Melanoma Case Study

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Melanoma is an aggressive form of skin cancer that has a high potential of metastasis, where the exact time point of its progression to metastasis is difficult to detect (Somasundaram and Herlyn, 2012). It is well known that once an early stage in situ skin cancer is surgically removed or cured, metastasis is unlikely. However, once the cells acquire the characteristics to metastasise, a good prognosis becomes hard to achieve. Rates of metastasis after removal increase with increasing invasion depth and local spread (Ref).
Melanoma not only arises from environmental sun exposure, but also from genetic predispositions. Studies have shown an increased risk with age (Berwick et al., 2015).
The highest risk factor for melanoma is ultraviolet …show more content…

Staging of melanoma includes classifying anatomical features as well as histological features. As a patient progresses in stages, the prognosis becomes worse. Major determinants of outcome in early stage patients, are presence of ulceration and tumor thickness (Dickson and Gershenwald, 2011). Stage 0 is considered as in situ and is 100% curable by surgical resection (Mocellin and Nitti, 2011). Stage I is defined as localized melanoma where malignant melanocytes are only found in the epidermis. The survival rate is high at this stage, between 70 % and 95% (Dickson and Greshenwald, 2011). Stage II melanomas have invaded the papillary dermis (Breslow, 1970). The 5-year survival rate for stage II patients is 53% to 82%, depending on the substage (Balch et al., 2009). Stage III patients display regional metastasis to local lymph nodes, and the prognosis is dependent on the number of nodes involved. Nodal involvement can be detected histologically or macroscopically in lymph node biopsies. The 5-year survival rate for stage III patients is between 40% and 78% depending on the substage (Balch et al., 2009). Stage IV melanoma displays distant metastasis to distant skin, subcutaneous and visceral tissues and distant lymph nodes, with a 5-year survival rate of 10% (Dickson and Gershenwald, …show more content…

Chemotherapy is the use of chemotherapeutic agents to treat cancers. Chemotherapy for stage IV melanoma patients is ineffective, and only yields responses of 10-20% (Anderson, Buzaid and Legha, 1995). Single-agent chemotherapy, Dacarbazine, is the only Food and Drug Administration (FDA) approved chemotherapeutic agent for treatment of metastatic melanoma. The response rate is approximately 15% at initial treatment, however the effects are not long lasting, at less than 2% survival at 6 years. Combination chemotherapy shows slightly higher response rates compared to single-agent chemotherapy, and remission rates are slightly improved (Bhatia, Tykodi, and Thompson,

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