{"id":550,"date":"2021-07-14T18:19:34","date_gmt":"2021-07-14T22:19:34","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathology\/?post_type=chapter&#038;p=550"},"modified":"2025-08-19T14:51:20","modified_gmt":"2025-08-19T18:51:20","slug":"diagnosis-and-treatment-of-metastatic-melanoma","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathology\/chapter\/diagnosis-and-treatment-of-metastatic-melanoma\/","title":{"raw":"Diagnosis and Treatment of Metastatic Melanoma","rendered":"Diagnosis and Treatment of Metastatic Melanoma"},"content":{"raw":"<div class=\"textbox textbox--learning-objectives\"><header class=\"textbox__header\">\r\n<p class=\"textbox__title\">Learning Objectives<\/p>\r\n\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nAt the end of this section, you will be able to:\r\n<ul>\r\n \t<li>Explain how melanoma is diagnosed by histological examination of a tissue biopsy.<\/li>\r\n \t<li>Describe how interprofessional collaboration between health care professionals aid in the diagnosis and treatment of metastatic melanoma.<\/li>\r\n \t<li>Outline key prevention measures that one can take to reduce their risk of developing melanoma.<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\n<h2>Diagnosis<\/h2>\r\nDiagnosis of melanoma is through histological examination. What does this look like?\r\n\r\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=\"2375\"]biopsy[\/pb_glossary]) by a health care professional. This biopsy is taking 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. All of this work is performed by a medical laboratory technologist with a histology specialization. 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.\r\n<h2>Treatment<\/h2>\r\nTreatment of melanoma, as well as most cancers, can be grouped as:\r\n<ul>\r\n \t<li>Chemo- and radiotherapy: both of these strategies aim to kill rapidly dividing cells whether by:<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li style=\"list-style-type: none\">\r\n<ul>\r\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>\r\n \t<li>Radiotherapy uses radiation to kill rapidly growing tumour cells. Usually, radiotherapy is localized to the site of the cancerous growth. However, some normal tissue - especially skin - will be affected by radiation if it happens to be in the path of the radiation beam. An important issue for radiotherapy is that certain organs have different 'tolerance' for radiation exposure.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<ul>\r\n \t<li>Surgical excision: remove the cancerous tissue and some surrounding tissue.\r\n<ul>\r\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>\r\n \t<li>Surgical excision of metastases will not cure the cancer - but it can relieve signs &amp; symptoms caused by the metastasis.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<h3>Medical Laboratory Sciences (Anatomic Pathology) in Surgical Treatment of Cancer<\/h3>\r\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.\r\n\r\n[h5p id=\"54\"]\r\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>\r\n\r\n<ul>\r\n \t<li>Immunotherapy: allow the body's immune system to recognize abnormal cancer cells and remove them.\r\n<ul>\r\n \t<li>This is in the early stages of implementation.<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t<li>Targeted therapy: inhibit the genes (or their protein products) which were damaged - thus stopping the uncontrollable cell division.\r\n<ul>\r\n \t<li>This is in the early stages of research and implementation.<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n&nbsp;\r\n\r\n[h5p id=\"52\"]\r\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>\r\n\r\n<h2>Prevention<\/h2>\r\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. Continuous monitoring of the skin - especially moles - may allow for early detection and, hence, early treatment. Patient survival rates increase when cancers are detected early.\r\n\r\n[h5p id=\"53\"]\r\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>\r\n\r\n<h2>Section Review<\/h2>\r\n<ul>\r\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>\r\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>\r\n \t<li>Prevention measures of modifiable risk factors (e.g. limiting sun damage to skin) can reduce the risk of developing melanoma. However, non-modifiable risk factors (e.g. age, genetics, skin tone) can not be changed; thus, there is always a risk.<\/li>\r\n<\/ul>\r\n<h1>Review Questions<\/h1>\r\n<div class=\"h5p\">[h5p id=\"111\"]<\/div>\r\n<div class=\"pdf\"><strong>1. Upon discovering an abnormal mole, a patient will be fast tracked for radiotherapy.\r\n<\/strong>\r\n<ul>\r\n \t<li>True<\/li>\r\n \t<li>False<\/li>\r\n<\/ul>\r\n<strong>2. How do you prevent melanoma? <span class=\"TextRun SCXW220217406 BCX2\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW220217406 BCX2\">Fill in the blanks with the following words:<\/span><\/span><\/strong>\r\n\r\nclothing, staying indoors, sunscreen, age\r\n\r\nSeveral lifestyle changes can be implemented to lower one's chance of melanoma. This is different than non-modifiable risks such as _____ which can't be changed with any lifestyle choice. Prevention of damaging exposure to the sun is best done by _____ during the sunniest times of the day. When going out into the sun, one is encouraged to wear _____ as reapplication isn't required, as seen with applying _____.