Melanoma Flashcards
Melanoma pT3a N0
what does this indicate
P = pathological T3 = tumour between 2-4 mm thick a = non ulcerated
No nodes involved
Melanoma pT3a N0
what does this indicate
P = pathological T3 = tumour between 2-4 mm thick a = non ulcerated
No nodes involved
2 scales used to describe how deeply a melanoma has gone into the skin
Clark scale
Breslow scale
what are the 5 levels of the clark scale
1) melanoma cells are only in the outer layer of the skin (epidermis)
2) cells are in the layer directly under the epidermis
3) melanoma cells are throughout the papillary dermis and touching on the next layer down
4) melanoma has spread into the reticular or deep dermis
5) melanoma has grown into the layer of fat under the skin
how is Breslow scale carried out
pathologist measures the thickness of the melanoma with a small ruler
2 scales used to describe how deeply a melanoma has gone into the skin
Clark scale
Breslow scale
what are the 5 levels of the clark scale
1) melanoma cells are only in the outer layer of the skin (epidermis)
2) cells are in the layer directly under the epidermis
3) melanoma cells are throughout the papillary dermis and touching on the next layer down
4) melanoma has spread into the reticular or deep dermis
5) melanoma has grown into the layer of fat under the skin
how is Breslow scale carried out
pathologist measures the thickness of the melanoma with a small ruler
what investigation is required to complete staging
CT or PETCT
FDG avid
metabolically active
mutation that if tested to be positive, is suitable for targeted therapy
BRAF
common side effects of Opdivo and Ipilimumab
immunotherapies
- fatigue
- diarrhoea
- skin rash
- nausea
- electrolyte changes
- liver changes
WHO performance status 0-5
0 = able to carry out all normal activity without restriction 1 = restricted in strenuous activity but able to carry out light work 2 = capable of all self care; up and about more than 50% waking hours 3 = symptomatic and in bed for greater than 50% day 4 = disabled and totally confined to bed/chair
3 causes fo extensive lymphadenopathy
- lymphomas
- axillary lymph nodes in a female consider breast ca
- neck nodes could be from cancer of head or neck
management of brain mets
- surgery
- radiotherapy
- systemic trx that can cross BBB
- high dose dex
- inform DVLA
