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Nursing 5: Test 1 Cancer > Skin Cancer > Flashcards

Flashcards in Skin Cancer Deck (25)
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Types of Skin Cancer
-Squamous Cell Carcinoma

1. Cancer of the epidermis that can be localized
-May metastasize to other tissue and organs

1

Types of Skin Cancer
-Basal Cell Carcinoma

1. Cancer of the basal cell layer of the epidermis
2. Can damage surrounding tissue and can advance to include underlying structures
3. NOT usually metastatic
4. Rate of recurrence is very high `

2

Types of Skin Cancer
-Malignant Melanoma

1. Aggressive, metastatic cancer that originates in the melanin-producing cells of the epidermis
2. 1/3 originate in existing nevi (moles)

3

Skin Cancer
-Risk Factors

1. Age
2. Sun Exposure and pre-pubescent sun burns
3. Occupation / recreation
4. Ethnicity & Family Hx

4

Basal & Squamous Cell Carcinoma
-Physical Assessment Findings

1. Small, waxy nodule w/ small, superficial blood vessels
2. Rough, scaly lesion that may bleed & has central area of ulceration or crusting (Squamous)
3. Size varies

5

Melanoma
-ABCDEF of Suspicious Lesions

1. A-symmetry (one side doesn't match the other)
2. B-orders (Ragged, notched, irregular or blurred)
3. C-olor (lack of uniformity in pigmentation.. 2 toned)
4. D-iameter (Width >6mm / size of pencil eraser)
5. E-volution, elevation, erythema
6. F-unny feeling, fast growing

6

Types of Skin Cancer
-Basal Cell Cancer

1. Basal cell cancer is the most common but least aggressive type of skin cancer
2. Rarely metastasizing
3. Tend to recur

7

Melanoma
-Risk Factors

1. High # of moles, or large moles
2. Fair skin, freckling, blond hair or blue eyes
3. Close relative w/ disease
4. Men w/ gene changes from a fam hx of breast or ovarian CA
5. Immune suppressant medications
6. Age >50 and UV radiation exposure

8

Malignant Melanoma
-Lentigo Maligna Melanoma

1. Occurs on skin that has had long-term sun exposure, such as the face, neck, and dorsal surface of the hands and lower extremities
2. Affects women more than men (60's -70's)
3. Lesion becomes malignant as soon as melanocytes invade dermis

9

Malignant Melanoma
-Superficial Spreading Melanoma

1. Most common type of melanoma
2. Arises from preexisting nevus
3. Found on trunk and back of men and legs of women
4. Radial growth phase 1-5 years // Vertical phase is rapid
5. During Vertical phase the lesion changes color to red, white, and blue
6. Lesion develops irregular borders and has raised nodules and ulcerations

10

Malignant Melanoma
-Acral Lentiginous Melanoma

1. More common in people with dark skin
2. Nodules are found on palms of the hands and soles of the meet, mucous membranes, and nail beds

11

Malignant Melanoma
-Nodular Melanoma

1. Lesions arise from unaffected skin rather than from preexisting lesion
2. Only has vertical growth phase making it harder to detect

12

Types of Basal Cell Cancer
-Superficial Basal Cell Cancer

1. Most often on the trunk and extremities
2. Second most common basal cell after nodular
3. Tumor is a flat papule w/ well defined borders
4. May ulcerate and be covered w/ crusts or shallow erosions

13

Types of Basal Cell Cancer
-Nodular Basal Cell Cancer

1. Most common type of basal cell cancer
2. Most likely appears on face, neck and head
3. Early stages, the tumor is a papule that looks like a smooth pimple
-It doubles in size every 6-12 months
4. Center or periphery may ulcerate and bleed easily

14

Types of Basal Cell Cancer
-Morpheaform Basal Cell Cancer

1. Rarest form and tumor forms finger-like projections that extend in any direction along dermal tissue planes
2. Flat ivory or flesh-colored scar
3. More likely to extend into and destroy adjacent tissue, especially muscle, nerve, and bone

15

Types of Basal Cell Cancer
-Pigmented Basal Cell Cancer

1. Found on head, neck, & face
2. May appear dark brown, blue, or black
3. Shiny well defined borders

16

Squamous Cell Cancer

1. Occurs most often on areas of skin exposed to UV rays and weather
-forehead, ears, top of nose
2. Much more aggressive than basal cell w/ faster growth rate and much greater potential to metastasize if untreated

17

Types of Basal Cell Cancer
-Keratotic Basal Cell Cancer

1. Found on preauricular and postauricular groove
2. Appears much like a nodular basal cell cancer
3. Tends to recur locally and also is the type most likely to METASTASIZE

18

Malignant Melanoma
-Where does it Present on men and women?

1. Most often found on the trunk of men and on the lower extremities of women
2. Change in color or size of nevus is reported in 70% of people dx w/ malignant melanoma

19

Squamous Cell Cancer
-Progression

1. Begins as small, firm, red nodule
2. May be crusted w/ keratin products
3. As it grows it may ulcerate, bleed and become painful
4. Area around nodule can become indurated (hardened)

20

Squamous Cell Cancer
-Actinic Keratosis

1. Directly r/t chronic sun exposure and photo-damage
2. May progress to squamous cell carcinoma
3. Classified as pre-malignant
4. Lesions are erythematous, rough, macules a few mm in diameter
-Often Shiny but may be scaly & if scale is removed it will bleed
5. Occur in multiple patches on face, hands, forearms
6. Enlargement or ulceration suggests transformation to malignancy

21

Clarks Levels for Staging
-Level 1

1. Into epidermis

22

Clarks Levels for Staging
-Level 2 & 3

1. Into epidermis and papillary dermis

23

Clarks Levels for Staging
-Level 4

1. Into epidermis, papillary dermis & reticular dermis

24

Clarks Levels for Staging
-Level 5

1. Into the epidermis, papillary dermis, reticular dermis & subcutaneous tissue
2. Most likely to metastasize