Talk:Melanoma

Research

Would like to discuss the possibility of adding a "Research" section to melanoma or to having a separate topic "Melanoma Research". Any thoughts? --Khaj 06:27, 25 July 2006 (UTC)

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Sunlight is a controversial cause of melanoma. Philiphughesmd 04:11, 9 December 2005 (UTC) Dr. Bernie Ackerman has written an entire book about the valueless sentinel lymph node biopsy. Philiphughesmd 04:14, 9 December 2005 (UTC)

I think it may be prudent to indicate that imiquamod and Moh's are not exactly first line or established treatments for melanoma. I've aimed to do so politely. Wide local excision remains the standard of care so the value of Moh's here is unclear. It is rarely appropirate to accept inadequate surgical resection of a cancer to minimise a scar. Will Blake 06:50, 29 May 2006 (UTC)

I have removed references to minimal deviation melanoma which is not a widely recognised subtype. Many feel it arises only when a pathologist is unwilling to commit to a benign or a malignant diagnosis. Hope no-one objects Will Blake 23:53, 29 May 2006 (UTC)

The following discussion is an archived debate of the proposal. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section.

The result of the debate was move. —Nightstallion (?) 13:58, 3 June 2006 (UTC)

Move: melanoma

I have asked to have this article moved to 'Melanoma' which is a more accurate, contemporary, precise and brief term. This is done on a consensus basis. Please record your feelings below. Any objectors? Will Blake 06:12, 29 May 2006 (UTC)

Although "melanosarcoma" may more accurately describe a malignant tumor of melanocytes, "melanoma" probably reflects common usage better. My understanding is that there are indeed benign tumors of melanocytes, but they are are far outnumbered by the malignant kind that common usage of "melanoma" has come to refer to the latter. -AED 06:13, 30 May 2006 (UTC)

This may indeed be confounding, but the medical jargon uses melanoma definitely for a malignant tumour (i.e. MesH definition. There are indeed various benign proliferations of melanocytes that and are given various names (ie "benign melanocytic lesions", various types of melanocytic naevi, mongolian spot, naevus of ota)--Dr. Friendly 21:55, 30 May 2006 (UTC)

The good doctor is correct, there are many benign tumours of melanocytes but none of them are ever refered to as melanoma. All the common naevi (junctional, compound, blue, spitz) are benign proliferations of melanocytes but the question is are they neoplasms or hamartomas? Thanks for your interest Will TALK 22:43, 30 May 2006 (UTC)

My vote should indicate that I certainly do not disagree that "melanoma" now almost always refers to malignant tumors and that other terms are now almost always refer to benign tumors. Given that we failed to be etymologically consistent with our use of Greek and Latin long ago, I don't quite agree that is more accurate to describe the malignant version as "melanoma". (Although it may appear as such to us now, the term "malignant melanoma" didn't come into being just for the sake of being redundant!) It is definitely the more contemporary use of the term, though. -AED 23:37, 30 May 2006 (UTC)

Your point is well made and correct Will TALK 23:55, 30 May 2006 (UTC)

Statements for or against

For

1. --Dr. Friendly 13:03, 29 May 2006 (UTC)
2. -AED 06:14, 30 May 2006 (UTC)
3. Rewster 06:24, 30 May 2006 (UTC)
4. JFW | T@lk 07:16, 30 May 2006 (UTC)

The above discussion is preserved as an archive of the debate. Please do not modify it. Subsequent comments should be made in a new section on this talk page. No further edits should be made to this section.

punch biopsy apperatus

I'm wondering, I've never seen the tool used for a punch biopsy. I'm thinking though, it sounds more like hole-puncher, than a small cookie-cutter. Do you think maybe that might be a better description of it?

