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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

Skin Cancer

Nonmelanoma and Melanoma Skin Cancers

objectives
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 cancer1
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.
skin cancer2
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
risk factors
Risk Factors
  • Sun exposure
  • Indoor tanning
  • Fair skinned; blond/red hair; blue/green eyes
  • Numerous or dysplastic nevi
  • Genetic predisposition
  • Immunosuppression
basal cell carcinoma
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.
bcc signs and symptoms
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
squamous cell carcinoma
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
scc signs and symptoms
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
diagnosis and staging
Diagnosis and Staging
  • Skin examination
  • Biopsy of suspicious lesions
  • Histologic examination
  • Staging is based on physical examination, pathology report, and lymph node involvement.
treatment
Treatment
  • Surgery
    • Cryosurgery
    • Curettage and electrodesiccation
    • Excision
    • Mohs surgery
treatment cont
Treatment (cont.)
  • Radiation therapy
    • Patients unable to tolerate surgery
    • Older patients with large lesions
  • Chemotherapy
    • Topical 5-FU
malignant melanoma
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.
diagnosis and staging1
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
treatment of melanoma
Treatment of Melanoma
  • Surgical resection
  • Radiation therapy
  • Chemotherapy
  • Hyperthermic regional perfusion
  • Biotherapy
skin cancer prevention
Skin Cancer Prevention
  • Reduce sun exposure.
  • Avoid indoor tanning, sun lamps.
  • Use sunscreens correctly and consistently.
  • Wear protective clothing.
skin cancer detection
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
abcde of self examination
ABCDE of Self-Examination

A = Asymmetry

B = Boarder

C = Color

D = Diameter

E = Evolving

references
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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