Clinical and therapeutic aspects of malign melanoma

Abstract

Introduction: Malignant melanoma (MM) is the most aggressive skin cancer, which develops through malignant transformation of melanocytes. The number of MM cases worldwide has increased faster than any other cancer in recent decades. MM is the fourth most common cancer among males (after prostate, bowel and lung cancers) and the third among females (after breast and bowel cancers). It accounts for about 50 new cases per 100,000 population each year. In RM 80-90 new cases of MM are recorded annually. The major problem of the health system is the tardive revelation of patients who show specific changes of the skin, leading to late treatment and negative prognosis. Purpose and objectives: The main objective of this thesis is to study the incidence, the most common causes, the results of the performed treatment in relation to cancer recurrence, and the prognosis of patients which addressed to the M.P.S.I. Institute of Oncology from R.M. during 2013 year. Material and Methods: The study described in the present paper is observational-descriptive (study variations in the distribution of disease in the population), according to the investigational volume - limited study (research a part of “statistical universe”). The methodology for conducting the research was based on the development of modern scientific study of the particularities of structure of the skin tumors morbidity in the population of the republic; the unit of study was the patient with primary cutaneous tumors. Research methodology was developed on basis of the local authors and foreign publications. In order to achieve the research objectives we have determined as a methodological protocol the application of the linear model for the organization and implementation of the research: finding the problem -> define the key concepts of the thesis -> determining research model -> determining sample -> observational study sheets -> data collection -> analysis and synthesis results - > work out the conclusions -> practical application of research results. Results: The achieved results offer to clinician exact data that allow: to improve the antitumoral therapy and respectively the population health, perspectives of continuously development of diagnosis, treatment and prophylaxis of cutaneous cancers; to lower the cost needed to care of patients which suffer of these diseases by reducing number of cases diagnosed in late severe stages, extension of diagnostic and treatment measures; to improve life conditions of patients suffering from skin cancer, by a performance management of these affections; to reduce population anxiety for cutaneous cancer by correct information regarding disease and the possibility of early diagnosis by dermatoscopy. The thesis results will contribute to enhance the efficacy in early diagnostic of cutaneous tumors and optimization of diagnostic process, and ultimately to increase the treatment efficacy in skin tumors and increase chances and rate of patient recovery. Conclusions: As a result of complex research conducted by the author on the evolution of the phenomenon epidemiometric parameters morbid skin tumors in Moldova in 2013 we concluded the following: incidence of malignant melanoma has increased by 1.5 times; morbidity skin tumors increased by 40%, malignant melanoma mortality rate - increased by 2.3 times in comparison with 2003. Our study also demonstrated that a large number of people showing skin specific processes address delayed for a specific consult, the average elapsed from onset until presentation to the doctor being about two years, and the underlying cause is unjustified neglect of patients and bad information on the possibility of treatment for early detection of skin tumors.