Excision biopsies are done for melanomas. Snowman 07:44, 1 August 2006 (UTC)

Suggestions for the article page

I think that it might be worth including:

• the origins of a melanocyte and the normal melanocyte
• some benign pigmented lesions

It helps to see the difference between benign and malignant pigmented lesions, but it is not always easy. Snowman 21:19, 2 August 2006 (UTC)

• the difficultly in diagnosis in children (Spitz naevus)

the histopathology is difficult. Snowman 21:19, 2 August 2006 (UTC)

• atypical presentation

Non-pigmented forms. The ulcer that does not heal. Subungual (under a finger or toe nail). Snowman 21:19, 2 August 2006 (UTC)

• premalignant or dysplatic forms
• large pigmented birth marks

all of the above would be more appropriate on the already existing melanocyte and nevus pages.--Khaj 10:25, 1 August 2006 (UTC)

The point is, I think certain large birth marks are more likely to undergo a mitotic change. Snowman 10:58, 1 August 2006 (UTC)

• photographs from light microscopy

of what? nevi or melanoma? Be specific.--Khaj 10:25, 1 August 2006 (UTC)

Lets say; various stages from dysplastic to metastatic melanoma.

• histological tissue preparation

there already is a histology page, there is nothing in histological preparation which is purely specific to melanoma.--Khaj 10:25, 1 August 2006 (UTC)

Special stains. Snowman 10:58, 1 August 2006 (UTC)

There are some melanoma histology pictures on wikicommons which could be used. --WS 18:48, 1 August 2006 (UTC)

• biopsy with adequate excision Snowman 13:38, 31 July 2006 (UTC)

again, be specific, biopsy of what? nevi or melanomas?--Khaj 10:25, 1 August 2006 (UTC)

The article page can be more specific than the discussion page. Snowman 10:58, 1 August 2006 (UTC)

In the UK the biobsy of a suspicious lesion should be done by a hospital specialist (dermatologist or possibly a surgeon). I think that a punch biosy should never by done (or in only rarely done on a large lesion) for a suspicious pigmented lesions, as the punch biosy itself my spread the mitotic cells following which a much larger area of excision is needed. Snowman 08:59, 3 August 2006 (UTC)

They should not be done, not because of spreading cells, but because accurate determination of depth of melanoma invasion is critical for treatment decisions and prognosis and this can not be reliably determined with a punch biopsy (PMID 15748548). The only exception is when the melanoma completely fits in the punch. --WS 15:16, 3 August 2006 (UTC)

Does anyone know PDF - images

Does anyone know how to extract images from a PDF file ? There's a wealth of melanoma photos that are said to be in PD but inside this PDF. Kpjas 08:22, 4 August 2006 (UTC)

These images may have a copyright and so can not be used on the wiki. Snowman 08:36, 4 August 2006 (UTC)

To be featured (to-do)

I think as a current MCOTW, we should improve it to become FA. In my opinion, what is needed:

• more images (I start to find some)
• longer history
• more references
• more external links

NCurse _work 11:41, 7 August 2006 (UTC)

Also need link or source for British study which suggests that melanoma is more common in indoor than outdoor workers. Figma 23:52, 7 August 2006 (UTC)

I started to add new references (finished at Prevention for today) and I added organizations links + Commons link. Question: should I create a gallery for the 4 histology images in commons? Maybe a histology section should be needed. NCurse _work 15:55, 8 August 2006 (UTC)

And I sent a letter to the American Academy of Dermatology to give us images. :) NCurse _work 16:08, 8 August 2006 (UTC)

Nice pictures, but are the captions correct? Snowman 12:30, 14 August 2006 (UTC)

Most of the captions are from their DermAtlas homepage. The original source. NCurse _work 12:37, 14 August 2006 (UTC)

Medical advice

This article page seems to provide medical advice more than once. Does the wiki give medical advice? Snowman 17:52, 8 August 2006 (UTC)

Seriously no! Where did you find these? Do you mean the Prevention section's Primary part? It has references. So that I wouldn't say this is a medical advice. But tell me your opinion please. NCurse _work 18:25, 8 August 2006 (UTC)

I inclination is to avoid advice at all costs, but I am not sure what the wiki policy is?

