Melanoma Discussion Essays
Mr. B, a 40-year-old avid long-distance runner previously in good health, presented to his primary provider for a yearly physical examination, during which a suspicious-looking mole was noticed on the back of his left arm, just proximal to the elbow. He reported that he has had that mole for several years, but thinks that it may have gotten larger over the past two years. Mr. B reported that he has noticed itchiness in the area of this mole over the past few weeks. He had multiple other moles on his back, arms, and legs, none of which looked suspicious. Upon further questioning, Mr. B reported that his aunt died in her late forties of skin cancer, but he knew no other details about her illness. The patient is a computer programmer who spends most of the work week indoors. On weekends, however, he typically goes for a 5-mile run and spends much of his afternoons gardening. He has a light complexion, blonde hair, and reports that he sunburns easily but uses protective sunscreen only sporadically. Melanoma Discussion Essays
Physical exam revealed: Head, neck, thorax, and abdominal exams were normal, with the exception of a hard, enlarged, non-tender mass felt in the left axillary region. In addition, a 1.6 x 2.8 cm mole was noted on the dorsal upper left arm. The lesion had an appearance suggestive of a melanoma. It was surgically excised with 3 mm margins using a local anesthetic and sent to the pathology laboratory for histologic analysis. The biopsy came back Stage II melanoma.
- How is Stage II melanoma treated and according to the research how effective is this treatment?
Post your initial response by Wednesday at midnight. Respond to one student by Sunday at midnight. Both responses must be a minimum of 150 words, scholarly written, APA formatted, and referenced. A minimum of 2 references are required (other than your text). Refer to grading rubric for online discussion.
- Once Mr. B has achieved no evidence of disease (NED) he will need to regularly perform self-exams of his skin and lymph nodes, as well as have a physician perform these exams regularly. The regularity of these exams is determined by the type of Stage II melanoma that Mr. B has (Melanoma Research Alliance, n.d.).
- The pathology results of Mr. B’s excised mole came back as Stage II melanoma. The standard treatment of care for Stage II melanoma is excision of the cancerous tissue (Melanoma Research Alliance, n.d.). Mr. B already had his mole excised with 3mm margins. According to Utjés et al. (2019) a margin of 3mm is appropriate and will not affect Mr. B’s survival rate.
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- Candice Russell posted Feb 3, 2021 9:41 AM
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- Skin cancer is said to be the most common cancer in the world and is the most commonly diagnosed cancer in the United States. The American Cancer Society stated melanoma is a less common form of skin cancer, however, is much more dangerous due to its ability to metastasize to other body parts, if not caught and treated early. Stark (2017) stated, “In melanoma, primary prevention and early detection of primary lesions offer the best outcome but rely heavily on self-monitoring and the expertise of medical professionals” (p. 75). Recommended treatment options depend on staging, location, and other factors like risk of cancer returning after treatment, certain genes found within the cancer cells, and the individuals’ overall health. To provide appropriate treatment, accurate staging is important.Mount Sinai, Kimberly and Eric J. Waldman Melanoma and Skin Cancer Center website, provides information regarding staging and treatment of Melanoma stage I and II. In stage II melanoma the tumor penetrates deep into the skin, deeper than 1mm, ulceration is possible but not in all cases (Stage 1 & stage 2 melanomas, n.d.). Tumor advancement at this stage is less likely, however, there is an increased risk of spreading. The thicker the melanoma, greater than 4mm, spreading is more likely (Stage 1 & stage 2 melanomas, n.d.).In the European Journal of Cancer, Garbe et al. (2010) stated “Interferon-alpha treatment can be offered to patients with more than 1.5mm in thickness and stage II and III melanoma as an adjuvant therapy, as this increases the relapse-free survival” (p. 270). Garbe et al. (2010) later stated the use of this therapy “lacks clear survival benefit and the presence of toxicity limits its use in practice” (p. 270). Surgical options for distant metastasis should be considered, “in the absence of surgical options, systemic medical treatment is indicated, but with, to date, low response rates” (Garbe et al., 2010). ReferencesBalch, C.M., Buzaid, A.C., Soong, S.‐J., Atkins, M.B., Cascinelli, N., Coit, D.G., Fleming, I.D., Gershenwald, J.E., Houghton, A., Jr., Kirkwood, J.M., McMasters, K.M., Mihm, M.F., Morton, D.L., Reintgen, D.S., Ross, M.I., Sober, A., Thompson, J.A. and Thompson, J.F. (2003), New TNM melanoma staging system: Linking biology and natural history to clinical outcomes. Semin. Surg. Oncol., 21 (1): 43-52. https://doi-org.wilkes.idm.oclc.org/10.1002/ssu.10020Garbe, C., Peris, K., Hauschild, A., Saiag, P., Middleton, M., Spatz, A., Grob, J.-J., Malvehy, J., Newton-Bishop, J., Stratigos, A., Pehamberger, H., & Eggermont, A. (2010). Diagnosis and treatment of melanoma: European consensus-based interdisciplinary guideline. European Journal of Cancer, 46(2), 270–283. https://doi.org/10.1016/j.ejca.2009.10.032 J Joyce KM. Surgical Management of Melanoma. In: Ward WH, Farma JM, editors. Cutaneous Melanoma: Etiology and Therapy [Internet]. Brisbane (AU): Codon Publications; 2017 Dec 21. Chapter 7. https://www.ncbi.nlm.nih.gov/books/NBK481850/ less1 UnreadUnread4 ViewsViews