Melanoma

It is estimated that there were about 42,000 new cases of melanoma diagnosed in 1999. It is projected that in the year 2000, 1 out of 75 Americans will be diagnosed to have malignant melanoma. People at high risk are those with light complexions, freckles, many or irregular moles, a tendency to burn, and exposure to several sunburns before age 20. A family history of melanoma also increases risk. Prevention is critical.

Stage I and II disease are limited, and can be effectively treated by surgical intervention. Stage III disease has metastasized or spread to the nearby lymph nodes, and this is often discovered when a patient has a re-excision of the primary lesion and selective sentinel lymph node dissection (SSLND). The SSLND has recently become the standard, replacing prophylactic complete lymph node removal, as it is far less invasive and disabling, and offers reliable staging for micrometastatic disease. Dr. Leong and his colleagues have performed over 700 sentinel node dissections here at the UCSF Comprehensive Cancer Center/Mt. Zion Campus. Patients who have advanced metastases, which have spread to the internal organs or to multiple subcutaneous sites, are classified as stage IV, and have a poor prognosis. The median survival is 6-8 months after metastasis, with an 80-90% mortality rate at 1 year after onset of metastases.