{"id":200,"date":"2023-12-04T10:22:39","date_gmt":"2023-12-04T15:22:39","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/dcbiol2200\/chapter\/diagnosis-and-treatment-of-metastatic-melanoma\/"},"modified":"2023-12-04T10:43:07","modified_gmt":"2023-12-04T15:43:07","slug":"diagnosis-and-treatment-of-metastatic-melanoma","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/dcbiol2200\/chapter\/diagnosis-and-treatment-of-metastatic-melanoma\/","title":{"raw":"Diagnosis and Treatment of Metastatic Melanoma","rendered":"Diagnosis and Treatment of Metastatic Melanoma"},"content":{"raw":"\n<div class=\"textbox textbox--learning-objectives\"><header class=\"textbox__header\">\n<p class=\"textbox__title\">Learning Objectives<\/p>\n\n<\/header>\n<div class=\"textbox__content\">\n\nAt the end of this section, you will be able to:\n<ul>\n \t<li>Explain how melanoma is diagnosed by histological examination of a tissue biopsy.<\/li>\n \t<li>Describe how interprofessional collaboration between health care professionals aid in the diagnosis and treatment of metastatic melanoma.<\/li>\n \t<li>Outline key prevention measures that one can take to reduce their risk of developing melanoma.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<h2>Diagnosis<\/h2>\nDiagnosis of melanoma is through histological examination.&nbsp; What does this look like?\n\nOften, melanoma starts as a irregular looking mole on the skin. That mole, with a little bit of surrounding 'normal' tissue is cut out (ie [pb_glossary id=\"1065\"]biopsy[\/pb_glossary]) by a health care professional.&nbsp; This biopsy is taking&nbsp; the entire mole including the epidermal and dermal layer of the skin. The biopsied mole is cut into very thin slices and mounted onto a glass slide and stained with H&amp;E.&nbsp; All of this work is performed by a medical laboratory technologist with a histology specialization.&nbsp; After a preliminary glance of the stained slide of the biopsied mole, the technologist then sends the slide to a histopathologist for diagnosis, using some of the skills and terms Lyz had demonstrated in the previous chapter.\n<h2>Treatment<\/h2>\nTreatment of melanoma&nbsp; - as well as most cancers - can be grouped as:\n<ul>\n \t<li>Chemo- and radiotherapy:&nbsp; both of these strategies aim to kill rapidly dividing cells whether by:<\/li>\n<\/ul>\n<ul>\n \t<li style=\"list-style-type: none\">\n<ul>\n \t<li>Chemotherapy uses chemicals which slow down or inhibit cell division. Usually, chemotherapy is absorbed in the entire body - so cell division in normal healthy cells will also be affected.<\/li>\n \t<li>Radiotherapy uses radiation to kill rapidly growing tumour cells.&nbsp; Usually, radiotherapy is localized to the site of the cancerous growth.&nbsp; However, some normal tissue - especially skin - will be affected by radiation&nbsp; if it happens to be in the path of the radiation beam.&nbsp; An important issue for radiotherapy is that certain organs have different 'tolerance' for radiation exposure.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n \t<li>Surgical excision:&nbsp; remove the cancerous tissue and some surrounding tissue.\n<ul>\n \t<li>Requires biopsy of surrounding structures and lymph nodes to assess for possibility of nearby metastases as a hint to possible further spread.<\/li>\n \t<li>Surgical excision of metastases will not cure the cancer - but it can relieve signs &amp; symptoms caused by the metastasis.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3>Medical Laboratory Sciences (Anatomic Pathology) in surgical treatment of cancer<\/h3>\nListen to Marion Regan, a medical laboratory technologist, speak about how technologists are giving instantaneous histological specimens to surgeons while the surgeon is excising cancerous tissues.\n\n[h5p id=\"54\"]\n<p style=\"text-align: center;background-color: #f0f0f0;padding: 5px\"><sup>Histological Preparation of Biopsy Tissue During Surgery by Marion Regan &amp; Jennifer Kong, licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/\">CC BY NC<\/a><\/sup><\/p>\n\n<ul>\n \t<li>Immunotherapy:&nbsp; allow the body's immune system to recognize abnormal cancer cells and remove them.\n<ul>\n \t<li>This is in the early stages of implementation.<\/li>\n<\/ul>\n<\/li>\n \t<li>Targeted therapy:&nbsp; inhibit the genes (or their protein products) which were damaged - thus stopping the uncontrollable cell division.\n<ul>\n \t<li>This is in the early stages of research and implementation.