Skin Cancer

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Skin Cancer
The Dark Side of the Sun
By Tracey A. Keegan, RN
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Learning Objectives
Viewer will learn the following from this
presentation Skin facts and anatomy of normal
skin Definition of Skin Cancer Types of Skin
Cancer Causes of Skin Cancer Distinguish a
benign mole from melanoma Understand treatment
modality Prevention Self Examination Knowledge
of sunscreens
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Skin Facts

• Bodys Largest Organ
• Weighs approximately 6lbs
• Laid Flat, and average adult skin measures 10
  20 ft.
• Protective shield against heat, light, injury
  and infection
• Regulates temperature, stores water, fat and
  vitamin D
• Senses painful and pleasant stimulation

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Anatomy of the Skin

• Epidermis
• Dermis
• Subcutaneous

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Epidermis
Thin outer layer of the skin 3 sublayers 1.
Stratus Corneum Continuous shedding of dead
cells (keratinocytes) 2.
Keratinocytes Provides skin with what it needs
for protection 3. Basal Layer Inner layer
that continues to divide and form new
keratinocytes Epidermis also contains
melanocytes which produce the skins pigment
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Dermis
Middle layer composed of Blood
vessels lymph vessels hair follicles sweat
glands Dermis is held together by protein
called collagen Contains pain and touch receptors
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Subcutaneous

• Deepest layer of the skin
• Consists of collagen and fat cells
• Conserves body heat
• SHOCK ABSORBER

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What is Skin Cancer?
A disease in which cancer (malignant) cells are
found in the outer layers of your skin Most
common types of cancer that start in the skin are
basal cell, squamous, and melanoma More
common in people with light colored skin with
over exposure to the skin Skin cancer can
occur anywhere on your body but most common in
places exposed to more sunlight ( i.e. face,
neck, hands and arms).
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Types of Skin Cancer
BASAL CELL SQUAMOUS CELL MALIGNANT MELANOMA
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Basal Cell
90 of all skin cancers Highly treatable,
slow growing Small, shiny bump or nodule on the
skin Appears on head, neck, face, arms and hands
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Squamous Cell
20 of all skin cancers More aggressive than
Basal Cell Highly treatable Appearance is a
nodule or red scaly patches of the skin Found on
face, ears, lips and mouth Can spread to other
body parts
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Malignant Melanoma
Malignant Melanoma MOST DEADLY 75 of all skin
cancer deaths Starts in the melanocytes (pigment
cells) Usually benign as a mole Spreads
quickly Affects all skin types
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What causes Skin Cancer?

• Sunburn and Sunlight
• Ultra Violet light
• Heredity
• Environment

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• Skin Cancer Causes
• Sunlight Sunburn
• Tanning is your skins response to UV light
• Protective reaction to prevent further injury to
  your skin from the sun
• Tanning does not prevent skin cancer
• Sunburn you receive this week may take up to 20
  years or more to become skin cancer

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Heredity

• Higher risk if there is family history
• Fair skin, northern heritage
• Multiple moles, large or atypical

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Environment

• Decrease in the Ozone Layer
• The Ozone serves as a filter to screen out
  and reduce the amount of Ultra violet we are
  exposed too
• Frequent visits to tanning salons
• People who are sun sensitive, tan poorly or not
  at all, have a 2-3 times increase of risk

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Distinguishing Benign Moles from Melanoma

• Moles that are present at birth and atypical
  moles, have a greater chance of becoming
  malignant.
• Made of clumps of melanocytes, produce the
  brownish pigment melanin.
• Typically, moles are smaller than the tip of a
  pencil eraser, circular or oval, tan to dark
  brown, and uniformly colored.
• Sometimes moles respond to increased hormonal
  activity or puberty or pregnancy by darkening and
  enlarging.
• USE THE ABCD RULE

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Normal Mole
Melanoma
Charactoristic
Sign
Asymmetry when half of the mole does not match
the other half Border when the border
(edges) of the mole are ragged or
irregular Color when the color of the mole
varies throughout Diameter if the moles
diameter is larger than a pencils eraser
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Treatment

