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Skin Cancer

Skin Cancer. Nonmelanoma and Melanoma Skin Cancers. Objectives. The learner will be able to: Describe the major forms of skin cancer. Explain treatment modalities used to manage skin cancer. Identify prevention and detection strategies utilized in the management of skin cancer. Skin Cancer.

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Skin Cancer

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  1. Skin Cancer Nonmelanoma and Melanoma Skin Cancers

  2. Objectives The learner will be able to: • Describe the major forms of skin cancer. • Explain treatment modalities used to manage skin cancer. • Identify prevention and detection strategies utilized in the management of skin cancer.

  3. Skin Cancer • Most common cancer in the United States • Approximately 1 out of every 5 Americans will be diagnosed with skin cancer during his or her lifetime. • 97% of skin cancers will be nonmelanoma skin cancers (NMSCs); basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the primary NMSCs. • An estimated 12,000 people will die from skin cancer in 2014.

  4. Skin Cancer • Malignant melanoma is the most deadly form of skin cancer. • Incidence rates in whites are 5 times higher than in Hispanics and 20 times higher than in African Americans. • Has been one of the fastest increasing malignancies over the past few decades

  5. Risk Factors • Sun exposure • Indoor tanning • Fair skinned; blond/red hair; blue/green eyes • Numerous or dysplastic nevi • Genetic predisposition • Immunosuppression

  6. Basal Cell Carcinoma • Comprises 70% of all skin cancers • Incidence increases with age. • Arises from keratinocytes • Slow-growing; locally invasive • Highly curable (almost 100% with early treatment) • Metastasis and death are rare.

  7. BCC – Signs and Symptoms • Usually occurs on sun-exposed areas • Pale pink or red; translucent, pearly appearance • Scaling and ulceration may occur. • Can damage underlying tissue and skin if untreated

  8. Squamous Cell Carcinoma • Like BCC, arises from keratinocytes • Accounts for 20% of all NMSCs • Mortality rate 1%2% • Frequently occurs on previously damaged skin • Metastasis possible

  9. SCC – Signs and Symptoms • Precancerous actinic keratosis lesions • Presentations vary: • Hard lesion with warty scale • Indurated, rounded base • Dull red lesion with teleangiectasis • Dome-shaped nodules with ulcerations and crusting

  10. Diagnosis and Staging • Skin examination • Biopsy of suspicious lesions • Histologic examination • Staging is based on physical examination, pathology report, and lymph node involvement.

  11. Treatment • Surgery • Cryosurgery • Curettage and electrodesiccation • Excision • Mohs surgery

  12. Treatment (cont.) • Radiation therapy • Patients unable to tolerate surgery • Older patients with large lesions • Chemotherapy • Topical 5-FU

  13. Malignant Melanoma • Cancer of the melanocytes • Average age at diagnosis is 61; however, it is one of the most common cancers in younger adults, especially young women • Rates have been rising for at least 30 years • Expected 76,100 new cases in 2014 with expected 9710 deaths • Highly metastatic • Survival depends on early diagnosis and treatment.

  14. Diagnosis and Staging • Total excisional biopsy • Complete physical and skin check • Lab work and diagnostic tests to help determine the existence of metastatic disease • Breslow thickness • Lymph node involvement

  15. Treatment of Melanoma • Surgical resection • Radiation therapy • Chemotherapy • Hyperthermic regional perfusion • Biotherapy

  16. Skin Cancer Prevention • Reduce sun exposure. • Avoid indoor tanning, sun lamps. • Use sunscreens correctly and consistently. • Wear protective clothing.

  17. Skin Cancer Detection • Warning signs: • A sore that does not heal • Obvious change in a wart or mole • Screening/early detection • Self-examination • Physician/clinician examination

  18. ABCDE of Self-Examination A = Asymmetry B = Boarder C = Color D = Diameter E = Evolving

  19. References American Cancer Society. (2014). Cancer facts and figures 2014. Retrieved from http://www.cancer.org/Research/CancerFactsFigures Beam, S., Belansky, H.B., & Levy, C. (2009). Melanoma. In P. Muehlbauer & C. McGowan (Eds.), Skin cancer (pp. 5179). Pittsburgh, PA: Oncology Nursing Society. Sheridan-Leos, N. (2007). Skin cancers. In M.E. Langhorne, J.S. Fulton, & S.E. Otto (Eds.), Oncology nursing (5th ed., pp. 298308). St. Louis, MO: Mosby.

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