Management of melanoma

BACKGROUND: Melanoma is a potentially curable cancer, but around 20% of patients will develop disease which is beyond surgical clearance. Rising incidence alongside breakthroughs in understanding the molecular biology of this disease identifying systemic therapies offering survival gains now demand a more proactive, integrated approach to melanoma management. SOURCES OF DATA: PubMed references relating to aspects of melanoma research and treatment. AREAS OF AGREEMENT: Rapidly rising incidence throughout the world. Effective surgery as well as new molecular targeted systemic biological agents and immunotherapies necessitating early diagnosis and multidisciplinary therapeutic interventions. AREAS OF CONTROVERSY: Role of screening and prevention. Benefit of interventions for locoregional melanoma, including role of sentinel lymph node biopsy. Integration and sequencing of treatments for unresectable melanoma. GROWING POINTS: Molecular determinants of melanoma influencing disease outcome and treatment decisions. AREAS TIMELY FOR DEVELOPING RESEARCH: Education and training of patient and healthcare professionals. Role of screening, surveillance and follow-up strategies. Biology of melanoma guiding treatment decisions.