Melanoma Research Paper

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 Research Paper. 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. 1. How is Stage II melanoma treated and according to the research how effective is this treatment?

Also termed as malignant melanoma, melanoma is a form of skin cancer developing from cells termed as melanocytes that produce melanin and occurring in the skin (Atkinson, 2017). However, the condition rarely occurs in the mouth, eyes, or intestines. Signs of melanoma include unusual growth and appearance of existing moles. While the exact cause of melanoma is unknown, exposure to ultraviolet radiation from sunlight increases cancer risk. A tissue biopsy of Mr. B revealed that he had stage II melanoma. The staging of melanoma is based on the American Joint Committee on Cancer (AJCC) staging system. It assigns a stage considering the Tumor-node-metastasis (TNM) scores and other prognostic factors (Gershenwald et al., 2017). Staging aims to ensure that melanomas in the same phase have like characteristics and treatment alternatives. In phase II, the melanoma extends the epidermis into the dermis. However, no evidence in this stage suggests that the melanoma has affected lymph tissues or other body organs.

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The standard treatment of stage II melanoma is excision, surgical removal of the tumor, and skin margin in its surrounding. A sentinel lymph node biopsy may also be proposed if the melanoma is suspected of having spread to the nearby lymph nodes (Gonzalez, 2018). If the biopsy detects melanoma, a complete lymph node dissection is recommended. However, this rarely occurs. Immunotherapy is another alternative used in treating stage II melanoma by ensuring that the body fights diseases more effectively. Immunotherapy techniques used are vaccine therapy, interferon, interleukin, and antibody-based therapy. Research suggests that surgery is the most effective treatment for stage II melanoma as it removes any cancer remaining after biopsy (Davis et al., 2019). The tumor is removed, including the biopsy site and a surgical margin and the underlying subcutaneous tissue to ensure the cancer is completely eliminated. Melanoma Research Paper.

References

Atkinson, V. (2017). Recent advances in malignant melanoma. Internal Medicine Journal, 47(10), 1114-1121. https://doi.org/10.1111/imj.13574

Davis, L. E., Shalin, S. C., & Tackett, A. J. (2019). Current state of melanoma diagnosis and treatment. Cancer Biology & Therapy, 20(11), 1366-1379. https://doi.org/10.1080/15384047.2019.1640032

Gershenwald, J. E., Scolyer, R. A., Hess, K. R., Sondak, V. K., Long, G. V., Ross, M. I., … & Haydu, L. E. (2017). Melanoma staging: evidence‐based changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA: a cancer journal for clinicians, 67(6), 472-492.

Gonzalez, A. (2018). Sentinel lymph node biopsy: Past and present implications for the management of cutaneous melanoma with nodal metastasis. American Journal of Clinical Dermatology, 19(S1), 24-30. https://doi.org/10.1007/s40257-018-0379-0 . Melanoma Research Paper.