SU_NSG6005_W10_A2_Luis_M - Running head EVIDENCE-BASED PHARMACOLOGY Evidence-Based Pharmacology Marcia Luis South University NSG6005 Margaret Andrews 1

SU_NSG6005_W10_A2_Luis_M - Running head EVIDENCE-BASED...

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Running head: EVIDENCE-BASED PHARMACOLOGY 1 Evidence-Based Pharmacology Marcia Luis South University NSG6005 Margaret Andrews June 06, 2016
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EVIDENCE-BASED PHARMACOLOGY 2 Metastatic Melanoma Melanomas are extremely proliferating, invasive and usually metastatic (Vasco- Velazquez et al., 2011). They are responsible for 4% of skin cancer cases and 74% of all skin cancer (Vasco-Velazquez et al., 2011). The incidence of metastatic melanoma continues to rise in the United States (US) (Vasco-Velazquez et al., 2011). Over 68,000 cases were diagnosed in 2009 (Vasco-Velazquez et al., 2011). Melanoma is a deadly form of cancer and therefore it is very important to find treatments that can prevent metastases and improve survival rates (Vasco- Velazquez et al., 2011). Pathophysiology Melanoma is a kind of skin cancer that is generally a result of damage to the deoxyribonucleic acid (DNA) in particular types of skin cells called melanocytes (Melanoma, n.d.). This type of damage is often a result of exposure to ultraviolet light resulting in cancerous tumors (Melanoma, n.d.). If detected early, it is frequently curable (Melanoma, n.d.). If it is not promptly treated, it can spread and metastasize to other body parts (Melanoma, n.d.). If melanoma is unable to be removed surgically (stage III unresectable) or it metastasizes (stage IV), it is known as advanced melanoma (Melanoma, n.d.). It is the second most common cancer in men ages 20-39 and the third most commonly diagnosed cancer amongst women ages 20-39 (Melanoma Stats, 2016). Caucasians are more likely to develop melanoma then African Americans (Melanoma Stats, 2016). Rates are higher in women before the age of 50 (Melanoma Stats, 2016). After 65, rates in men double and exceed those in women (Melanoma Stats, 2016). By age 80 rates in men triple that of women (Melanoma Stats, 2016). Roughly 10% of people diagnosed with melanoma have a familial history (Melanoma Stats, 2016). Melanoma Stages
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EVIDENCE-BASED PHARMACOLOGY 3 There are 4 main classifications of melanoma cancer (Melanoma, n.d.). This is determined based on the thickness of the tumor and how far it has spread (Melanoma, n.d.). A biopsy of the cells is diagnostic and can determine the stage of cancer. The main stages of melanoma are (Melanoma, n.d.): 1 Stage 1-A small cancerous tumor is formed in the epidermis and is growing at a slow rate. 2 Stage 2-Tumor is localized and larger than 1 millimeter in thickness. It grows at a faster rate. 3 Stage 3-Tumor spreads to lymph nodes and is removable by surgery. 4 Stage 4-Metestatic tumor has spread to lymph nodes or to organs of the body. Regardless of the stage, not all advanced melanoma is the same (Melanoma, n.d.). Patients are unique genetically and this can influence the presentation of the tumor (Melanoma, n.d.). Different cell mutations can make the disease unique (Melanoma, n.d.). Genomic Issues & Disease Process Metastasis is a multifaceted process that consists of several consecutive steps (Hoek, 2011). During this progression, cancer cells take over the tissues and spread into the blood vessels (Hoek, 2011). Exposure to the sun is thought to directly contribute to the malignant
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