Skin Cancer Flashcards

1
Q

What are the 3 main types of skin cancers and what layer of the skin do they occur in?

A

Squamous cell carcinoma, Basal cell carcinoma, Malignant Melanoma. All occur in the epidermis.

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2
Q

What are the different types of biopsies used for investigating skin cancer?

A

Incisional, excisional, punch, and shave

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3
Q

Name the different ways a BCC can present?

A

Nodular, superficial, morpheoic, pigmented, and ulcerated

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4
Q

What are the properties of a nodular BCC?

A
  • Slow growing pearly nodule that may ulcerate
  • Pink hue
  • Elevated shiny border
  • May be cystic
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5
Q

Where do nodular BCCs often arise?

A

The face (forehead, temples, nose, upper lip)

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6
Q

What are the properties of a superficial BCC?

A
  • Thin erythematous plaques with a blue tinge
  • Dry or scaly
  • Eroded or crusted
  • Shiny rim
  • Often asymptomatic
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7
Q

Where do superficial BCCs most often arise?

A

Trunk and limbs

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8
Q

What are the properties of a morphoeic BCC?

A
  • Scar-like plaque or dent
  • Often deeply invasive
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9
Q

Where do morphoeic BCCs most often arise?

A

Mid-face

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10
Q

What are the properties of a SCC?

A
  • Irregular, red papule or plaque
  • Scaly, warty, crusted surface
  • May become nodular
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11
Q

Where do SCCs most often arise?

A

Face, ears, neck, lips, dorsum of hands

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12
Q

Which type of non-melanoma (BCC and SCC) is the most common?

A

BCC (~80%)

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13
Q

What is Bower’s disease?

A

Early form of SCC. Spreads along the skin surface rather than into the skin. Very slow growing; only a risk if neglected.

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14
Q

What are the subtypes of Malignant Melonoma?

A

Superficial spreading
Nodular
Acral lentiginous
Lentigo maligna melanoma

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15
Q

What are the 5 signs of malignant melanoma?

A

Asymmetrical
Borders (uneven)
Colours (variety)
Diameter (larger than 6mm)
Evolving

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16
Q

What staging system is used for non-melanomas?

A

TNM

17
Q

What is the Breslow thickness of an melanoma and how is this used in staging?

A

How deep the melanoma goes in the skin. There are 5 stages and this is used in place of the T in the TNM staging for melanomas.

18
Q

What are the main forms of treatment for BCCs and SCCs?

A

Surgery
Chemo
Photodynamic therapy
RT

19
Q

What surgical techniques may be considered for treatment of a BCC or an SCC?

A

Surgical Excision
Cryosurgery
Moh’s micrographic surgery

20
Q

What specific type of non-melanoma is photodynamic therapy used for?

A

Superficial BCC only

21
Q

When is RT indicated for BCCs and SCCs?

A

-Older patients where long term cosmesis not an issue
- Large lesions
- Position of legion makes surgery difficult
- Multiple lesions
- Patient unfit for surgery
- To reduce chance of recurrence post-surgery
- Treat recurrence after surgery

22
Q

When is RT indicated for melanomas?

A

Stage III: areas where lymph nodes are removed

Stage IV: to metastases

23
Q

What are the 4 types of RT that are used to treat skin cancer?

A

kV
electrons
VMAT MV with bolus
Total body electrons

24
Q

What doses are prescribed for VMAT RT for skin cancer?

A

60 Gy 30#
45 Gy 10# (>4cm)
35 Gy 5# (<4cm)
28 Gy 2# (7 weeks apart)
18 Gy 1#

25
Q

What are the main side-effects of RT for skin cancer?

A

Skin scab over
Depigmentation
Loss of hair follicles
Loss of sweat glands
Lacrimal gland damage

26
Q

What is apposition and why is it important for kV and electron treatment?

A

Where the applicator is positioned on a flat surface. It is needed for an even dose distribution.

27
Q

What steps are occur in the diagnosis of skin cancer?

A

Attend GP
Refer dermatology
Dermoscopy
Biopsy
Lymph Node Biopsy
CT/MRI

28
Q

What aetiological factors contribute towards melanomas?

A

Over exposure to UV radiation
Tar and soot

29
Q

What aetiological factors contribute towards non-melanomas?

A

UV
Family history of SCC
Psoriasis
HIV
CT brain scan before age 20