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  • Image not available.Cutaneous melanoma is an increasingly common malignancy, but it is a cancer that can be cured if detected early. Public education about screening and early detection is one strategy for controlling the increase in incidence and the mortality associated with cutaneous melanoma.
  • Image not available. Surgical resection can cure patients with early-stage melanoma.
  • Image not available. The toxicities associated with interferon-α2b therapy are significant and require patient education, close patient monitoring, and appropriate dose modification based on toxicity.
  • Image not available. Patients with locally advanced disease should be evaluated for adjuvant therapy; recommended options include interferon α2b or participation in a clinical trial.
  • Image not available. High-dose aldesleukin (interleukin 2) is an option for some individuals with metastatic melanoma. The toxicities associated with this regimen are significant and warrant close patient selection. Individuals receiving high-dose aldesleukin require close monitoring and management by an experienced healthcare team. A small subset of patients experience a durable response with this therapy, although the question of risk versus benefit should be assessed on an individualized basis.
  • Image not available. Metastatic melanoma remains a clinical challenge. At this time, there is not a single standard treatment approach for individuals with metastatic disease. Dacarbazine and temozolomide are considered the most active chemotherapies and can be used as single agents. Combination chemotherapy has not been shown to be superior to single-agent therapy with dacarbazine.
  • Image not available. As the biology of melanoma has been further delineated, a growing number of potential targets for drug therapy have been identified. Recent work has focused on drugs that target specific pathways of melanoma development and progression.

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On completion of the chapter, the reader will be able to:

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  • 1. Discuss the known etiologic factors of melanoma; including both host factors and environmental factors.
  • 2. Outline the pathogenesis of melanoma.
  • 3. Identify the histologic subtypes of melanoma and describe clinical features of each subtype.
  • 4. Describe the clinical features of a pigmented lesion as highlighted by the mnemonic ABCD; asymmetry, borders, colors, diameter.
  • 5. Discuss strategies for early detection and prevention of melanoma.
  • 6. Describe the current staging of an individual diagnosed with melanoma.
  • 7. Describe the controversy regarding the use of interferon alfa as adjuvant therapy in high-risk individuals after surgical resection.
  • 8. Describe the common toxicities and appropriate management strategies for interferon alfa in the treatment of individuals after surgical resection of melanoma.
  • 9. Describe the advantages and disadvantages of aldesleukin therapy for the treatment of individuals with metastatic melanoma.
  • 10. Describe the common toxicities and appropriate management strategies for individuals receiving aldesleukin for the treatment of melanoma.
  • 11. Formulate an appropriate treatment plan for a patient receiving aldesleukin for metastatic melanoma.
  • 12. Discuss the current role of chemotherapy, biochemotherapy, and vaccines in the treatment of a patient with melanoma.

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Melanoma is the sixth most common cancer in the United States. The incidence of melanoma steadily increased from the 1970s to the 1990s and has remained relatively stable since 2000. While nonmelanoma skin cancers (NMSCs) are the most common malignancies of the ...

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