Aim of the melanoma case study
This case study aims to facilitate the development of competencies that reflect the role of the Specialist Cancer Nurse (SCN) in managing disease and treatment related care for a person at risk of or diagnosed with melanoma across the cancer journey.
Australia currently has the world's highest rate of skin cancer. Rates in the USA are a third less and rates in the UK are a quarter less than in Australia.4
Melanoma was the fourth most common cancer in both men and women in Australia in 2009, representing 10.1% of all cancer cases.2
There are many points along the cancer journey when the SCN can improve outcomes for people at risk of or affected by melanoma. These include:
Section 1: Reduce risk
There are clearly defined risk factors associated with the development of melanoma. Ultraviolet (UV) radiation exposure through sun exposure or artificial means such as solariums, especially in the first 25 years of life, is the major environmental risk factor associated with melanoma. Genetic and geographic factors are also linked to increased risk of developing melanoma.4, 5
The SCN plays an important role in population specific public health efforts to reduce exposure to lifestyle and occupational risk factors linked to melanoma.6
Section 2: Find the condition early
Morbidity and survival outcomes are improved when melanoma is detected and diagnosed early. Five-year survival rates are 92-97% for Stage I melanoma, 53-80% for Stage II, 40-78% for stage III and 10-28% for Stage IV.7
The SCN can facilitate early detection through education related to the signs and symptoms of melanoma and promoting review of suspicious lesions.
Section 3: Have the best treatment and support during active treatment
Primary localised melanoma is treated exclusively by surgery, but advanced and recurrent disease may involve the administration of biological and targeted therapies, antineoplastic agents and radiotherapy.4 Given the rapid developments in novel molecular, targeted and immunotherapy treatment approaches, individuals may be given the opportunity to enter a clinical trial or access to treatments through compassionate circumstances.4, 8
The SCN can have an important role in providing information and support to people during treatment, and in preventing and managing adverse effects from treatments.
Section 4: Have the best treatment and support between and after active treatment
People treated for melanoma may require life-long follow up care, as the individual diagnosed with melanoma has an increased risk of developing future melanomas.
The SCN provides targeted education and resources to enable individuals to detect recurrent disease and new primary melanomas early. Education and support may also be required to manage the psychological and physical morbidity associated with melanoma and its treatment.