Mayo Clinic Proceedings Home

Malignant Melanoma: An Emerging and Preventable Medical Catastrophe

  • Edward T. Creagan
    Address reprint requests to Dr. E. T. Creagan, Division of Medical Oncology, Mayo Clinic Rochester, 200 First Street SW, Rochester, MN 55905
    Division of Medical Oncology, Mayo Clinic Rochester, Rochester, Minnesota
    Search for articles by this author
      The natural history of malignant melanoma, including the diagnosis, prognosis,.and treatment options, is reviewed in an attempt to formulate appropriate management strategies. Awareness on the part of clinicians is important, inasmuch as early detection of malignant melanoma offers the best chance for improved survival. Most lesions are excised with a margin of 1 to 3 cm, and follow-up assessment intervals are based on the depth of the primary lesion. Follow-up usually consists of a medical history, physical examination, chest roentgenography, and hematologic and chemistry profiles. Routine use of sophisticated imaging studies is unnecessary because the yieid from such an approach has been low. Patients with melanomas thicker than 1.6 mm and those with histologic evidence of involvement of regional lymph nodes are at risk for development of disseminated disease and may be candidates for adjuvant therapy. In patients with severe weight loss and poor nutrition because of advanced disease, analgesic agents, stool softeners, and appetite enhancers are palliative measures that should be considered.
      CT (computed tomographic), MRI (magnetic resonance imaging)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Mayo Clinic Proceedings
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Weiss M
        • Loprinzi CL
        • Creagan ET
        • Dalton RJ
        • O'Fallon J
        • Novotny P
        Utility of follow-up tests for detecting disease-recurrence of surgically resected primary malignant melanoma [abstract].
        Proc Annu Meet Am Soc Clin Oncol. 1995; 14: 307
        • Creagan ET
        • Dalton RJ
        • Ahmann DL
        • Jung S-H
        • Morton RF
        • Langdon Jr, RM
        • et al.
        Randomized, surgical adjuvant clinical trial of recombinant interferon alfa-2a in selected patients with malignant melanoma.
        J Clin Oncol. 1995; 13: 2776-2783
        • Kirkwood JM
        • Strawderman MH
        • Ernstoff MS
        • Smith TJ
        • Borden EC
        • Blum RH
        Interferon alfa-2b adjuvant therapy of high-risk resected cutaneous melanoma: the Eastern Cooperative Oncology Group Trial EST 1684.
        J Clin Oncol. 1996; 14: 7-17
        • Cascinelli N
        • Bufalino R
        • Morabito A
        • Mackie R
        Results of adjuvant interferon study in WHO melanoma programme [letter].
        Lancet. 1994; 343: 913-914
        • Prescott LM
        Adjuvant interferon alfa-2a improves survival in locally advanced melanoma: WHO study.
        Clin Cancer Lett. 1995; 18: l-3
        • Creagan ET
        Regional and systemic strategies for metastatic malignant melanoma.
        Mayo Clin Proc. 1989; 64: 852-860
        • Creagan ET
        • Schaid DJ
        • Ahmann DL
        • Frytak S
        Disseminated malignant melanoma and recombinant interferon: analysis of seven consecutive phase II investigations.
        J Invest Dermatol. 1990; 95: 188S-192S
        • Kirkwood JM
        Systemic therapy of melanoma.
        Curr Opin Oncol. 1994; 6: 204-211
        • Rusthoven J
        • Quirt I
        • Iscoe N
        • McCulloch P
        • James K
        • Lohmann R
        • et al.
        A randomized, placebo-controlled trial comparing BCNU (B), dacarbazine (D), and cisplatin (P) versus BDP and high-dose tamoxifen in the treatment of metastatic melanoma [abstract].
        Proc Annu Meet Am Soc Clin Oncol. 1995; 14: 413
        • Creagan ET
        Psychosocial issues in oncologic practice.
        Mayo Clin Proc. 1993; 68: 161-167
        • Lickiss JN
        Palliative care and melanoma: the care of the patient with progressive disease.
        World J Surg. 1992; 16: 282-286