Melanoma

Incidence is increasing, with a lifetime risk in the US of 1 in 35 in men and 1 in 54 in women.

Melanoma is the third most common skin cancer, but is the most common cause of skin cancer-related death.

Up to 20% of patients develop metastatic disease.

The prognosis depends on the stage at diagnosis: 99% of patients with in-situ melanoma will be cured with simple excision, while less than 10% of patients with metastatic disease will live beyond 5 years, although this statistic will change with the current era of new therapeutic agents.

Recent advances in the understanding of tumor biology and immune regulation have led to the development of systemic targeted agents that have changed clinical practice, with further improvements expected with new compounds and combinations.

Melanoma is a malignant tumor arising from melanocytes. It is among the most common forms of cancer in young adults and typically presents as a new or changing deeply pigmented skin lesion. Lesions are often on sun-exposed anatomic locations in fair-skinned people. Diagnosis is by physical examination and confirmed by histopathological analysis of a biopsy.[1]MacKie RM. Clinical recognition of early invasive malignant melanoma. BMJ. 1990;301:1005-1006. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1664014/pdf/bmj00204-0007.pdf http://www.ncbi.nlm.nih.gov/pubmed/2249043?tool=bestpractice.com Early-stage melanoma has an overall survival rate of nearly 100%, while metastatic melanoma can be rapidly fatal.[2]Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63:11-30. http://www.ncbi.nlm.nih.gov/pubmed/23335087?tool=bestpractice.com [3]Little EG, Eide MJ. Update on the current state of melanoma incidence. Dermatol Clin. 2012;30:355-361. http://www.ncbi.nlm.nih.gov/pubmed/22800543?tool=bestpractice.com