Malignant Melanoma Health Article

Alternative treatment

Though radiation therapy has a minimal role in the primary treatment of malignant melanoma, for patients who have metastatic disease, radiation may be helpful. This is true in patients who have developed tumor deposits in areas such as the brain or the bone.

Prognosis

Almost all patients survive stage Ia malignant melanoma, and the suvivorship for stage I overall is more than 90%. Survival drops in stage IIa to about 65% at five years and is worse yet for stage IIb at slightly over 50%. Stage III has a survival rate at 5 years of 10% to 47%, depending on the size and number of regional nodes involved. Stage IV malignant melanoma is almost always a fatal disease.

Coping with cancer treatment

For those with familial tendencies for malignant melanoma, genetic counseling may be appropriate. Psychological counseling may be appropriate for anyone having trouble coping with a potentially fatal disease. Local cancer support groups may be helpful and are often identified by contacting local hospitals or the American Cancer Society.

Prevention

Though it is difficult to prove that sunscreens statistically reduce the frequency of malignant melanoma at this time, most authorities recommend use as protection from ultraviolet light (considered a major factor in the development of melanoma.) Avoidance of severe sunburns is recommended.

BOOKS

Abeloff, Armitage, Lichter, and Niederhuber. Clinical Oncology Library, 2nd ed. London: Churchill Livingstone, 1999.

Schwartz, Shires, Daly, et al, ed. Principles of Surgery. New York: McGraw Hill, 1999.

PERIODICALS

Agarwala, Sanjiv S., and John M. Kirkwood. "Adjuvant Therapy of Melanoma." Seminars in Surgical Oncology 14, no. 4 (June 1998): 302-10.

Averbrook, Bruce J., Leo J. Russo, and Edward G. Mansour. "A Long-Term Analysis of 620 Patients with Malignant Melanoma at a Major Referral Center." Surgery 124 (October 1998): 739

Cascinelli, Natale. "Margin of Resection in the Management of Primary Melanoma." Seminars in Surgical Oncology 14, no. 4 (June 1998): 272-75.

Gilchrest, B.A., et al. "The Pathogenesis of Melanoma Induced by Ultraviolet Radiation." New England Journal of Medicine 340 (29 April, 1999): 17.

Grin, Caron M., and Marti Rothe. "Pigmented Lesions: Innocent or Deadly?" Consultant 40 (February 2000): 304.

Joseph, Emmanuella, et. al. "Results of Complete Lymph Node Dissection in 83 Melanoma Patients with Positive Sentinel Nodes." Annals of Surgical Oncology 5, no. 2 (Mar.1998): 119-25.

Karakousis, Constantine P., "Therapeutic Node Dissections in Malignant Melanoma." Seminars in Surgical Oncology 5, no. 6 (Sept. 1998): 473-82.

Langley, Richard G.B., and Arthur J. Sober. "Clinical Recognition of Melanoma and its Precursors" Hematology/Oncology Clinics of North America 12, no. 4 (August 1998).

Nathan, Faith E., and Michael J. Mastrangelo. "Systemic Therapy in Melanoma" Seminars in Surgical Oncology 14, no. 4 (June 1998): 319-27.

Weinstock, Martin A. "Early Detection of Melanoma." JAMA, The Journal of the American Medical Association 284 (16 August 2000): 886.

OTHER

Cancer Resource Center American Cancer Society. 20 June 2001 <http://www3.cancer.org/cancerinfo>.

Melanoma Patient's Information Page 20 June 2001 <http://www.mpip.org>.

National Cancer Institute. 13 June 2001 <http://rex.nci.nih.gov/PATIENTS/INFO_PEOPL_DOC.html>.

Richard A. McCartney, MD

KEY TERMS

Adjuvant therapy—Therapy administered to patients who are at risk of having microscopic untreated disease present but have no manifestations.

Dermis—The deeper portion or layer of the skin.

Dysplastic nevus syndrome—A familial syndrome characterized by the presence of multiple atypical appearing moles, often at a young age.

Epidermis—The superficial layer of the skin.

Genome—Composed of DNA, the genome is the genetic makeup of the cell.

Immunotherapy—Therapy using biologic agents that either enhance or stimulate normal immune function.

Integument—The skin.

Lymph node dissection—Surgical removal of an anatomic group of lymph nodes.

Lymphedema—Swelling of an extremity following surgical removal of the lymph nodes draining that extremity.

Melanocyte—Cells derived from the neural crest that are in the skin and produce the protein pigment melanin.

Metastasis—A tumor growth or deposit that has spread via lymph or blood to an area of the body remote from the primary tumor.

Nevus—A mole.

Resection—The act of removing something surgically.

Skin appendages—Structures related to the integument such as hair follicles and sweat glands.

Systemic disease—Used to refer to a patient who has distant metastasis.

Variegation—Patchy variation.