Subject: Cancer patients (Health aspects)
Cancer patients (Medical examination)
Melanoma (Risk factors)
Melanoma (Diagnosis)
Melanoma (Research)
Author: Cowper, Anne
Pub Date: 03/22/2007
Publication: Name: Australian Journal of Medical Herbalism Publisher: National Herbalists Association of Australia Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2007 National Herbalists Association of Australia ISSN: 1033-8330
Issue: Date: Spring, 2007 Source Volume: 19 Source Issue: 1
Topic: Event Code: 310 Science & research
Geographic: Geographic Scope: Australia Geographic Code: 8AUST Australia
Accession Number: 174818469
Full Text: Roberts H, Haskett M, Kelly J. 2006 Melanoma clinical features and early diagnostic techniques. MedToday 7:5;39-47.

Australia has the highest incidence of melanoma in the world, with an estimated risk of developing an invasive melanoma before the age of 75 years being one in 25 for Australian men and one in 34 for Australian women. This Australian article reviews the clinical features of melanoma and the new techniques that have been developed to help with diagnosis. Early diagnosis is essential. The overall five year survival rate is 95% for patients with lesions thinner than 1 mm, but falls to less than 50% in those with lesions exceeding 4 mm in thickness.

The main risk factors for the development of melanoma are increased naevus numbers (however the prophylactic removal of melanocytic naevi is not recommended), previous melanoma, strong family history. Other risk factors are history of blistering sunburn, type 1 skin (burns easily without tanning), freckling, blue eyes, red hair and immunosuppression.

Those with a high risk for developing melanoma should have annual medical examinations, have baseline skin images taken and carry out regular self examination. Exposure to UV radiation is the only known preventable risk factor. All patients should adopt sun protection strategies including physical protection through natural shade and clothing where possible rather than sunscreens.

During a physical examination no area should be neglected, including the scalp, breasts, buttocks, soles of the feet and between the toes. Involvement of the genitalia is uncommon and need not be examined unless there are specific concerns.

Clinical features include asymmetry, border irregularity, colour variegation, diameter greater than 6 ram. Superficial spreading melanomas (SSM) account for about 70% of melanoma cases. SSM are most often found on the trunk in men and legs in women. They present as an enlarging (over months) asymmetrical pigmented lesion with variegated pigmentation and irregular borders.

Computer assisted diagnosis is a new frontier in diagnosis however this technology cannot yet reliably diagnose up to 20% of melanomas.

Anne Cowper

PO Box 45, Concord West NSW 2138

Gale Copyright: Copyright 2007 Gale, Cengage Learning. All rights reserved.

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