/v4/letter/s/59ef9b/32.png) [@scr4](https://boards.straightdope.com/u/scr4)\ **Post date:** [June 29, 2005, 3:44pm UTC](https://boards.straightdope.com/t/cancer-question/310369/1 "2005-06-29T15:44:37Z")
This is _not_ a request for medical advice. I found out someone I know was diagnosed with cancer, and I want to get some idea of what’s going on based on what little second-hand information I have. All I know was that this person was diagnosed with melanoma (yes, I know that alone means “pretty serious”), but the primary site was not found. Does this likely mean it has metastasized already, and melanoma cells were found elsewhere in the body? Any speculation on prognosis? ---
**Author:** ![Philster](https://avatars.discourse-cdn.com/v4/letter/p/13edae/32.png) [@Philster](https://boards.straightdope.com/u/Philster)\ **Post date:** [June 29, 2005, 4:19pm UTC](https://boards.straightdope.com/t/cancer-question/310369/2 "2005-06-29T16:19:32Z")
You have to look at melanoma as the starting point. Okay, someone has melanoma. The dangerous thing about it is that melanoma is very likely to metastasize. It can be found on various parts of the skin…different areas, but I don’t believe that means it metastasized – the skin is one organ. If cancer shows up somewhere else, other than the skin, then it has metastisized (unless it is a huge coincidence that say liver cancer developed on its own simultaneously). ---
**Author:** ![jim\_marren\_yahoo.com](https://avatars.discourse-cdn.com/v4/letter/j/d26b3c/32.png) [@jim\_marren\_yahoo.com](https://boards.straightdope.com/u/jim_marren_yahoo.com)\ **Post date:** [June 29, 2005, 4:26pm UTC](https://boards.straightdope.com/t/cancer-question/310369/3 "2005-06-29T16:26:16Z")
usually the melanoma is surgically removed and then may or may not be treated with radiation it might not be that bad, but you never know ---
**Author:** ![scr4](https://avatars.discourse-cdn.com/v4/letter/s/59ef9b/32.png) [@scr4](https://boards.straightdope.com/u/scr4)\ **Post date:** [June 29, 2005, 6:36pm UTC](https://boards.straightdope.com/t/cancer-question/310369/4 "2005-06-29T18:36:17Z")
Thanks, but what I’m really confused about is “no initial site found” - at least I think that’s what I was told. How does that happen, and if it isn’t found, how would they diagnose melanoma? ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [June 29, 2005, 6:49pm UTC](https://boards.straightdope.com/t/cancer-question/310369/5 "2005-06-29T18:49:25Z")
Sounds like a bad situation. Finding melanoma in an obvious metastasis rather than at a primary skin site means the cancer has spread. Excision alone is no longer a viable treatment. Chemo and possible radiation would probably be called for along with possible debulking, interferon, etc. etc. It is not unusual to find melanoma by metastasis but not find the primary skin lesion. Sometimes the primary lesion resolves after the cancer has spread. I wish we knew why it happens, so we could use it to treat patients. Melanoma that has already spread is difficult to treat and results in death far more often than not. Sorry. ☹ ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [June 29, 2005, 7:04pm UTC](https://boards.straightdope.com/t/cancer-question/310369/6 "2005-06-29T19:04:38Z")
Oh, and essentially you diagnose melanoma in a metastasis by looking under the microscope and seeing lots of melanoma cells in the tumor. ---
**Author:** ![Earl\_Snake-Hips\_Tucker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/earl_snake-hips_tucker/32/3269_2.png) [@Earl\_Snake-Hips\_Tucker](https://boards.straightdope.com/u/Earl_Snake-Hips_Tucker)\ **Post date:** [June 29, 2005, 7:54pm UTC](https://boards.straightdope.com/t/cancer-question/310369/7 "2005-06-29T19:54:41Z")
How does that differ from looking at the primary site? ---
**Author:** ![alice\_in\_wonderland](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/alice_in_wonderland/32/176_2.png) [@alice\_in\_wonderland](https://boards.straightdope.com/u/alice_in_wonderland)\ **Post date:** [June 29, 2005, 8:05pm UTC](https://boards.straightdope.com/t/cancer-question/310369/8 "2005-06-29T20:05:49Z")
> [@Earl Snake-Hips Tucker](#): > > How does that differ from looking at the primary site? Well, it think the mets can be anywhere - like in a lung or a liver or a brain or whatever. If they did a biopsy of a growth in such a site, and found a boat-load of melanoma cells, they would know that it was a met, as opposed to a primary cancer. I think… ---
**Author:** ![scr4](https://avatars.discourse-cdn.com/v4/letter/s/59ef9b/32.png) [@scr4](https://boards.straightdope.com/u/scr4)\ **Post date:** [June 29, 2005, 8:22pm UTC](https://boards.straightdope.com/t/cancer-question/310369/9 "2005-06-29T20:22:16Z")
Damn. That’s what I was afraid of. ☹☹ But thanks for the straight answer. ---
**Author:** ![Pazu](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pazu/32/15522_2.png) [@Pazu](https://boards.straightdope.com/u/Pazu)\ **Post date:** [June 29, 2005, 10:57pm UTC](https://boards.straightdope.com/t/cancer-question/310369/10 "2005-06-29T22:57:14Z")
> [@alice\_in\_wonderland](#): > > Well, it think the mets can be anywhere - like in a lung or a liver or a brain or whatever. If they did a biopsy of a growth in such a site, and found a boat-load of melanoma cells, they would know that it was a met, as opposed to a primary cancer. I think… That is essentially correct. Trouble with melanoma is that, besides the “unknown primary site” problem that **Qadgop** mentioned, it can metastasize to just about any site imaginable. Without a known cutaneous primary, you’d also want to do a few confirmatory immunohistochemical stains (e.g. HMB45, MART-1) to confirm the diagnosis of melanoma as well, since melanoma cells can often mimic primary carcinomas in appearance.