Basal cell carcinoma AND squamous cell cancer Flashcards
incidence and natural hx -4
BCC most common human cancer
BCC etiology -3
basal cell layer,
mets rare,
extensive local damage if untreated
SCC etiology -4
rapid growth,
local invansion,
mets potential,
perineural involvement associated with increased risk of recurrence post tx and inc risk of mets
risk factors -9
UV light, age, actinic keratoses, ionizing radiation, chronic immunosuppression, viruses, chronic arsenic exposure, chronic skin inflammation, genetic conditions (xeroderma pigmentosum, epidermolysis bullosa, albinism, epidermodysplasia verruciformis)
risk factors for recurrence -7
increased size,
poorly differentiated borders,
recurrent dz,
site of prior RT,
immunosuppression,
aggressive growth pattern,
perineural involvement
prevention -3
minimize UV,
sunscreen,
treat actinic keratosis (premalignant SCC) with retanoids
signs and sx -4
nodularity,
erythema,
scaly plaque,
necrosis
primary tx concepts -7
goal: cure of tumor AND maximal preservation of function
vismodegib indication
metastatic or locally advanced BCC that has recurred following surgery or who are not candidates for surgery or XRT
CR 21-22%
median response duration: 7.6 mo
vismodegib ADR -12
muscle spasms, alopecia, dysgeusia, ageusia wt loss, fatigue, N, D, V dec appetite, constipation, arthralgias
follow up -3
close follow-up extremely important with pt counseling
BCC - q6mo x5yr (36% develop another primary BCC within 5yrs)
SCC - q3mo x5yr, then q6mo indefinitely
prognosis -2
2000 deaths out of 1-2 million new dx
rare met dz <50% 5yr OS