Outpatient Follow-up and Secondary Prevention for Melanoma Patients
Abstract
:1. Introduction
2. Secondary Prevention of Melanoma
2.1. Behavioral Methods of Prevention
2.2. Melanoma Chemoprevention
2.2.1. Statins, Fibrates, and Apomine
2.2.2. Anti-inflammatory Agents
2.2.3. Anti-oxidants
2.2.4. Anti-proliferatives
2.2.5. Diet, Micronutrients and Nutritional Supplements
3. Diagnostic Follow-up of the Melanoma Patient
3.1. Dermatoscopy
3.2. Reflectance Confocal Microscopy
3.3. Full Body Mole Mapping
Modality | Advantages and Disadvantages |
---|---|
Imaging: Chest X-ray, abdominal sonogram, CT, PET | - Low sensitivity, high false positive rates unless Stage III or higher [97] - 50% of follow-up costs [128] |
Labs: Liver chemistries, LDH | - Useful in Stage IV disease [95] |
Lymph node sonography | - Higher sensitivity than palpation [118,119] - May confer survival benefit [120] - Reveals 13% of relapses [97] - Comprises 24% of follow-up costs [128] |
Routine History and full body exam | - Detects >50% of recurrences - Non-invasive - Associated with thinner 2nd primary melanomas [129] |
Physical exam and lymph node ultrasound combined | - Detects majority of patients with macroscopic lymph node metastasis - Only 10% of histologically tumor positive sentinel nodes are macroscopically detectable [130] |
Patient self-monitoring | - Detects up to three-quarters of reported recurrences [131,132,133,134] - With proper education and/or images, could decrease frequency of follow-up visits [133] |
Sequential body-mapping, utilizing digital photography | - Increases detection of thin lesions [86] - Decreased mean Breslow depth at diagnosis [86] - Increased diagnostic accuracy of 13.5%, increased sensitivity, increased specificity depending on dermatologist experience with modality [87] |
3.4. Follow-up Schedules for Melanoma Patients
3.5. Serum Markers
3.6. Imaging
5. Conclusion
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Gamble, R.G.; Jensen, D.; Suarez, A.L.; Hanson, A.H.; McLaughlin, L.; Duke, J.; Dellavalle, R.P. Outpatient Follow-up and Secondary Prevention for Melanoma Patients. Cancers 2010, 2, 1178-1197. https://doi.org/10.3390/cancers2021178
Gamble RG, Jensen D, Suarez AL, Hanson AH, McLaughlin L, Duke J, Dellavalle RP. Outpatient Follow-up and Secondary Prevention for Melanoma Patients. Cancers. 2010; 2(2):1178-1197. https://doi.org/10.3390/cancers2021178
Chicago/Turabian StyleGamble, Ryan G., Daniel Jensen, Andrea L. Suarez, Anne H. Hanson, Lauren McLaughlin, Jodi Duke, and Robert P. Dellavalle. 2010. "Outpatient Follow-up and Secondary Prevention for Melanoma Patients" Cancers 2, no. 2: 1178-1197. https://doi.org/10.3390/cancers2021178