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Therapy Prin & Procedure > Skin Cancer > Flashcards

Skin Cancer Flashcards

1
Q

Squamous cell carcinoma account for about ______ of non-melanoma skin cancers

A

20%

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2
Q

Why is there such a wide range of estimates on how many skin cancers occur in the US

A

Few patients report skin cancer

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3
Q

Melanin gives color to

A

Eyes
Hair
Iris

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4
Q

In African American, _____ is more common

A

Squamous cell carcinoma

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5
Q

Women have higher rates of non-melanoma skin cancer on which body part

A

Legs

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6
Q

Smoking causes ____ of the lip

A

SCC

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7
Q

What is the number 1 cause of non-melanoma skin cancer

A

UV Ray exposure

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8
Q

The connective tissue layer of the skin is the

A

Dermis

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9
Q

The epithelial layer of the skin is the

A

Epidermis

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10
Q

This layer of the skin is generally found in areas were the skin is thicker, such as the palms of the hands and sole of the feet

A

Stratum lucidum

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11
Q

Germ cells give rise to keratinocytes in the

A

Stratum basale

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12
Q

Melanin protects the cells by

A

Positioning itself inside the keratinocytes between the nucleus and the UV rays

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13
Q

These are skin cancers of the sebaceous glands

A

Adenocarcinoma

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14
Q

This skin cancer resembles eczema and is often treated with TSEB/TSET (total skin electron therapy)

A

Mycosis fungoides

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15
Q

The technique used to treat TSEB/TSET is known as

A

Stanford technique

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16
Q

Which skin cancer has the highest mortality rate

A

Melanoma

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17
Q

Transmission for blocking material should not exceed

A

5%

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18
Q

What is an effective way to protect the nasal cartilage when treating the nose with electron

A

Use lead wrapped with wax inserted into the nasal cavity

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19
Q

What margins are usually used for non-melanoma Electron treatment

A

2cm margin

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20
Q

What is the most common skin cancer

A

Basal cell carcinoma

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21
Q

T/F
BCC and SCC is very curable and is NOT required to be reported to cancer registries so that’s why we don’t know the exact number of incidences

A

True

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22
Q

T/F

Non-melanoma (BCC and SCC) is more common then a melanoma however, there’s more deaths involved with melanoma

A

True

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23
Q

What is the ratio of BCC to SCC in men and women

A

Men (5:1) (BCC:SCC)

Women (10:1) (BCC:SCC)

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24
Q

What are the tendencies for people to develop skin cancers re groups into what 4 categories

A

Geographic location
Skin type (fair skin 10x higher risk)
Multiplicity
Gender

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25
Q

Non-melanoma out numbers melanoma by what ration

A

22:1 (non-melanoma:melanoma)

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26
Q

Beside skin being fair, what other skin type have a higher risk of developing skin cancer

A

Albinos
Freckles
Light colored eyes
People with xeroderma pigmentosum

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27
Q

What is xeroderma pigmentosum

A

A defect in genetics where the cell/skin cannot repair DNA damage by UV light

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28
Q

What is the purpose of melanin

A

Acts as a protective substance that gives color to skin,hair, and iris

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29
Q

____ is more commonly seen in African Americans

A

Squamous cell carcinomas

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30
Q

_____ occurs more often in exposed body parts

A

Squamous cell carcinoma

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31
Q

Non-melanoma is 3x more in which sex

A

Men

However women have higher incidence of non-melanoma on the legs

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32
Q

Melanoma is twice as high in men over the age of

A

65

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33
Q

Major cause of skin cancer is

A

UV exposure (sunlight)

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34
Q

T/F

Risk of melanomas increase4-5times after 5 times or more blistering sun burns during adolescence

A

True

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35
Q

“______” people develop melanoma more often

A

Indoor people

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36
Q

“_____” people are more likely to get BCC or SCC

A

Outdoor people

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37
Q

Sunlight contains 2 types of UV rays that are harmful to the skin. What are they

A

UVA and UVB

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38
Q

Risk factor for SCC

A

HPV
Immunosuppression
Burns or chronic heat exposure
Scar

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39
Q

Melanoma develops from

A

Melanocytes

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40
Q

What produces melanin

A

Melanocytes

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41
Q

What are the 2 categories of moles

A

Those at birth

This acquired later in life

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42
Q

What is the function of the skin

A

Regulate the body temp
Acts as a protective barrier
Works in the production of Vitamin D
Provides receptors for external stimuli

