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Skin Cancer disease detailed review and information
- 1. SKIN CANCER BY: Mr. M.Shivananda Reddy
- 2. • Skin canceris the most commonly diagnosed cancer. • Skin cancers are either non-melanoma or melanoma. • A persistent skin lesion that does not heal is highly suspicious for malignancy and should be examined by a health care provider. • Early detection and treatment can often lead to a highly favourable prognosis. • The visibility of the skin lesions increases the likelihood of early detection and diagnosis
- 3. Risk Factors forSkin Cancer • Damage in the ozone layer • Fair-skinned and fair-haired people due to insufficient skin pigmentation • Prolonged exposure to sun light. • Exposure to chemical pollutants(arsenic, nitrates, coal, tar and pitch, oils and paraffins) • History of x-ray therapy for acne or benign lesions • Scars from severe burns • Chronic skin irritations • Immunosuppression • Genetic factors
- 4. Types of skincancers: The most common types of skin cancer are: • Basal Cell Carcinoma (BCC) • Squamous cell (epidermoid) carcinoma (SCC). • Malignant melanoma
- 5. Basal Cell Carcinoma(BCC) • BCC is the most common type of skin cancer. • It generally appears on sun-exposed areas of the body and is more prevalent in regions where the population is subjected to intense and extensive exposure to the sun. • The incidence is proportional to the age of the patient and the total amount of sun exposure, and it is inversely proportional to the amount of melanin in the skin.
- 6. • Basal cellcarcinoma (BCC) is a locally invasive malignancy arising from epidermal basal cells. It is the most common type.
- 7. Clinical manifestations: • BCCusually begins as a small, waxy nodule with rolled, translucent, pearly borders; telangiectatic vessels may be present. • As it grows, it undergoes central ulceration and sometimes crusting. • The tumors appear most frequently on the face. • BCC is characterized by invasion and erosion of adjoining tissues. • It rarely metastasizes, but recurrence is common.
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- 9. Squamous Cell Carcinoma(SCC) • Squamous cell carcinoma (SCC) is a malignant neoplasm of keratinizing epidermal cells. • It frequently occurs on sun-exposed skin or at the base of skin lesion. • SCC is less common than BCC. • SCC can be highly aggressive, has the potential to metastasize, and may lead to death if not treated early and correctly.
- 10. Clinical manifestations: • Thelesions may be primary, arising on the skin and mucous membranes, or they may develop from a precancerous condition, such as scarred or ulcerated lesions. • SCC appears as a rough, thickened, scaly tumor that may be asymptomatic or may involve bleeding. • The border of an SCC lesion may be wider, more infiltrated, and more inflammatory than that of a BCC lesion. • Exposed areas, especially of the upper extremities and of the face, lower lip, ears, nose, and forehead, are common sites
- 12. Management of BCC& SCC The treatment method depends on the tumor location; the cell type, location, and depth; the cosmetic desires of the patient; the history of previous treatment; whether the tumor is invasive, and whether metastatic nodes are present. The management of BCC and SCC includes • Surgical excision • Mohs’ micrographic surgery • Electrosurgery • Cryosurgery • Radiation therapy
- 13. Surgical excision • Theprimary goal is to remove the tumor entirely. • When the tumor is large, reconstructive surgery with use of a skin flap or skin grafting may be required. • A pressure dressing applied over the wound provides support.
- 14. Mohs’ Micrographic Surgery.: •The procedure removes the tumor layer by layer. • The first layer excised includes all evident tumor and a small margin of normal-appearing tissue. • The specimen is frozen and analyzed by section to determine if all the tumor has been removed. • If not, additional layers of tissue are shaved and examined until all tissue margins are tumor free. • In this manner, only the tumor and a safe, normal-tissue margin are removed.
- 15. Electro surgery • Electrosurgery is the destruction or removal of tissue by electrical energy. • The current is converted to heat, which then passes to the tissue from an electrode.
- 16. Cryosurgery • Cryosurgery destroysthe tumor by deep freezing the tissue. • A thermocouple needle apparatus is inserted into the skin, and liquid nitrogen is directed to the center of the tumor until the tumor base is −40°C to −60°C.
- 17. Radiation Therapy • Exposethe tumor surface to ionizing and non-ionizing radiation to kill the cancerous cells
- 19. Malignant Melanoma • Amalignant melanoma is a cancerous neoplasm in which abnormal melanocytes are present in the epidermis and the dermis (and sometimes the subcutaneous cells). • Most lethal of all the skin cancers • Most melanomas arise from cutaneous epidermal melanocytes
- 20. RISK FACTORS: • Thecause of malignant melanoma is unknown • Ultraviolet rays are strongly suspected, based on indirect evidence such as the increased incidence of melanoma in countries near the equator • Family history
- 21. Clinical Manifestations • Superficialspreading melanoma occurs anywhere on the body. • It usually affects middle-aged people and occurs most frequently on the trunk and lower extremities. • The lesion tends to be circular, with irregular outer portions. • The margins of the lesion may be flat or elevated and palpable.
- 22. • The malignantmelanoma may appear in a combination of colors, with hues of tan, brown, and black mixed with gray, blue- black, or white. • Sometimes a dullpink rose color can be seen in a small area within the lesion.
- 24. Management • Surgical excisionis the treatment of choice for small, superficial lesions. • Deeper lesions require wide local excision, after which skin grafting may be needed. • Regional lymph node dissection is commonly performed to rule out metastasis.
- 25. • Immunotherapy: • Monoclonalantibodies directed at melanoma antigens. • Autologous immunization against specific tumor cells. • Chemotherapy may be used for metastatic melanoma
- 26. Nursing diagnoses • Acutepain related to surgical excision and grafting • Anxiety and depression related to possible life- threatening consequences of melanoma and disfigurement • Deficient knowledge about early signs of melanoma • Risk for infection related to break in the skin barrier
- 27. Other Malignancies ofthe Skin • Kaposi’s sarcoma • Basal and Squamous cell carcinomas in the immunocompromised population
- 28. KAPOSI’S SARCOMA • Kaposi’ssarcoma (KS) has received renewed attention since its association with HIV infection and AIDS. • Most patients have nodules or plaques on the lower extremities that rarely metastasize beyond the lower extremities. • This KS is chronic, relatively benign, and rarely fatal.
- 29. Basal and Squamouscell carcinomas in immunocompromised • The incidence of basal cell carcinoma and squamous cell carcinoma is increased in all immuno-compromised individuals, including those infected with HIV. • Clinically, the tumors have the same appearance as in non–HIV-infected people; however, in HIV patients, the tumors may grow more rapidly and recur more frequently.