Cancer Flashcards
Referral recommendation for skin lesion suspected of a basal cell carcinoma?
- consider routine referral
- only 2ww (suspected ca referral) referral if concern that delay may have impact eg. due to factors such as site or size
When to refer pt using suspected ca pathway referral (appointment within 2w) for melanoma?
1) suspicious pigmented skin lesion with weighted 7 point checklist score of 3 or more
or
2) dermoscopy suggests melanoma
3) pigmented or non-pigmented lesion that suggests nodular melanoma
4) suspected SCC
5) BCC but concern that delay will have signif impact eg. due to size or site
Pigmented lesion on the skin?
?melanoma
Can get what type of melanomas rarely?
nodular and amelanotic
What checklist is used to assess pigmented skin lesions?
7-point checklist
Melanoma may present when?
after spread to regional lymph nodes or wider mets
Main method to diagnose melanoma?
excision biopsy in secondary care
Raised lesion on skin?
?SCC
Diagnose SCC?
possible to visually but confirm by excision biopsy
Ulcer with raised rolled edge; prominent fine blood vessels around a lesion or nodule on the skin (pearly or waxy)?
Basal cell carcinoma
Diagnosis of BCC?
possible visually but confirm by excision biopsy
7-point checklist for suspected melanoma?
Major (2 points each):
- change in size
- irregular shape
- irregular colour
Minor (1 each):
- largest diameter 7mm+
- inflam
- oozing
- change in sensation
Most common type of ca in Western world?
BCC
BCC characteristics?
- lesions also called Rodent ulcers
- slow growth
- local invasion
- mets v rare
Most common type of BCC?
nodular
Nodular BCC?
- sun exposed sites eg. head, neck
- initially= pearly, flesh coloured papule with telangiectasia
- later= ulcerate leaving central crater
Mx options for BCC?
- surgical removal
- curettage
- cryotherapy
- topical cream= imiquimod, fluorouracil
- radiotherapy
Bladder ca commonly affects who?
males 50-80yrs
RFs for bladder ca?
- male
- current or previous (within 20yrs) smokers
- exposure to hydrocarbons eg. 2-Napthylamine
- chronic bladder inflam from Schistosomiasis infection= SCC
-rubber manufacture - cyclophosphamide
Exposure to hydrocarbons eg. benzidine or 2-Naphthylamine from exposure to aniline dyes (eg. working in printing and textile industry) increases the risk of what?
bladder ca
examples of benign tumours of the bladder? (uncommon)
- inverted urothelial papilloma
- nephrogenic adenoma
Examples of bladder malignancies?
- Urothelial (transitional cell) carcinoma (>90%)
- SCC (1-7% expect is higher in regions affected by schistosomiasis- rare in UK)
- Adenocarcinoma
Most common bladder malignancy?
urothelial (transitional cell) carcinoma (>90%)
Urothelial carcinomas may arise as what?
solitary lesions or may be multifocal causing ‘field change’ within the urothelium