Xin is a 58-year-old Asian who is a mechanical engineer at a large telecom company. They visited the physician because a week ago they noticed dark colored lesions on the inner thighs, which have increased in number and size. For the last three months they have been feeling weaker and more fatigued than usual; with a weight loss during that period going from 170 to 155 pounds. Xin quit smoking over 20 years ago and is currently a social drinker. They states to be fairly healthy. They swim for 30 minutes every day during the weekdays and on weekends likes to go hiking or long rambling walks with their partner. Xin’s spouse is 54 and has rheumatoid arthritis; they have a healthy rambunctious labradoodle at home. Xin’s father died at age 80 from complications due to Alzheimer’s disease and Xin’s mother died at age 68 from intestinal cancer. They want to know if this new problem will interfere with their upcoming annual summer cruise. For the last five years they have gone on a two- to three-week summer cruise with together, traveling in the past to Japan, Taiwan, Scandinavia, Alaska, the Bahamas, and, most recently, Greece and Turkey,