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Cancer
 
Melanoma

The Cancer Monthly database currently has the results (survival, side effects, and more) for 20 recent therapies for melanoma.

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Introduction

The incidence of melanomas has increased 300% in the past 40 years. Melanomas affect approximately 54,000 people in the U.S. and result in over 8,000 deaths each year. Individuals who are most susceptible to this tumor are those with fair complexions, red or blond hair, blue eyes, and freckles, and who tan poorly and sunburn easily.

The tumor can affect people of all ages and it has distinct clinical features that make it possible to cure it by surgical excision alone. An increase
in size or change in color is noted by the patient in 70% of early lesions.
There are four types of cutaneous melanoma:

  1. Superficial spreading melanoma
  2. Lentigo maligna melanoma
  3. Acral lentiginous melanoma
  4. Nodular melanoma

Treatment

Once the diagnosis of malignant melanoma has been confirmed, the tumor is staged to determine prognosis and treatment. The staging is based on the tumors thickness, and whether there is ulceration, nodal disease or distant metastases.

For newly diagnosed cutaneous melanoma, a wide surgical excision is typically used. Regional lymph node removal may also be recommended but the efficacy of this procedure remains controversial. (Some studies demonstrate a survival benefit and some studies do not.) For patients who do not have metastases, but who are at high risk for metastases, adjuvant interferon alpha (2a or 2b) may be capable of improving disease-free and overall survival in some patients. However, this treatment has been associated with severe toxicity.

Melanomas may spread by the lymph system or the bloodstream. Liver, lung, bone and brain are common sites of metastases. Metastatic melanoma is generally incurable but a number of new approaches are being studied in patients. The Cancer Monthly database currently has the results (survival, side effects, etc.) for 20 recent therapies for melanoma

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Source: Katarina G. Chiller, et al., Cancer of the Skin, in HARRISON'S PRINCIPLES OF INTERNAL MEDICINE, pt. 5 § 73, at 497-502 (Dennis L. Kasper, M.D. et al., eds, 16th ed 2005).