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n&nbsp;\n\n[h5p id=\"52\"]\n<p style=\"text-align: center;background-color: #f0f0f0;padding: 5px\"><sup>Treatment of Melanoma by Lyz Boyd, licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/\">CC BY NC<\/a><\/sup><\/p>\n\n<h2>Prevention<\/h2>\nWhat's unique about melanoma - compared to many cancers - is that one can lower one's risk by by limiting exposure of the skin &amp; eyes to the sun.&nbsp; Continuous monitoring of the skin - especially moles - may allow for early detection and, hence, early treatment.&nbsp; Patient survival rates increase when cancers are detected early.\n\n[h5p id=\"53\"]\n<p style=\"text-align: center;background-color: #f0f0f0;padding: 5px\"><sup>Prevention of Melanoma by Lyz Boyd, licensed under - <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/\">CC BY NC<\/a><\/sup><\/p>\n\n<h1>Section Review<\/h1>\n<ul>\n \t<li>Whether it is a biopsy of a suspicious mole or surgical excision of a tumour, a medical laboratory technologist will histologically prepare and stain the tissue, allowing for visual examination of key features of cancerous changes and whether the basement membrane is intact.<\/li>\n \t<li>Depending on the level of invasion of spread, melanoma can be treated by surgical excision of the tumour, localized treatment with radiotherapy, or systemic treatment with chemo- or immunotherapy.<\/li>\n \t<li>Prevention measures of modifiable risk factors (e.g.&nbsp; limiting sun damage to skin)&nbsp; can reduce the risk of developing melanoma.&nbsp; However non-modifiable risk factors (e.g. age, genetics, skin tone) can not be changed; thus, there is always a risk.<\/li>\n<\/ul>\n<h1>Review Questions<\/h1>\n[h5p id=\"111\"]\n\n&nbsp;\n","rendered":"<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<p class=\"textbox__title\">Learning Objectives<\/p>\n<\/header>\n<div class=\"textbox__content\">\n<p>At the end of this section, you will be able to:<\/p>\n<ul>\n<li>Explain how melanoma is diagnosed by histological examination of a tissue biopsy.<\/li>\n<li>Describe how interprofessional collaboration between health care professionals aid in the diagnosis and treatment of metastatic melanoma.<\/li>\n<li>Outline key prevention measures that one can take to reduce their risk of developing melanoma.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<h2>Diagnosis<\/h2>\n<p>Diagnosis of melanoma is through histological examination.&nbsp; What does this look like?<\/p>\n<p>Often, melanoma starts as a irregular looking mole on the skin. That mole, with a little bit of surrounding &#8216;normal&#8217; tissue is cut out (ie <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_200_1065\">biopsy<\/a>) by a health care professional.&nbsp; This biopsy is taking&nbsp; the entire mole including the epidermal and dermal layer of the skin. The biopsied mole is cut into very thin slices and mounted onto a glass slide and stained with H&amp;E.&nbsp; All of this work is performed by a medical laboratory technologist with a histology specialization.&nbsp; After a preliminary glance of the stained slide of the biopsied mole, the technologist then sends the slide to a histopathologist for diagnosis, using some of the skills and terms Lyz had demonstrated in the previous chapter.<\/p>\n<h2>Treatment<\/h2>\n<p>Treatment of melanoma&nbsp; &#8211; as well as most cancers &#8211; can be grouped as:<\/p>\n<ul>\n<li>Chemo- and radiotherapy:&nbsp; both of these strategies aim to kill rapidly dividing cells whether by:<\/li>\n<\/ul>\n<ul>\n<li style=\"list-style-type: none\">\n<ul>\n<li>Chemotherapy uses chemicals which slow down or inhibit cell division. Usually, chemotherapy is absorbed in the entire body &#8211; so cell division in normal healthy cells will also be affected.<\/li>\n<li>Radiotherapy uses radiation to kill rapidly growing tumour cells.&nbsp; Usually, radiotherapy is localized to the site of the cancerous growth.&nbsp; However, some normal tissue &#8211; especially skin &#8211; will be affected by radiation&nbsp; if it happens to be in the path of the radiation beam.&nbsp; An important issue for radiotherapy is that certain organs have different &#8216;tolerance&#8217; for radiation exposure.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<ul>\n<li>Surgical excision:&nbsp; remove the cancerous tissue and some surrounding tissue.\n<ul>\n<li>Requires biopsy of surrounding structures and lymph nodes to assess for possibility of nearby metastases as a hint to possible further spread.<\/li>\n<li>Surgical excision of metastases will not cure the cancer &#8211; but it can relieve signs &amp; symptoms caused by the metastasis.