Book contents
- Frontmatter
- Contents
- List of contributors
- Preface to the first edition
- Preface to the second edition
- Acknowledgements
- Abbreviations
- 1 Practical issues in the use of systemic anti-cancer therapy drugs
- 2 Biological treatments in cancer
- 3 Hormones in cancer
- 4 Pathology in cancer
- 5 Radiotherapy planning 1: fundamentals of external beam and brachytherapy
- 6 Radiotherapy planning 2: advanced external beam radiotherapy techniques
- 7 Research in cancer
- 8 Acute oncology 1: oncological emergencies
- 9 Acute oncology 2: cancer of unknown primary
- 10 Palliative|care
- 11 Management of cancer of the head and neck
- 12 Management of cancer of the oesophagus
- 13 Management of cancer of the stomach
- 14 Management of cancer of the liver, gallbladder and biliary tract
- 15 Management of cancer of the exocrine pancreas
- 16 Management of cancer of the colon and rectum
- 17 Management of cancer of the anus
- 18 Management of gastrointestinal stromal tumours
- 19 Management of cancer of the breast
- 20 Management of cancer of the kidney
- 21 Management of cancer of the bladder
- 22 Management of cancer of the prostate
- 23 Management of cancer of the testis
- 24 Management of cancer of the penis
- 25 Management of cancer of the ovary
- 26 Management of cancer of the body of the uterus
- 27 Management of cancer of the cervix
- 28 Management of cancer of the vagina
- 29 Management of cancer of the vulva
- 30 Management of gestational trophoblast tumours
- 31 Management of cancer of the lung
- 32 Management of mesothelioma
- 33 Management of soft tissue and bone tumours in adults
- 34 Management of the lymphomas and myeloma
- 35 Management of cancers of the central nervous system
- 36 Management of skin cancer other than melanoma
- 37 Management of melanoma
- 38 Management of cancer of the thyroid
- 39 Management of neuroendocrine tumours
- 40 Management of cancer in children
- Multiple choice questions
- Multiple choice answers
- Index
- References
37 - Management of melanoma
Published online by Cambridge University Press: 05 November 2015
- Frontmatter
- Contents
- List of contributors
- Preface to the first edition
- Preface to the second edition
- Acknowledgements
- Abbreviations
- 1 Practical issues in the use of systemic anti-cancer therapy drugs
- 2 Biological treatments in cancer
- 3 Hormones in cancer
- 4 Pathology in cancer
- 5 Radiotherapy planning 1: fundamentals of external beam and brachytherapy
- 6 Radiotherapy planning 2: advanced external beam radiotherapy techniques
- 7 Research in cancer
- 8 Acute oncology 1: oncological emergencies
- 9 Acute oncology 2: cancer of unknown primary
- 10 Palliative|care
- 11 Management of cancer of the head and neck
- 12 Management of cancer of the oesophagus
- 13 Management of cancer of the stomach
- 14 Management of cancer of the liver, gallbladder and biliary tract
- 15 Management of cancer of the exocrine pancreas
- 16 Management of cancer of the colon and rectum
- 17 Management of cancer of the anus
- 18 Management of gastrointestinal stromal tumours
- 19 Management of cancer of the breast
- 20 Management of cancer of the kidney
- 21 Management of cancer of the bladder
- 22 Management of cancer of the prostate
- 23 Management of cancer of the testis
- 24 Management of cancer of the penis
- 25 Management of cancer of the ovary
- 26 Management of cancer of the body of the uterus
- 27 Management of cancer of the cervix
- 28 Management of cancer of the vagina
- 29 Management of cancer of the vulva
- 30 Management of gestational trophoblast tumours
- 31 Management of cancer of the lung
- 32 Management of mesothelioma
- 33 Management of soft tissue and bone tumours in adults
- 34 Management of the lymphomas and myeloma
- 35 Management of cancers of the central nervous system
- 36 Management of skin cancer other than melanoma
- 37 Management of melanoma
- 38 Management of cancer of the thyroid
- 39 Management of neuroendocrine tumours
- 40 Management of cancer in children
- Multiple choice questions
- Multiple choice answers
- Index
- References
Summary
Introduction
Melanocytes originate in the neural crest of the embryo and migrate widely during development to locations such as the basal layer of the epidermis and the uveal tract. As a result, malignant melanoma (MM) can affect sites other than the skin, including the central nervous system (e.g. meninges and uveal tract) and the aerodigestive and genitourinary tracts (e.g. nasopharynx, oral cavity and vagina). Cutaneous melanoma has one of the fastest rising cancer incidences worldwide. In the UK it is the fifth commonest cancer and the second commonest cancer in the 15–34 year age group, with about 27% of cases occurring below the age of 50 (http://www.cancerresearchuk.org/, accessed February 2015).
Mortality rates have also increased over time, but less so than the increase in incidence because of improvements in the chance of survival from melanoma. Mortality rates appear to have stabilised in some countries, most notably Australia. A shift to proportionately more in situ and thin melanomas being diagnosed in the same period suggests that this reduction in mortality may be due to earlier detection (Coory et al., 2006).
This chapter focuses on cutaneous melanoma, but will also cover some of the main features of the rarer subtypes such as mucosal and ocular melanoma.
Cutaneous melanoma
Types of cutaneous melanoma
The main clinicopathological varieties of cutaneous MM are superficial spreading, nodular, acral lentiginous and lentigo maligna melanoma.
Incidence and epidemiology
The annual age-standardised disease incidence of cutaneous melanoma in the UK is 17 per 100,000. Approximately 11,500 new cases are diagnosed per year in England and Wales, comprising 4% of all new cancer cases. Around 2000 deaths from melanoma occur annually in the UK (from Cancer Research UK, http://www.cancerresearchuk.org/, accessed February 2014).
The incidence of cutaneous melanoma has continued to rise worldwide for the last 40 years. The annual increase varies between populations, but in general has been in the order of 3–7% per year for fair-skinned Caucasian people. Some of this increase may be due to increased surveillance and therefore earlier detection, as well as changes in diagnostic criteria. However, most of the increase is considered real, and linked to changes in lifestyle resulting in excessive recreational exposure to sunlight (Lens and Dawes, 2004).
- Type
- Chapter
- Information
- Practical Clinical Oncology , pp. 499 - 512Publisher: Cambridge University PressPrint publication year: 2015