Aust Prescr
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The treatment and outcomes for people with metastatic melanoma have changed considerably in the past few years with the introduction of targeted anticancer drugs. About half of the patients with metastatic melanoma will have activating mutations in the BRAF gene. These people may benefit from a BRAF inhibitor (vemurafenib or dabrafenib) or a MEK inhibitor (trametinib). ⋯ Ipilimumab is another drug indicated for metastatic melanoma. It works by altering the patient's own immune response to the tumour. Toxicities are common with these drugs and include arthralgias, fatigue, photosensitivity, squamous cell carcinomas, fever, diarrhoea, pruritus and immune-related adverse effects.
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Diagnostic imaging is often not indicated in chronic abdominal pain. In particular, undifferentiated abdominal pain is rarely an indication for a CT scan. CT scanning is overused even when imaging is required. ⋯ Alarm symptoms, including anaemia, blood in the stool, waking at night with gastrointestinal symptoms, and weight loss, should be investigated. The most appropriate modality depends on the symptoms. Clinical information on request forms for CT scans should be specific and include the suspected condition as this helps the radiologist to determine an appropriate imaging protocol.