• Photography to monitor change
• Biopsy
• Defines type of lesion
• Defines depth of penetration
• Clark level
• Breslow thickness
• CT/ MRI
• Investigate further metastisis
• Chemotherapy
• Radiation

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Prevention

• Self examination
• Hidden areas
• Avoid UV sunlight
• Monitor tanning index!
• Avoid excessive sunbathing or days at the beach
• Wear a wide brimmed hat when out in the sun
• UV blocking sunglasses
• Protective clothing
• Use Sunscreen (apply correctly)

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Examine your body front and back in the mirror,
then right and left sides with arms
raised. Bend elbows and look carefully at
forearms, upper underarms, and palms. Look at
the backs of your legs and feet, the spaces
between your toes and on the sole.
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Examine the backs of your neck and scalp with a
hand mirror. Part hair for a closer
look. Finally, check your back and buttocks
with a hand mirror.
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Sunlight can age your skin, but there are other
ways of protecting yourself! Comic by RGJ
Richard Jolley
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Sunscreens and Sunburns
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Sunscreens and Sunburns

• Rated by Food and Drug Administration
• Evaluate SPF (sun protective factor)
• Evaluate substance or waterproof ability
• SPF of 20 indicates 20 times longer to sunburn
  with sunscreen
• Add UVA and UVB for additional exposure
• Minimal protection SPF 2-12
• Moderate protection SPF 12-30
• High protection SPF 30
• Available in hypo-allergenic, water resistant,
  and waterproof formulas
• Paba no longer used because it provides only
  partial UVB and no UVA protection

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Book 1 Skin Cancer and How to cure it. Book 2
Melanoma Spotting Book 3 First Aid for Burnt
skin Comic by RGJ Richard Jolley
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Behavioral Protection

• There are many things you can do to protect
  yourself from the most damaging solar radiation
• Stay inside or seek shade during the peak hours
  of solar radiation, from 10 am to 2 pm. Tightly
  woven clothing helps block harmful solar
  radiation from reaching your skin. Loosely woven
  clothing is not adequate, since the gaps in the
  weave allow the radiation to pass through
• Use a hat or sun visor to protect your head and
  neck. Baseball caps do not provide protection for
  your neck, sides of your face or your ears a
  wide brimmed hat is better.
• If you insist on getting a tan, consider using a
  self-tanning lotion that contains
  dihydroxyacetone (DHA).
• Avoid tanning salons they typically also expose
  skin to UVB radiation similar to sunlight.
• Educate children about sun exposure and
  sunburns. Childhood sunburns are an indicator for
  an increased risk of malignant melanoma and
  non-melanoma skin cancers.
• Avoid sunburns and wear t-shirts while swimming
  outdoors.

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What happened to us? No kissing, no foreplay, No
Skin Cancer Checks!
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References
American Academy of Dermatology (2002).
Retrieved March 21, 2003 from www.skincarephyscia
ns.com An Introduction to skin cancer. (nd)
Retrieved March 25, 2003 from
www.maui.net Belcher, A. (1992). Cancer
Nursing. St. Louis Mosby Cancer Web (2002).
Prevention of Skin Cancer. Retrieved March 21,
2003 from www.cancerweb.ncl.ac.uk/cancernet Gilch
rest, B., Eller, M., Geller, a. Yaar, M.
(1999). The Pathogenesis of Melanoma Induced by
Ultraviolet Radiation. The New England Journal
of Medicine (17) vol. 340 1341-1348
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References continued...
Habif, T. (1996). Clinical Dermatology A Color
guide to Diagnosis and Therapy (3rd ed.). St.
Louis Mosby Kenet, B. Lawler, P. (1994).
Saving Your Skin. New York Four Walls Eight
Windows Lamberg, L. (1990). The Encyclopedia of
Health Skin Disorders. New York Philadelphia
Chelsea House Publishers Poole, C. Dupont, G.
(1998). Melanoma Prevention, Detection and
Treatment. New Haven-London Yale University
Press Skin Cancer, Melanoma (2002). Retrieved
March 21, 2003 from www.aolsvc.health.webmd.aol.
com Skin-Cancers.net (2000). Skin Cancer.
Retrieved March 25, 2003 from www.skin-cancers.ne
t