Melanoma Care Options™ Issue 3: Treatment of Melanoma in Special Circumstances

Authors:
Lawrence E. Flaherty, MD (editor)
Clara Curiel-Lewandrowski, MD
Mohammed Kashani-Sabet, MD
David W. Ollila, MD

Coauthor:
Merrick I. Ross, MD, FACS (Steering Committee Editor, Working Group Leader)

Barriers to Care Authors:
Ashfaq A. Marghoob, MD, FAAD (dermatology)
Douglas S. Reintgen, MD (surgical oncology)
Thomas E. Olencki, DO (medical oncology)

1. Interested in reading the publication and earning CME credits online? Click here to register, click here to download the publication and click here to take the CME test and evaluation on line.

2. Just want to download the publication? Click here to download the publication. You can always print out and fax the CME information to us later.

Continuing Medical Education Information

Instructions for Participation:

• Read the case presentations and comments in the newsletter
• Fill out the CME test and evaluation online or complete the posttest questions and evaluation form at the end of the newsletter, and fax or mail them to our office

To receive a maximum of 1.5 AMA PRA Category 1 Credits^™ (or 1.5 CNE credits) for this activity:

• Within 4 weeks of successful completion, you may access your credit transcript at http://ccehs.upmc.edu/
• 70% of your posttest answers must be correct for you to receive a certificate of credit

To receive up to 1.5 CNE credits for this activity:

• Within 4 weeks of successful completion, a certificate will be mailed to the address provided
• 70% of your posttest answers must be correct for you to receive a certificate of credit

Target Audience

This activity is directed toward dermatologists, dermatologic surgeons, surgical and medical oncologists, general surgeons, oncology nurses, primary care physicians, and other health care professionals who treat or screen for melanoma.

Statement of Need

Many cases of melanoma fall outside the mainstream situations covered by evidence-based guidelines. The appropriate management of these cases requires a careful evaluation of available literature and an understanding of special circumstances that may influence diagnosis, staging, lymph node biopsy, and surgical and nonsurgical therapeutic options. This publication presents 4 cases of melanoma in special circumstances (melanoma during pregnancy, in-transit melanoma, melanoma with an unknown primary, and head and neck melanoma) and addresses controversies in the staging and treatment of these cases. A review of relevant literature, with a focus on recent publications, and faculty recommendations are provided to help guide practitioners in choosing the optimal management strategies for melanoma patients with special circumstances.

Learning Objectives:

After completing this activity, the participants will be able to:

• Address treatment issues in melanoma with complicating features or special circumstances, including pregnancy, in-transit melanoma, unknown primaries, or head and neck melanoma
• Discuss the diagnostic pitfalls and available treatment modalities for melanoma in pregnant women
• Describe the prognostic features and available treatment options for melanomas in problematic sites, including in-transit melanoma, head and neck melanoma, melanoma in pregnant patients, and metastatic melanoma with unknown primary origin
• Compare and contrast the prognostic features of melanoma with unknown primary versus other types of metastatic melanoma

Continuing Education Credit

The University of Pittsburgh School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The University of Pittsburgh School of Medicine designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits^™. Each physician should only claim credit commensurate with the extent of his/her participation in the activity.

1.5 contact hours of Continuing Nursing Education will be granted by the University of Pittsburgh School of Nursing. The University of Pittsburgh School of Nursing is an approved provider of continuing nursing education by the Pennsylvania State Nurses Association (PSNA), an accredited approver by the American Nurses Credentialing Centers Commission on Accreditation.

We gratefully acknowledge an educational grant from Schering-Plough Corporation in support of this activity.

Contributing Authors and Disclosures

Clara Curiel-Lewandrowski, MD
Assistant Professor of Dermatology
University of Arizona
Tucson, Arizona
No financial relationships to disclose

Lawrence E. Flaherty, MD
Professor of Medicine and Oncology
Karmanos Cancer Institute
Wayne State University
Detroit, Michigan
Grants/Research Support: Schering-Plough Corporation, Chiron
Therapeutics, Celgene, Bayer; Consultant: Bayer; Speakers
Bureaus: Schering-Plough Corporation, GlaxoSmithKline

Mohammed Kashani-Sabet, MD
Associate Professor of Dermatology
Director, Melanoma Center
UCSF Cancer Center
University of California San Francisco School of Medicine
San Francisco, California
Consultant: Schering-Plough; Speakers Bureau: Schering-Plough Corporation.

David W. Ollila, MD
Associate Professor of Surgery
Director, Multidisciplinary Melanoma Program
University of North Carolina School of Medicine
Chapel Hill, North Carolina
No financial relationships to disclose

Merrick I. Ross, MD, FACS
Professor of Surgical Oncology
University of Texas M.D. Anderson Cancer Center
Houston, Texas
Speakers Bureaus: Schering-Plough Corporation, Genentech, Inc

Ashfaq A. Marghoob, MD, FAAD
Associate Clinical Member
Clinical Director, Skin Care Center
Memorial Sloan-Kettering Cancer Center
Hauppauge, New York
No financial relationships to disclose

Douglas S. Reintgen, MD
Director
Lakeland Regional Cancer Center
Lakeland, Florida
Speakers Bureau: Schering Oncology

Thomas E. Olencki, DO
Clinical Professor
Division of Hematology/Oncology
James Cancer Hospital and Solove Research Institute
Ohio State University
Columbus, Ohio
Speakers Bureau: Schering-Plough Corporation

Michael Bihari, MD
Freelance Medical Writer
Falmouth, Massachusetts
No financial relationships to disclose

Date of Original Release: December 15, 2007
Expiration Date: December 15, 2008
Date of last review: December 15, 2007