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Melanoma

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Shanita Gaiters

on 10 September 2015

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Transcript of Melanoma

What is Melanoma?

Accounts for 4% of all skin cancers but it is the most dangerous type of skin cancer. It is the leading cause of death from skin disease.
Caused by changes in cells called melanocytes, which produce a skin pigment called melanin. Melanin is responsible for skin and hair color.

History
Change in the shape and color of moles, the mole may itch or bleed.
May cause general symptoms like loss appetite, nausea, vomiting and fatigue
Scaliness
Itching
Oozing or bleeding
MELANOMA
Risk Factors
Pathophysiology
Diagnosis
Screening
By Shanita Gaiters
Prevention
Nursing Consideration
Not all melanomas can be prevented, but there are things you can do that could reduce your risk of getting melanoma.
The most important way to reduce the risk of melanoma is to protect yourself from UV rays. Practice sun safety when you are outdoors. If you are going to be in the sun follow these 4 steps: "Seek! Slip! Slop! Slap!

"Seek" Shade
Limit UV rays
Avoid being outdoors in direct sunlight too long between the hours of 10 am and 4 pm, when UV light is strongest.

Long-sleeved shirts and long pants or skirts protect the most.
Dark colors generally protect more than light colors.
A tightly woven fabric protects better than loosely woven clothing.
Dry fabric is generally more protective than wet fabric
.


"Slip" on a Shirt
Sunscreens and lip balms with protection against UVA and UVB rays and with sun protection factor (SPF) values of 30 or higher
Use sunscreen even on hazy days or days with light or broken cloud cover because UV rays still come through.
Cover the arms, legs, neck and face
Apply at least every 2 hours to maintain protection.

"Slop" On Some Sunscreen
"Slap" on a Hat & Sunglasses
A hat with at least a 2- to 3-inch brim all around protects ears, eyes, forehead, nose, and scalp.

Sunglasses provide the best protection for the eyes and the skin area around the eyes.
Genetics
People with fairer skin, with light hair and eye color
are at a higher risk
Any moles that are formed after the first few
decades of life.
Immunodeficient individuals due to chemotherapy
treatment, HIV patients, and organ transplant

Signs
Symptoms
Hidden Melanoma
.
Melanoma under a
NAIL
(Subungual melanoma)
- is a rare form that occurs under a nail and can affect the hands or the feet.
Melanoma in the
MOUTH, DIGESTIVE TRACT, URINARY TRACT,
or
VAGINA.
(Mucosal Melanoma)
- develops in the mucous membrane that lines the nose, mouth, esophagus, anus, urinary tract and vagina. Mucosal melanomas is difficult to detect.
Melanoma in the
EYE
(Ocular melanoma)
- may cause vision changes and may be diagnosed during an eye exam
Signs and Symptoms

Punch biopsy
- Skin around the mole is removed


Excisional biopsy
- The entire mole or growth is removed


Incisional biopsy
- Most irregular part of a mole is removed

Treatment
Early Stages
Surgery to remove melanoma
Advance Stages
Surgery to remove lymph nodes
Chemotherapy
Radiation therapy
Prognosis
•The thickness of the tumor and where it is in the body.
•How quickly the cancer cells are dividing.
•Whether there was bleeding.
•Whether cancer has spread to the lymph nodes or other places in the body.
•The patient’s general health.
Melanoma is aggressive so the earlier the detection the greater the success rates. Performing a thorough self skin examination each month and visiting a dermatologist each year helps to detect it early
In 1787, John Hunter was the first to operate on a melanoma patient, but didn't know what it was
In 1840, Samuel Cooper, stated that the only chance for cure depends on the early removal.
Nine 2400 year old Peruvian mummies were tested in the 1960s and showed signs of melanoma in the skin and bones.
QUESTIONS?
Reference
Provide information with the risk factors, signs and symptoms.
Emphasize biggest risk factor of UV rays
Self-skin assessment


•Benign melanocytic nevi:
controlled proliferation of normal melanocytes to produce a benign nevus.
•Atypical/dysplastic nevi
: abnormal growth of melanocytes in a pre-existing nevus or new location resulting in a pre-malignant lesion with random cytologic atypia. These appear as flat macules, > 5mm in size, with irregular borders and variable pigmentation.

Radial growth:
melanocytes acquire ability to proliferate horizontally in the epidermis and histologically show continuous atypia (melanoma in situ). E-cadherin helps confine the cells intraepidermally but a few cells may invade the papillary dermis.
•Vertical growth: numerous biochemical events including the loss of E-cadherin and expression of N-cadherin allow malignant cells to invade basement membrane and proliferate vertically in the dermis as an expanding nodule with metastatic potential.
•Metastasis: malignant melanocytes spread to other areas of body, usually first to lymph nodes then to skin, subcutaneous soft tissue, lungs and the brain


,
5 steps
3 Types of Skin Cancer
Basal cell cancer-
Epidermis, most common but least dangerous
Squamous cell cancer-
Dermis, most likely to spread and, if untreated,
can be fatal.

Melanoma-
Melanocytes, is the least common, but most aggressive
Epidemiology
In 2010
61,061 people in the United States were diagnosed with melanomas of the skin- 35,248 men and 25,813 women
9,154 people in the United States died from melanomas of the skin-6,002 men and 3,152 women.
White men and women have the highest rate of getting melanoma followed by Native Americans, Hispanics, Asians, and African Americans.

Phases
Radial Growth-
Melanocytes begin to grow out of control. Melanocytes are found between the epidermis and the dermis, less than 1mm
Invasive Radial Growth -
Cells start to acquire invasive potential. melanoma is capable of spreading, 1 mm
Vertical Growth Phase
- grow into the surrounding tissue and can spread around the body through blood or lymph vessels. Deeper parts of the dermis, greater than 1mm
Metastasis
-Spread of cancer to distal parts of the body
Skin Cancer Rates by Race and Ethnicity. (2013, August 12). Centers for Disease Control and Prevention. Retrieved March 26, 2014, from http://www.cdc.gov/cancer/skin/statistics/race
Board, A. (2012, April 5). Melanoma. U.S. National Library of Medicine. Retrieved March 28, 2014, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001853
Chang, A. (2008). Melanoma. Magill's medical guide (4th rev. ed., pp. 1715-1716). Pasadena, Calif.: Salem Press.
Ferrara, M. H. (2010). Skin Cancer. Human diseases and conditions (2nd ed., pp. 766-769). Detroit: Charles Scribner's Sons/Gale Cengage Learning.

Hodgetts, J. (2011). Diagnosis and management of malignant melaoma. Cancer Nursing Practice, 10, 30-37.

Melanoma. (n.d.). Cleveland Clinic Center for Continuing Education. Retrieved March 27, 2014, from http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/dermatology/cutaneous-malignant-melanoma/

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