Melanoma, Dizziness, and When to Seek Urgent Care

Dizziness or lightheadedness can occur in people with melanoma for several reasons, ranging from treatment side effects to more serious complications like brain metastases or anemia. While occasional mild dizziness may have benign causes, persistent, worsening, or severe lightheadedness can signal an urgent problem that needs prompt medical evaluation. ^{[1] [2]}

---

How Melanoma Can Lead to Dizziness

• Brain metastases (spread to the brain): Melanoma is one of the cancers most likely to spread to the brain, where tumors can press on brain tissue and disrupt functions that control balance and coordination. Symptoms may include headaches, personality or mental changes, seizures, vision changes, weakness or numbness, trouble speaking, and loss of balance; dizziness/lightheadedness often accompanies these changes. ^{[2] [3]}

• Cancer- or treatment-related anemia: Cancer and its treatments can lower blood counts. Anemia reduces oxygen delivery to the brain and can cause dizziness, lightheadedness, fatigue, and pallor; symptomatic or clinically severe anemia may require urgent evaluation and treatment such as transfusion or erythropoiesis‑stimulating agents, depending on guideline‑based indications. ^{[4] [5]}

• Side effects of immunotherapy or targeted therapy: Modern melanoma treatments (like checkpoint inhibitors and BRAF/MEK inhibitors) can cause dizziness or lightheadedness, either directly or indirectly through issues such as dehydration, low blood pressure, or inflammation of organs (for example, endocrine glands). Treatment guides advise contacting the oncology team urgently if dizziness is severe, persistent, or occurs with other warning signs (chest pain, shortness of breath, uncontrolled vomiting, or severe headache). ^{[1] [6]}

• Dehydration and orthostatic hypotension: Cancer therapies or diarrhea can lead to dehydration and drops in blood pressure when standing. This can cause lightheadedness that improves with hydration and getting up slowly, but persistent symptoms still warrant medical review to rule out other causes. ^{[7] [8]}

• Paraneoplastic neurologic syndromes: Rarely, immune reactions linked to cancer can affect the nervous system. These syndromes can impair coordination and balance and present with dizziness among other neurological symptoms, and they require prompt assessment because early diagnosis helps prevent permanent nerve damage. ^{[9] [10]}

---

When Persistent Lightheadedness Should Prompt Urgent Evaluation

You should seek urgent medical care if dizziness or lightheadedness is persistent and especially if any of the following are present, as they may indicate brain involvement, significant anemia, cardiovascular issues, or serious treatment side effects:

• New or worsening neurological symptoms: severe headache, confusion, seizures, vision changes, weakness or numbness on one side, trouble speaking or understanding, or loss of balance with falls. These are classic signs of possible brain metastases and need prompt imaging (often MRI). ^{[2] [3]}

• Signs of significant blood problems: feeling extremely lightheaded, very tired, unusually pale, or short of breath at rest; these can point to anemia requiring immediate workup and possibly transfusion. Oncology care pathways emphasize contacting your team urgently for these symptoms. ^{[11] [5]}

• Red‑flag treatment symptoms: uncontrolled vomiting, severe diarrhea with dizziness, chest pain, racing heartbeat, or a severe headache not relieved by usual pain medication while on cancer therapy. Patient information for melanoma therapies advises going to the nearest emergency department for these combinations of symptoms. ^{[1] [6] [12]}

• Persistent dizziness despite hydration and rest: Even if dehydration is suspected, ongoing lightheadedness should be assessed to exclude anemia, medication side effects, or neurologic causes. ^{[7] [8]}

---

What Your Care Team May Do

• Clinical assessment and neurologic exam: To check for focal deficits, changes in cognition, coordination, and balance. Findings guide next steps like urgent imaging. ^{[2] [3]}

• Brain imaging: MRI is typically used to detect brain metastases because it is sensitive for small lesions; CT may be used initially in emergency settings. Early identification helps tailor treatments such as steroids, radiation, surgery, or systemic therapy. ^{[13] [14]}

• Blood tests: Complete blood count (CBC) to assess hemoglobin and hematocrit, iron studies, and other labs to identify anemia and its causes. Management may include transfusion for symptomatic or severe anemia and guideline‑directed iron or ESA therapy in appropriate cases. ^{[4] [5]}

• Medication review and supportive care: Adjustment of cancer drugs causing dizziness, hydration strategies, and monitoring for endocrine or autonomic side effects. Care teams advise urgent contact for persistent or severe symptoms. ^{[1] [8]}

---

Practical Steps You Can Take Now

• Track your symptoms: Note timing, triggers (standing up, after medications), and associated signs (headache, vision change, weakness). A detailed log helps your clinicians triage appropriately. ^[3]

• Hydration and safety: Drink fluids if not restricted and rise slowly from sitting or lying positions to reduce orthostatic lightheadedness. However, do not delay care if symptoms persist or worsen. ^[7]

• Use your oncology team’s emergency pathway: If you are on immunotherapy or targeted therapy and develop persistent dizziness, especially with red‑flag symptoms (severe headache, chest pain, trouble breathing, uncontrolled vomiting/diarrhea), contact your team immediately or go to the nearest emergency department. ^{[1] [12]}

---

Summary

Melanoma can be associated with dizziness through several pathways, most importantly brain metastases and treatment‑related or cancer‑related anemia, but also medication side effects, dehydration, and rare immune‑mediated neurologic syndromes. Persistent lightheadedness particularly with headache, neurologic changes, pallor and fatigue, chest pain, or shortness of breath should prompt urgent medical evaluation to rule out serious complications and start appropriate treatment. ^{[2] [11] [1] [5]}