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Glossary entry

English term or phrase:

high-risk melanoma

English answer:

Stage 2 or 3 melanoma [with high risk of progression]

Added to glossary by liz askew
Aug 30, 2007 07:43
17 yrs ago
1 viewer *
English term

high-risk melanoma

English Medical Medical: Health Care melanoma treatment
Does this term mean that a patient is at high risk of disease progression, spread of metastases or recurrence? Help me, please,to clear it up!
Responses
4 Stage 2 or 3 melanoma
4 yes!
3 high risk of metastases
Change log

Sep 1, 2007 08:08: liz askew Created KOG entry

Discussion

GEKAMON (X) (asker) Aug 31, 2007:
My name is Jane.
Dr Sue Levy (X) Aug 31, 2007:
Don't worry about points Gekamon (do you have a name?). Besides, I don't deserve any after writing "it's size" with an apostrophe. Shame on me!!!
GEKAMON (X) (asker) Aug 31, 2007:
Sorry, not goes but go.
GEKAMON (X) (asker) Aug 30, 2007:
Dr Sue Levy, 4 points should definetely goes to you! :)
Dr Sue Levy (X) Aug 30, 2007:
The aggressiveness and hence "risk" of a melanoma has little to do with it's size.
Dr Sue Levy (X) Aug 30, 2007:
metastasised.
Dr Sue Levy (X) Aug 30, 2007:
I think "high risk of progression" which encompasses local recurrence, local spread and distant metastases is the best way to think of this. At diagnosis, a melanoma can be considered high risk by its histological nature, even if it has not spread or
GEKAMON (X) (asker) Aug 30, 2007:
It's a presentation, so the context is scarse. I have separate phrases, eg. Adjuvant therapy for high-risk melanoma;
Objective - Compare effects of HDI therapy on RFS and OS in high-risk melanoma patients. There is no specific indications, so I think I need a general term which would include all possible symptoms.
Dr Sue Levy (X) Aug 30, 2007:
It can mean a number of things, as you have seen. Without the precise context, it is impossible to say.

Responses

37 mins
Selected

Stage 2 or 3 melanoma

Find out more from this:

http://64.233.183.104/search?q=cache:IW3cz-bdLWEJ:www.cancer...


This page tells you about treatment for stage 2 and 3 melanoma. You can scroll down the page to read all the information here. Or use the following links to go straight to sections on
 What stage 2 and 3 melanoma means
 How is stage 2 and 3 melanoma treated?how
 Sentinel node biopsy
 Removing your lymph nodes
 Treatment with chemotherapy or biological therapy (adjuvant treatment)

What stage 2 and 3 melanoma means

Melanoma that is stage 2 or 3 may sometimes be described by doctors as high risk. This is because there is a possibility that your melanoma could come back in another part of your body. Stage 2 melanomas are thicker than 2.0mm or thicker than 1.0mm and ulcerated. Ulcerated means that the covering layer of skin is broken. And melanomas that are ulcerated are more likely to spread. There is also a higher risk of spread with a thicker melanoma than with a thin one because the melanoma cells have grown deeper into the skin. Some doctors prefer to call stage 2 melanomas between 1.0mm and 4mm intermediate risk. And only those over 4mm thick are high risk.

Your melanoma may also be called high risk if you have
 Any nearby lymph nodes that contain melanoma cells
 A local recurrence of a primary melanoma
 'In transit' metastases



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Note added at 1 hr (2007-08-30 09:13:53 GMT)
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Well, whatever you decide, make sure you base your decision on some sound medical evidence, rather than somebody's say so.., unless they are a Health Professional of course.

Good luck to you!
Note from asker:
The point is that I've come across different definitions of a high-risk melanoma. Some describe it as a melanoma with a high risk of recurrence. The other tell about the high risk of tumour cells spreading (metastases). I don't know which one to choose :( I think that disease progression is a wider notion that cover both recurrence and metastases.
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3 KudoZ points awarded for this answer. Comment: "Thank you!"
27 mins

yes!

I think it means that this melanoma - or melanomas in general - are highly likely to spread...
Something went wrong...
5 hrs

high risk of metastases

both ladies explained a lot. A local melanoma poses little threat, so local recurrence poses little threat too. The greatest risk is generalisation of the disease, which is metastases. And there are several indices of the risk of metastases (grading).

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Note added at 12 hrs (2007-08-30 20:07:30 GMT)
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What is not true? The only risk of melanoma is its spread to other organ - by definition it is called metastasis. So the high risk melanoma is the one likely to cause metastasis. I meant Sue that localised melanoma poses little threat to neighbouring tissues (infiltrating them by continuity). There are cancers that can infiltrate vital organs and cause for example intestinal/urinary obstruction. Melanoma spreads systemically and that was my intention. So it is not local threat by systemic threat. That is what I meant by little local threat. In other words, the risk of localised melanoma is the fact that it can cause metastases.

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Note added at 23 hrs (2007-08-31 07:27:53 GMT)
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according to: http://www.medscape.com/viewarticle/447728_print

High-risk melanoma patients are defined as those who are at high risk for recurrence from micro-metastatic disease. Treating micro-metastatic disease before it becomes clinically detectable is the aim of adjuvant therapy. High-risk patients include those with nodal metastasis (stage III) and those with T4N0M0 melanomas

Peer comment(s):
neutral Dr Sue Levy (X) : local melanomas classified as T3-4 at time of diagnosis without evidence of spread are in fact high risk// no but you said a localised melanoma poses little threat, and that is not true//OK got you - I think we agree in the end :-)
3 hrs
I agree, I did not write anything about evidence of spread. Just the risk of spread, who would care about local progression? Before melanoma is large enough to cause local damage, it kills to generalised disease. /We agreed from the very beginning in fact
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