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43
Q

The skin is an ______ membrane

A

Epithelial membrane

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44
Q

The connective tissue is the _____ layer

A

Dermis

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45
Q

The epithelial layer is the _______. This layer is extremely thin, outer layer and has 4-5 layers, depending on location

A

Epidermis

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46
Q

Both the dermis an epidermis is held together by an intermediate layer called

A

Basement membrane

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47
Q

The _____ is the deep layer, connective tissue that contains blood and lymphatic vessels;nerves and nerve endings, sweat glands and hair follicles

A

Dermis

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48
Q

Melanin serves to protect the skin by protecting the _____ of the keratinocytes

A

Nucleus of the keratinocytes

49
Q

Describe the characteristic of the keratinocytes

A

Stratified epithelial cells
90% of epidermal cells
Provide a barrier
Can be damaged by UV rays

50
Q

The melanin lies between

A

The skin surface and the cell nucleus

51
Q

Malignant melanoma arise from melanocytes located in the

A

Stratum basale

52
Q

Malignant melanoma is commonly seen in which body part

A

Legs of women

Trunk an face of men

53
Q

Describe BCC

A

Slow growing and does not tend to metastasize
Most common
Arise from stem cells in stratum basale

54
Q

Describe SCC

A

Fast growing and tends to metastasize
Arise from the more mature keratinocytes of the upper layer of the epidermis
Most common in sun exposed areas like the arms, face, head and neck, and hands

55
Q

Skin cancer of the sebaceous glands are called

A

Adenocarcinoma

56
Q

This types of skin cancer resembles eczema, disease of the T-lymphocytes and AKA myosis fungoides

A

Cutaneous T-cell lymphoma

57
Q

Kaposi’s sarcoma are

A

Slow growing
Purple lesions
Common in AIDS patients

*sarcomas arise from connective tissues

58
Q

Mycosis fungoides can be treated with

A

TSEB/TSET

59
Q

The technique use for TSEB/TSET is known as

A

Stanford technique

60
Q

What is the ABCD rule for detecting melanoma

A

A-asymmetry
B-border
C-color
D-diameter

61
Q

Melanomas have what kinds of borders

A

Notched, uneven borders

62
Q

Most melanoma have a diameter that is

A

Greater than 6cm

63
Q

Melanoma pre-cursors

A 
Color
Surface
Texture
Sensation 
Change in surrounding and normal skin
64
Q

What kind of biopsy is performed for suspicion of SCC or melanomas to determine depth of tension

A

Wide excisional biopsy

65
Q

What is Clark’s level

A

It is different level describing disease invasion

66
Q

What is Breslow’s system

A

System that characterize melanomas based on tumor thickness

67
Q

What are the 2 important prognostic indicators

A

Tumor thickness

Ulceration

68
Q

Only chance of spread for melanoma is

A

Direct extension

69
Q

What is the order of spread for melanoma

A 
Direct extension into subcutaneous tissue 
Regional lymphatics 
Distant skin and subcutaneous tissues 
Lung 
Liver,bone, brain
70
Q

Treatment of choice for melanoma

A

Surgery (wide excision 5x5) for curative treatment
Chemo is used for mets or post op
XRT is rare but can be used for palliative disease

71
Q

T/F

Melanomas typically are radioresistant

A

True

72
Q

Appearance of SCC

A

Scaly, ulcerated or modular and may contain characteristics of BCC

73
Q

T/F

Early non-melanoma lesions are considered to be 100% curable

A

True

74
Q

Treatment of choice for non-melanoma

A

Several options

Depends on location, risk of reoccurrence, volume of invasion and cosmetic reasons on

75
Q

Margins for non-melanoma

A

Small 3-5mm

Large 1cm

76
Q

What is Moh’s surgery

A

Removal of a layer of tumor at a time and look under microscope and repeat until margins are negative

77
Q

T/F

XRT is used for non-melanoma when cosmetic outcome is important

A

True

78
Q

T/F

Early non-melanoma lesions are considered to be 100% curable

A

True

79
Q

A form of surgery for non-melanoma that uses liquid nitrogen or CO2 -50 degrees C freezes and kills tumor cells

