Melissa O Neill, O MS, APRN Nurse Practitioner, Dermatology
Three Types of Skin Cancer > Basal Cell Carcinoma > Squamous Cell Carcinoma > Malignant Melanoma
Basal Cell Carcinoma > Most common skin cancer > A new spot or bump that is getting larger > Sore that does not heal > Pink, red, shiny, translucent bump > May have irregular blood vessels > May appear pressed down > Sometimes may bleed following minor trauma
Basal Cell Carcinoma > Basal cell carcinoma Most common Local spread Cured Cured with surgery
Squamous Cell Carcinoma > Second most common form of skin cancer > Bump with rough surface > Flat, red, scaly patch > Face, Ears, Lips, Hands or Arms
Squamous Cell Carcinoma > Squamous cell carcinoma Very common Some distant spread (5%) Surgery (local), chemotherapy (distant)
Types of Skin Cancer (cont) > Melanoma Increasingly common About 55,000 new cases every year Most types spread readily Most serious type of skin cancer About 1 in 7 melanoma patients die of their disease Risk rising dramatically
Lifetime Risk of Developing Melanoma in the US 0.025 1:50 Lifetime Risk 0.020 0.015 0.010 1:250 1:150 1:135 1:74 0.005 1:1500 1:600 0.000 1935 1960 1980 1985 1993 2000 2010 Rigel DS, Carucci JA. CA Cancer J Clin. 2000;50:215-236. American Cancer Society. Cancer Facts & Figures 2003.
What Does Melanoma Look Like?
Malignant Melanoma
Melanoma and Skin Cancer Risk Factors > Environmental Excess sun exposure and exposure to UV radiation >3 3 blistering sunburns during childhood Actinic keratosis Use of sun lamps, tanning beds > Hereditary Fair complexion Moles History of cancer, especially melanoma
Prevent Skin Cancer-Be SunAWARE > A -Avoid unprotected UV exposure at all times > W -Wear sun protective clothing, hats, sunglasses > A -Apply sunscreen with SPF 30 or greater > R -Routinely check your whole body for changes > E -Educate your family and friends about sun protection
Prevent Skin Cancer Stay in the shade.
A: Avoid Unprotected UV exposure especially at peak hours > UV Index > UV intensity peaks on Summer Solstice > 80% of rays penetrate the clouds
Prevent Skin Cancer (cont) Avoid peak sun hours: 10 AM 4 PM.
Prevent Skin Cancer (cont) Wear protective clothing.
W: Wear Sun protective clothing and sunglasses, and seek shade > Wear long sleeve shirts > A hat with a 3 inch brim > Sunglasses > Seek Shade
Regular summer clothing is not an optimal alternative > Regular clothing shows much skin > Most regular summer clothing fabric protects less that SPF 30 > Clothing should maximize skin coverage
Sun Protective Clothing: www.coolibar.com
Swimwear Trends: Sun Protective Clothing is an Old Idea > 1920s Clothing coverage has halved from 1920s to 1995, but vacation time at sunny resorts increased 30 fold.
Swimwear Trends > 1950s The increase in melanoma was associated with increased sun exposure 5-145 years earlier
Swimwear Trends: Modern Times brought less clothing, more sun, more skin cancer > 2000s
Prevent Melanoma (cont) Wear protective sunglasses.
Prevent Skin Cancer (cont) Use sunscreen on unprotected areas.
A: Apply broad spectrum sunscreen > Apply a SPF 30+ to all unprotected skin > Use 1 ounce per application for adults to achieve total body protection > Apply 20 minutes prior to exposure > Reapply every 2 hours or after swimming or perspiring
What about sunscreen for protection > The literature reports usage is typically 1/10 to ½ the recommended amount > One adult at the beach or pool for 6 hours needs to completely use a 4 oz bottle of sunscreen > Under application leads to sunburn
Prevent Melanoma (cont) Check your skin.
R: Routinely check your whole body for changes > Anyone can get skin cancer anywhere > Report suspicious changes to a healthcare practitioner
I Know my ABCs! Do You?
Self-exam: What to Look For ABCDE method > A for Asymmetry > B for Border > C for Color > D for Diameter > E for Evolution
The ABCDEs of Melanoma: Asymmetry Symmetrical: Asymmetrical:
The ABCDEs of Melanoma: Border Regular: Irregular:
The ABCDEs of Melanoma: Color Consistent: Variable:
The ABCDEs of Melanoma: Diameter Normal: Large:
The ABCDEs of Melanoma: Evolution
Diagnosing Skin Cancers & Melanoma > Biopsy Standard of care Partial or complete removal of mole or lesion Determines depth of lesion Best for melanomas <1.5 cm in size
Staging Melanoma > Classifies severity of disease Thickness and depth of primary mole or lesion Ulceration (breaking through the top layer of skin) Spread to other sites (metastasis) > Procedures Biopsy SLN mapping Other tests
The Stages of Melanoma Stage IA Stage IB Stage IIA Stage IIB Later Stages
The Stages of Melanoma (cont) Stage IIIA Stage IIIB Stage IIIC Stage IV
Melanoma/Skin Cancer Management > Primary care physician > Dermatologist > Surgeon > Medical oncologist
Points to Remember > It is better to prevent skin cancer and melanoma than to have to treat it Minimize sun exposure: Shade, cover, sunscreen > Perform regular self-exams exams to catch any suspicious moles or other lesions as early as possible > If you find something that you suspect is a skin cancer, see a health care provider as soon as possible
Your Skin is Precious, please take care of it!
Other Conditions Treated in > Acne > Warts > Moles > Skin rashes > Eczema > Psoriasis > Skin Growths > Leg Veins > Unwanted Hair Growth Dermatology Clinic: > Rosacea > Fungal Infections of the Skin and Nails > Allergic Reactions on the Skin > Any condition of the hair, skin and nails
Thank You! medicine.creighton.edu Dermatology: 280-5600 Skin cancer screenings