Are Headaches a Symptom of Melanoma?

Headaches are not a typical symptom of early, skin‑limited melanoma, but they can occur when melanoma spreads to the brain (brain metastases) or as a side effect of certain melanoma treatments. In other words, a new or worsening headache in someone with a history of melanoma may warrant medical evaluation, especially if accompanied by neurologic symptoms. ^{[1] [2] [3]}

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Early Melanoma vs. Advanced Disease

• Early cutaneous melanoma: Usually presents with skin changes (asymmetry, border irregularity, color variation, diameter growth, and evolving features) rather than systemic symptoms like headache. Headache is not considered a common early warning sign of a skin melanoma. ^[4]

• Melanoma with brain involvement (metastases): When melanoma spreads to the brain, tumors can irritate or compress brain tissue, often causing headaches and other neurologic symptoms such as nausea/vomiting, seizures, weakness or numbness, vision or speech changes, balance problems, personality changes, or confusion. ^{[1] [5] [3] [6] [7]}

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How Common Are Headaches in Brain Metastases?

• Brain metastases are among the most frequent neurologic complications of cancer, and melanoma is one of the cancers most likely to spread to the brain. ^[8]

• Across brain metastasis populations, headache is one of the most common presenting symptoms, reported in roughly half of patients. ^[9]

• Clinical series show severe headaches occurred in nearly half of patients at the onset of brain metastasis, highlighting headache as a key early clue when metastases develop. ^[10]

• In patients with brain metastases treated with whole‑brain radiation, headache improvement was observed in a large proportion, underscoring the link between headaches and intracranial disease burden. ^[11]

Takeaway: While not specific to melanoma, headache is a frequent symptom when cancers (including melanoma) spread to the brain. ^{[8] [9]}

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What Headache Features Raise Concern?

• New, persistent, or progressively worsening headaches, especially if different from your usual pattern. Morning‑predominant headaches or those with nausea/vomiting can indicate increased intracranial pressure. ^[7]

• Headache plus neurologic changes (confusion, seizures, weakness, numbness, vision changes, speech difficulty, or balance problems) should prompt urgent medical assessment. ^{[1] [5] [3]}

• In people receiving immunotherapy (e.g., nivolumab, ipilimumab) or targeted therapy (e.g., BRAF/MEK inhibitors like dabrafenib/trametinib, encorafenib/binimetinib), a very bad headache not relieved by pain medication needs immediate medical attention, as it can signal serious nervous system side effects or treatment‑related complications. ^{[12] [13] [14] [15] [16] [17]}

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Why Melanoma Can Cause Headaches

• Brain metastases: Tumors may raise intracranial pressure, inflame tissues, or involve pain‑sensitive structures, producing headaches; MRI is usually the most sensitive test to detect brain metastases. ^[8]

• Treatment effects: Some melanoma therapies can rarely lead to immune‑related nervous system problems (e.g., inflammation of brain/meninges), where headache is a warning symptom requiring prompt evaluation. ^{[18] [19]}

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When to Seek Care

• Seek urgent care if you have a very severe headache not helped by usual pain medicines, or if headache is accompanied by fever, stiff neck, confusion, drowsiness, seizures, weakness, vision/speech changes, or balance issues. ^{[12] [13] [14] [16] [18] [19]}

• Discuss persistent or changing headaches with your oncology team, especially if you have a history of melanoma or are currently on melanoma therapy. They may recommend brain imaging (often MRI) to check for metastases or treatment‑related complications. ^[8]

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Summary

• Headaches are not a common sign of early, skin‑only melanoma. ^[4]

• Headaches can be a symptom when melanoma spreads to the brain, and they often co‑occur with other neurological changes. ^{[1] [5] [3] [8] [9]}

• Severe or unusual headaches in someone with melanoma particularly during treatment should be evaluated promptly. ^{[12] [13] [14] [16] [18] [19]}

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Quick Reference: Red Flags for Headache in Melanoma

• New, persistent, or worsening headache pattern. ^[9]
• Morning‑worse headaches, nausea/vomiting. ^[7]
• Neurologic symptoms (confusion, seizures, focal weakness/numbness, vision/speech changes, balance problems). ^{[1] [5] [3]}
• Severe headache not relieved by pain meds during immunotherapy/targeted therapy. ^{[12] [13] [14] [16]}

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Table: Headache Contexts in Melanoma

Scenario	Is Headache Typical?	Other Common Signs	What to Do
Early cutaneous melanoma	Uncommon	Skin changes (ABCDE), local texture changes	Skin exam; dermatology follow‑up. [4]
Brain metastases	Common (≈50% across cancers)	Nausea/vomiting, seizures, focal deficits, confusion, balance issues	Urgent clinical review; consider brain MRI. [9] [1] [5] [8]
Immunotherapy or targeted therapy	Possible warning sign	Fever, stiff neck, confusion, dizziness/drowsiness	Contact care team urgently for severe/unrelieved headache. [12] [13] [18] [19] [14] [16]

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If you’d like, I can help you interpret your specific headache pattern and suggest what to discuss with your clinician.