Any mole that is irregular in color or shape should be examined by a doctor to determine if it is a malignant melanoma. This is at the beginning of the diagnosis section. It does not appear to be contraversial, but it is medical advice. Perhaps is could be rephrased to something like Moles that are irregular in color or shape are suspicious of a malignant melanoma or a premalignant melanoma. This has changed the sentence from advice to a tutorial.

The prevention section says To prevent or detect melanomas (and increase survival rates), it is recommended that the public[17]. May be better to say recommended by "name-here" in "date-here" that the public..... I feel that the exact origin of the people with relatives sentence should be clear. Perhaps the whole section should be rephrased so that is is a tutorial rather than advice. Snowman 18:30, 9 August 2006 (UTC)

You're right. I made the change that you recommended ("Moles that are irregular..."). Otherwise, yes, all of that section should be rewritten. I'll try it. Maybe we should leave Melanoma MCOTW for an other week. NCurse _work 18:50, 9 August 2006 (UTC)

Melanoma has been choosen for MCOTW, and I expect that it will become an excellent article. I think that a tutorial style would be best for a featured article. I wonder if advice is different in Australia, England, USA, Scotland or Germany. I wonder it there are websites that can be linked for the primary and secondary prevention advice. There might be one for UK. Snowman 08:22, 10 August 2006 (UTC)

Should we move it to Peer? NCurse _work 17:57, 10 August 2006 (UTC)

Peer - What is that? Snowman 17:59, 10 August 2006 (UTC)

Sorry. Peer review of course. :) NCurse _work 18:13, 10 August 2006 (UTC)

What does that involve and why will that help? Snowman 18:18, 10 August 2006 (UTC)

See Wikipedia:Peer review --WS 22:06, 10 August 2006 (UTC)

When I change MCOTW, maybe this article could get a peer review. Why will that help? When I wanted Aortic dissection to be featured, peer review showed a lot of faults in the article. It could help because much more people use Peer review than MCOTW. But we can wait with that. NCurse _work 18:21, 10 August 2006 (UTC)

Of course it is also perfectly possible to have both at the same time. --WS 22:06, 10 August 2006 (UTC)

Thank you for pointing out the Wiki Peer review page. Melanoma is especially complex area in dermatology and histopathology. Snowman 08:58, 11 August 2006 (UTC)

NCurse please reign in your editing. Many of your changes are unnecessary and subtract from clarity. For example, you added a reference which was already existing (at the time of this writing references 8 and 9 are THE SAME, I noticed this because I wrote/edited much of the history section ... which you are editing to its detriment, please STOP). Despite your extensive efforts I think most of you're recent flood of changes are unnecessary. Khaj 09:23, 14 August 2006 (UTC)

Please tell me what and I fix my faults. Or comment here: Wikipedia:Peer review/Melanoma. Thanks! NCurse _work 09:32, 14 August 2006 (UTC)

Believe me I don't want to ruin the article. I try to make it better. NCurse _work 09:36, 14 August 2006 (UTC)

Citing slides you found in a pdf file on the internet is not a valid citation. Find alternative citations or remove them. Khaj 14:49, 14 August 2006 (UTC)

I removed them. NCurse _work 16:07, 14 August 2006 (UTC)

I see also that you reverted my reversions, WHICH I DISCUSSED ABOVE. As someone who has worked in melanoma research for six years it is REALLY FRUSTRATING to deal with someone like you. Why is it that I must pre-discuss every change WHEN YOU APPARANTLY DO NOT? It is very obvious why professionals in the biological sciences rarely donate their expertise here. You are an obvious sufferer of editcountitis. I am so frustrated with you that I am close to saying I that I give up ... you win ... at the moment it looks like this entry on Wikipedia is destined for the "please ignore" bin when I discuss further reading materials with my students. The poor english, the failure to understand what a citation really must provide, and the general bone-headedness of non-professional ham-fisted "contributors" in particular are extremely offputting. Khaj 17:06, 14 August 2006 (UTC)