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Browsing by Subject "Melanoma"

Now showing 1 - 3 of 3
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    Comparison of quality of life and health behaviors between melanoma survivors and controls
    (2016-01) Vogel, Rachel
    Unlike most cancer types, melanoma incidence has been increasing over the past 30 years in the United States. The unique characteristics of melanoma argue for research that captures the specific issues faced by melanoma survivors. Studies of long-term melanoma survivors are lacking, and the survivorship research to date has been limited by the inability to make comparisons with a population control group. The goal of this dissertation was to document the long-term effects of a melanoma diagnosis and treatment on survivors and compare their quality of life and health behaviors with population controls. First, a series of focus groups were conducted to describe the breadth of experiences among melanoma survivors, focusing on the experience at diagnosis, ongoing physical, emotional and social concerns, and behavioral changes since diagnosis (Manuscript 1). Based on these data, a comprehensive questionnaire to address the quality of life issues faced by melanoma survivors was designed and tested. Finally a cross-sectional study of melanoma survivors and population controls was conducted. The goal was to collect data to evaluate the impact of melanoma on long-term survivorship focusing on quality of life (Manuscript 2) and sun exposure and protection behaviors (Manuscript 3). A total of 592 melanoma survivors and 518 controls completed the survey. Results indicate that long-term survivors of melanoma reported similar general physical and emotional quality of life as controls. In addition, while they generally reported greater use of sun protection behaviors than controls, a significant subgroup experienced sunburn in the past year, putting them at elevated risk for future melanomas. The data presented in this dissertation suggest that long-term melanoma survivors reported similar quality of life as controls, though opportunities exist to improve their sun exposure and protection behaviors.
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    Completion Lymph Node Dissection or Observation for Melanoma Sentinel Lymph Node Metastases: A Decision Analysis
    (2015-12) Burke, Erin
    Objective: To determine whether melanoma patients with sentinel lymph node (SLN) metastases should undergo completion lymph node dissection (CLND). Background: Randomized trial results comparing CLND with observation for patients with SLN metastases are not available. Methods: We developed a Markov model to simulate the prognosis of hypothetical cohorts of patients with SLN metastases who underwent either immediate CLND or observation with delayed CLND if macroscopic disease developed. Model parameters were derived from published studies and included the likelihood of non-SLN metastases, risk of dying from melanoma, CLND complication rates, and health-related quality-of-life weights. Outcomes included 5-year overall survival (OS), life expectancy (LE), and quality-adjusted life expectancy (QALE). Results: The projected 5-year OS for 50-year-old patients with SLN metastases who underwent immediate CLND was 67.2% compared to 63.1% for the observation group. The LE gained by undergoing immediate CLND ranged from 2.19 years for patients aged 30 to 0.64 years for patients aged 70 years. The QALE gained by undergoing immediate CLND ranged from 1.39 quality-adjusted life years for patients aged 30 to 0.36 for patients aged 70 years. In sensitivity analysis over a clinically plausible range of values for each input parameter, immediate CLND was no longer beneficial when the rate of long-term complications increased and the quality-of-life weight for long-term complications decreased. Conclusion: Immediate CLND following positive SLN biopsy was associated with OS and QALE gains compared with observation and delayed CLND for those who develop clinically apparent LN metastases.
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    Learning your ABCDE’s: When To Worry About a Mole
    (2012-07-24) Majerus, Matt