Monday, February 25, 2008

Melanoma Review

I wrote a post about Melanoma last year here. It is a good review of melanoma in general, so I won't re-write it. Just want to hit a few highlights here.

  • Melanoma is a malignancy with the highest yearly increase in incidence. Every year, about 4% or 5% more patients than in the prior year get diagnosed with melanoma.
  • The good news is that most patients are cured because of early detection. The key is early detection.
  • There is up to 50% chance of recurrence in patients whose primary melanoma in the skin is greater than 4 mm in depth, or if there are any positive lymph nodes.
  • At this point in time, recurrence is almost equal to mortality. This is due to the fact that melanoma is relatively resistant to currently available cytotoxic chemotherapies and radiation therapies.
  • A personal history of endometriosis or uterine fibroma is associated with higher risk for cutaneous melanoma in women.
  • A history of ovarian cysts, uterine polyps, breast adenoma/fibroadenoma, or breast fibrocystic disease is not significantly associated with melanoma risk.

EARLY DETECTION IS KEY! So if you have any moles that look like these, go see your family doctor or dermatologist. Have a full skin exam done.

CURRENT TREATMENT

StageTreatmentAdjuvant
Stage 0:
Melanoma-in-situ
Wide ExcisionSkin Exams
Stage 1A:
Low-risk Primary
Wide ExcisionSkin Exams
Stage 1B and II:
Intermediate and high-risk primary
Wide ExcisionSkin Exams,
Imaging for metastasis,
Enrollment in clinical trial
Stage III or IV, resectableWide ExcisionSkin Exams,
Imaging for metastases,
Enrollment in clinical trial
Stage III or IV, unresectable Fine-needle aspiration or biopsy,
Imaging for metastases,
Enrollment in clinical trial

The Dr Benabio over at The Derm Blog has some nice information about Melanoma that you may want to check out.

REFERENCES

Current Treatments and Guidelines for Metastatic Melanoma; Jedd D Wolchok MD; Medscape Article, December 19, 2007

Novel Therapies for Metastatic Melanoma; Steven J O'Day MD; Medscape Article, December 19, 2007

Endometriosis Linked to Increased Risk for Melanoma; Laurie Barclay MD; Medscape Article, October 30, 2007

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