Search

Skin cancer is the most common form of cancer; the World Health Organization estimates that more than 2 million cases of skin cancer are being diagnosed each year worldwide. Excessive sun exposure and ultraviolet (UV) radiation are the major avoidable risk factors for skin cancer, including melanoma. Sun protection can be achieved through behavioral modification, social changes and environmental changes: regular use of sunscreen, wearing hats and protective clothes, staying in the shade, creating shade by planting trees or constructing canopies, practicing work and sport activities during the time of the day when the sun is not the strongest and many others. The aim of this paper was to investigate the knowledge and attitudes about sun protection and sun behavior patterns in Croatia, as well as the perception of melanoma among general population. Our results indicate relatively good sun behavior patterns among our participants and their mostly correct perception of melanoma.

Melanoma is considered to be one of the most aggressive skin tumors. Various studies have shown that the incidence rate for this malignancy is rising rapidly all over the world. Incidence rates vary substantially worldwide with New Zealand and Australia having the highest rates. In the past 40 years in Croatia the incidence of melanoma is also in rise for more than 300%. Women and men are almost equally affected. According to anatomical site in most populations the rise is the greatest for the male trunk, and extremities in both sexes. There has been little change in rates for the head and neck. In the last decades, melanoma often occurs in relatively younger people, between the age of 25 and 40, rarely in the childhood. However, survival in patients with melanoma in Western European countries has increased markedly in recent years, due to timely recognition of the disease. Unfortunately, in Croatia the mortality remains higher even though the incidence is lower than those in some Western European countries. The authors are presenting epidemiological data on melanoma during the last 6 years (for the period 2002-2007) from the Croatian Referral Centre for Melanoma which is placed in the University Hospital "Sestre milosrdnice" in Zagreb.

A diagnosis of cancer and its treatment can create considerable distress, anxiety and depression for both patients and their families. The emotional impact of melanoma can be long lasting and profound, although the data in this field is inconsistent. Our last study showed that melanoma has a medium influence on patients' psychological status and quality of life. The aim of this paper was to investigate illness perceptions in patients with melanoma and its correlations with quality of life and emotional status. 60 patients suffering from malignant melanoma were included in the study. Results of this study show that patients perceive melanoma as a relatively long lasting illness, relatively easy to control, but hard to cure; and as an illness with not many consequences to their health. The causes of melanoma as perceived by patients are exposure to sun, heredity, immunity and stress. Illness perceptions are correlated with patients'quality of life, the influence illness has on the quality of life and depression.

All follow up protocols for patients with malignant melanoma (MM) are oriented to early detection of metastases. As most of the relapses happened in regional lymph nodes, special attention is given to this region, using different diagnostic tools. Sentinel lymph node biopsy (SLNB) is generally accepted method in determining status of lymph nodes in MM patients, in their staging. This method provides valuable prognostic information, facilitates early therapeutical lymphadenectomy and so provides good base for identification of those patients who are candidates for different adjuvant modalities of treatment. (In 2001 American Joint Committee on Cancer introduced new staging system for melanoma patients which presents good frame for prognosis and therapeutical approach. Inclusion of new criteria will allow better and more individualized prognosis and treatment.) The most important predictor of SLNB outcome is thickness of tumor according to Breslow, while there is no sufficient data to show correlation with other factors. We retrospectively studded 431 patients, out of which SLNB was performed on 188. Forty patients or 21.3% had positive lymph nodes. Our results showed strong correlation of tumor thickness and Clark level of invasion with SLNB outcome. Metastatic lymph nodes were founded in all acral-lentiginous melanoma patients, followed by nodular melanoma--55.6% and superficial spreading melanoma--14.1%. Results showed statistically significant predilection of positive SLNB in male patients and no correlation of positive SLNB with histological type of tumor. On the contrary, it showed significant correlation with development of metastases. Thus our results are similar to other comparable studies.