\r\n\r\n&nbsp;\r\n<div class=\"textbox\">\r\n<h2>Answer Key<\/h2>\r\n<ol>\r\n \t<li>False<\/li>\r\n \t<li>Age, staying indoors, clothing, sunscreen<\/li>\r\n<\/ol>\r\n<\/div>\r\n<\/div>","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. 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_550_2375\">biopsy<\/a>) by a health care professional. This biopsy is taking 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. All of this work is performed by a medical laboratory technologist with a histology specialization. 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, as well as most cancers, can be grouped as:<\/p>\n<ul>\n<li>Chemo- and radiotherapy: 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, so cell division in normal healthy cells will also be affected.<\/li>\n<li>Radiotherapy uses radiation to kill rapidly growing tumour cells. Usually, radiotherapy is localized to the site of the cancerous growth. However, some normal tissue &#8211; especially skin &#8211; will be affected by radiation if it happens to be in the path of the radiation beam. 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: 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<div id=\"h5p-54\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-54\" class=\"h5p-iframe\" data-content-id=\"54\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Med Lab histology\"><\/iframe><\/div>\n<\/div>\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: 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: 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<div id=\"h5p-52\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-52\" class=\"h5p-iframe\" data-content-id=\"52\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Treatment of melanoma\"><\/iframe><\/div>\n<\/div>\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, compared to many cancers, is that one can lower one&#8217;s risk by by limiting exposure of the skin &amp; eyes to the sun. Continuous monitoring of the skin &#8211; especially moles &#8211; may allow for early detection and, hence, early treatment. Patient survival rates increase when cancers are detected early.<\/p>\n<div id=\"h5p-53\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-53\" class=\"h5p-iframe\" data-content-id=\"53\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Prevention of melanoma\"><\/iframe><\/div>\n<\/div>\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<h2>Section Review<\/h2>\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. limiting sun damage to skin) can reduce the risk of developing melanoma. 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<div class=\"h5p\">\n<div id=\"h5p-111\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-111\" class=\"h5p-iframe\" data-content-id=\"111\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Treatment and prevention of melanoma\"><\/iframe><\/div>\n<\/div>\n<\/div>\n<div class=\"pdf\"><strong>1. Upon discovering an abnormal mole, a patient will be fast tracked for radiotherapy.<br \/>\n<\/strong><\/p>\n<ul>\n<li>True<\/li>\n<li>False<\/li>\n<\/ul>\n<p><strong>2. How do you prevent melanoma? <span class=\"TextRun SCXW220217406 BCX2\" lang=\"EN-US\" xml:lang=\"EN-US\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW220217406 BCX2\">Fill in the blanks with the following words:<\/span><\/span><\/strong><\/p>\n<p>clothing, staying indoors, sunscreen, age<\/p>\n<p>Several lifestyle changes can be implemented to lower one&#8217;s chance of melanoma. This is different than non-modifiable risks such as _____ which can&#8217;t be changed with any lifestyle choice. Prevention of damaging exposure to the sun is best done by _____ during the sunniest times of the day. When going out into the sun, one is encouraged to wear _____ as reapplication isn&#8217;t required, as seen with applying _____.<\/p>\n<p>&nbsp;<\/p>\n<div class=\"textbox\">\n<h2>Answer Key<\/h2>\n<ol>\n<li>False<\/li>\n<li>Age, staying indoors, clothing, sunscreen<\/li>\n<\/ol>\n<\/div>\n<\/div>\n<div class=\"glossary\"><span class=\"screen-reader-text\" id=\"definition\">definition<\/span><template id=\"term_550_2375\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_550_2375\"><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":1232,"menu_order":14,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["lyz-boyd","jen-2"],"pb_section_license":""},"chapter-type":[],"contributor":[59,64],"license":[],"class_list":["post-550","chapter","type-chapter","status-publish","hentry","contributor-jen-2","contributor-lyz-boyd"],"part":326,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters\/550","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/users\/1232"}],"version-history":[{"count":25,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters\/550\/revisions"}],"predecessor-version":[{"id":9348,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters\/550\/revisions\/9348"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/parts\/326"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters\/550\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/media?parent=550"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapter-type?post=550"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/contributor?post=550"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/license?post=550"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}