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3>Medical Laboratory Sciences (Anatomic Pathology) in surgical treatment of cancer<\/h3>\n<p>Listen to Marion Regan, a medical laboratory technologist, speak about how technologists are giving instantaneous histological specimens to surgeons while the surgeon is excising cancerous tissues.<\/p>\n<p style=\"text-align: center;background-color: #f0f0f0;padding: 5px\"><sup>Histological Preparation of Biopsy Tissue During Surgery by Marion Regan &amp; Jennifer Kong, licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/\">CC BY NC<\/a><\/sup><\/p>\n<ul>\n<li>Immunotherapy:&nbsp; allow the body&#8217;s immune system to recognize abnormal cancer cells and remove them.\n<ul>\n<li>This is in the early stages of implementation.<\/li>\n<\/ul>\n<\/li>\n<li>Targeted therapy:&nbsp; inhibit the genes (or their protein products) which were damaged &#8211; thus stopping the uncontrollable cell division.\n<ul>\n<li>This is in the early stages of research and implementation.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;background-color: #f0f0f0;padding: 5px\"><sup>Treatment of Melanoma by Lyz Boyd, licensed under <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/\">CC BY NC<\/a><\/sup><\/p>\n<h2>Prevention<\/h2>\n<p>What&#8217;s unique about melanoma &#8211; compared to many cancers &#8211; is that one can lower one&#8217;s risk by by limiting exposure of the skin &amp; eyes to the sun.&nbsp; Continuous monitoring of the skin &#8211; especially moles &#8211; may allow for early detection and, hence, early treatment.&nbsp; Patient survival rates increase when cancers are detected early.<\/p>\n<p style=\"text-align: center;background-color: #f0f0f0;padding: 5px\"><sup>Prevention of Melanoma by Lyz Boyd, licensed under &#8211; <a href=\"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/\">CC BY NC<\/a><\/sup><\/p>\n<h1>Section Review<\/h1>\n<ul>\n<li>Whether it is a biopsy of a suspicious mole or surgical excision of a tumour, a medical laboratory technologist will histologically prepare and stain the tissue, allowing for visual examination of key features of cancerous changes and whether the basement membrane is intact.<\/li>\n<li>Depending on the level of invasion of spread, melanoma can be treated by surgical excision of the tumour, localized treatment with radiotherapy, or systemic treatment with chemo- or immunotherapy.<\/li>\n<li>Prevention measures of modifiable risk factors (e.g.&nbsp; limiting sun damage to skin)&nbsp; can reduce the risk of developing melanoma.&nbsp; However non-modifiable risk factors (e.g. age, genetics, skin tone) can not be changed; thus, there is always a risk.<\/li>\n<\/ul>\n<h1>Review Questions<\/h1>\n<p>&nbsp;<\/p>\n<div class=\"glossary\"><span class=\"screen-reader-text\" id=\"definition\">definition<\/span><template id=\"term_200_1065\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_200_1065\"><div tabindex=\"-1\"><p>Eextraction of sample cells or tissues for examination to determine the presence or extent of a disease. The tissue is examined under a microscope by a pathologist for histological changes<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><\/div>","protected":false},"author":103,"menu_order":26,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["lyz-boyd","jen-2"],"pb_section_license":""},"chapter-type":[],"contributor":[117],"license":[],"class_list":["post-200","chapter","type-chapter","status-web-only","hentry","contributor-jen-2"],"part":131,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/dcbiol2200\/wp-json\/pressbooks\/v2\/chapters\/200","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/dcbiol2200\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/dcbiol2200\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/dcbiol2200\/wp-json\/wp\/v2\/users\/103"}],"version-history":[{"count":1,"href":"https:\/\/pressbooks.bccampus.ca\/dcbiol2200\/wp-json\/pressbooks\/v2\/chapters\/200\/revisions"}],"predecessor-version":[{"id":1249,"href":"https:\/\/pressbooks.bccampus.ca\/dcbiol2200\/wp-json\/pressbooks\/v2\/chapters\/200\/revisions\/1249"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/dcbiol2200\/wp-json\/pressbooks\/v2\/parts\/131"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/dcbiol2200\/wp-json\/pressbooks\/v2\/chapters\/200\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/dcbiol2200\/wp-json\/wp\/v2\/media?parent=200"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/dcbiol2200\/wp-json\/pressbooks\/v2\/chapter-type?post=200"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/dcbiol2200\/wp-json\/wp\/v2\/contributor?post=200"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/dcbiol2200\/wp-json\/wp\/v2\/license?post=200"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}