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The process of immune editing is supported by the notion that the first site of melanoma metastasis is detected in the lymph nodes, an organ composed of many cytotoxic immune cells ( Figure 2 ) ( Figure 2 )

519 Serotonin-norepinephrine reuptake inhibitors (SNRIs) Duloxetine: The most prescribed SNRI for PDPN and has regulatory approval for treating neuropathic pain

Regular communication with the prescribing clinician is therefore more important than relying on lab testing alone

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Lifestyle considerations: While dietary B12 intake is not relevant in pernicious anaemia (due to malabsorption), maintaining a balanced diet supports overall health