Chapter 8 Case Study
Mr. J, age 42, is a construction worker in Las Vegas. He recently noticed that a mole on his
face seemed to be getting larger and darker. At first he did not worry because he was in the
sun a lot and assumed the change may have been caused by sunburn. After a month, not
only was the mole larger and darker, but it appeared to be “bumpy.” His doctor diagnosed
a malignant melanoma skin cancer following biopsy of the nevus. Mr. J reports pain in his
right shin that does not go away when he puts his feet up or sleeps.
1. Relate Mr. J’s skin changes to the warning signs for malignant melanoma.
The warning signs that Mr. J was having was the color, size and texture of the mole
changing. Another sign of malignant melanoma is the pain in his shin. This is a warning
sign of possible metastasis.
2. Discuss the normal progression of this malignancy. What is the significance of the
bone pain that Mr. J is experiencing?
Mr. J said that after he noticed the mole he had waited about a month before reporting it
to his PCP. This would give the mole enough time to metastasize to his other organs and
that is not even considering the timing that he did not notice the mole before that. Since it
is malignant it means that it has spread from one place in the body to another. This has
started on his face and to his leg possibly. It is very common for melanoma to spread to
the bones. Since it is at that stage it is unfortunate but he has most likely developed
advanced melanoma between stages 3 and 4.
3. Discuss the treatment available for this patient and the prognosis for recovery.
Since his cancer has developed further and is not in the early stages it requires additional
treatment. Treatment could include chemo or radiation, immunotherapy, targeted therapy
and possibly even clinical trials. His prognosis as long as he go along with treatments in
removing the melanoma I believe he has positive outcome for his recovery.
References:
https://www.skincancer.org/skin-cancer-information/melanoma
https://www.cancer.org/cancer/melanoma-skin-cancer/treating/by-stage.html
https://www.cancercenter.com/melanoma/types/tab/metastatic-melanoma/
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