A

Cryosurgery

80
Q

When is XRT for non-melanoma

A

When surgery is not an option. Used when cosmetic outcome is important

81
Q

T/F
XRT can be used for large fields to encompass lymphatics. Photons are rare but may be used in certain scalp treatments o penetrate deeper lesions

A

True

82
Q

Electrons and kV treatments both uses a _____ to Collimator the electron beam for non-melanoma XRT

A

A cone

83
Q

Cerrobend is also called

A

Lipowids metal

84
Q

What is the cerrobend to lead ratio

A

1.25cm cerrobend for 1cm of lead

85
Q

Regardless of the radiation used, transmission should not be more than _____

A

5%

86
Q

The field for electron treatment should cover how much

A

Entire lesion plus 2cm

And 1cmm may be used for small superficial lesions

87
Q

Nasal cartilages and pinna of the ear can lead to chondritis which can lead to excision. They should be filled in with ___ to protect from scatter

A

With a shield covered in wax or vinyl

88
Q

Shield should be coated with _____ material in order to prevent scatter to the eyelid

A

Low z materials

89
Q

At what dose can cause cataracts

A

200cGy

90
Q

Inner ear should not exceed what dose

A

1000cGy

91
Q

What chemotherapy is used and its side effects

A

Topical 5FU. It can cause inflammation and irritation during treatment but does not scar

92
Q

What is telangiectasia

A

Also known as spider veins. Are small dilated blood vessels near the surface of the skin

93
Q

What is the NCCN guidelines for BCC/SCCgreater than 2cm

A

1.5cm-2cm margin using 55-66Gy

94
Q

What is the NCCN guideline for BCC/ SCC less than 2cm

A

1cm-1.5cm margin with 35-64Gy

95
Q

What is the NCCN guideline dose for BCC/ SCC post op

A

50-60Gy

96
Q

SCC accounts for about ___ of non-melanoma skin cancer

A

20%

97
Q

Why is there such a wide range of estimates on how many skin cancer occurrence in the US

A

Doctors are not required to report the incidence to cancer registries

98
Q

In the past 60 years, what skin cancer has increased more than any other

A

Melanoma

99
Q

This is a genetic condition cause by a defect in mechanism that repair DNA damage caused by UV light

A

Xeroderma pigmentosum

100
Q

In black people ____ is more common

A

SCC

101
Q

Women have higher rates of non-melanoma skin cancers on the ____

A

Legs

102
Q

T/F

Overall, women are 3 times more likely than men to have BCC or SCC

A

False. Men are 3 times more likely to develop BCC or SCC

103
Q

Melanomas primarily occur with people who are

A

In people who stay indoors with occasional intense sun exposure

104
Q

The propensity of a mole to develop into melanoma is greatest in :

A

Junctional nevi and compound nevi

105
Q

What is thought to be the reason for moles in the junctional nevi and compound nevi to become melanomas?

A

They are exposed to more UV rays

106
Q

A prescription requires 0.5cm of wet gauze for Bolus and 100cm SSD to the Bolus. What does the SSD to the skin reads before placing the Bolus

A

100.5cm

107
Q

The connective tissue of the skin is the

A

Dermis

108
Q

The epithelial layer of the skin is the ?

hint: “epi”

A

Epidermis

109
Q

Melanin protects the cell by

A

Positioning itself inside the keratinocyte between the nucleus and the UV rays

110
Q

When is radiation used for treatment of melanoma

A

It can be used as an adjuvant or for palliative measures

111
Q

This procedure uses mineral oil o allow the stratum cornermen to become visible which allows a dermatologist to view the dermal-epidermal junction

A

Dermatoscopy and epiluminescence microscopy

112
Q

Which skin cancer has the highest mortality rate

A

Merkel cell carcinoma

113
Q

This is a procedure that delivers high doses of chemotherapy to the intended lesion but spares the rest of the body from the side effects of chemo

A

Isolated limb perfusion

114
Q

Moh’s surgery is used mostly for

A

SCC

115
Q

Dmax for electron skin treatment is generally no less than

A

90%

116
Q

What is an effective way to protect nasal cartilage when treating the nose with electrons

A

Use lead wrapped with wax inserted into the nasal cavity

117
Q

Which UV rays are thought to cause most skin cancers

A

UVB

118
Q

What is the largest margin usually used for non-melanoma electron treatment.

A

2cm

Therapy Prin & Procedure (17 decks)

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