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Early Detection of Melanoma and Other Skin Cancers


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This lecture provides an overview of skin cancer including risks, early detection, and treatment. Learn to identify the early signs of skin cancer. Melanoma and non-melanoma skin tumors will be discussed and prevention of skin cancer will be emphasized.

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Early Detection of Melanoma and Other Skin Cancers

  1. 1. An Overview of Skin Cancer: Diagnosis, Treatment & Prevention Naheed R. Abbasi, MD, MPH Summit Medical Group July 11, 2012
  2. 2. Skin Cancer: An Epidemic 2012 SEER data reveal that the most prevalent type of cancer in men are prostate (43%), colorectal (9%) and melanoma (7%) ; in women the top three are breast (41%), uterine (8%) and colorectal (8%.) (Siegel R, Desantis C, Virgo K et al. CA Cancer J Clin 2012 June 14) Incidence of skin cancer is rising in both women and men and lifetime risk of invasive melanoma has increased from 1/100 in 1993 to 1/52 in 2012. (Rigel et al., NYU Melanoma Cooperative Group, 2012.) Among Caucasians in 2012, lifetime risk of melanoma is 1/55 in women and 1/36 in men.
  3. 3. Why Such An Epidemic? Ultraviolet light is still the greatest risk factor Tanning beds are a major culprit Baby boomers are living longer Sun protection has not always been practiced widely by Americans, and childhood sun exposures play a major role in skin cancer risk.
  4. 4. Key Skin Cancer Risk Factors Ultraviolet light, natural and artificial, cummulative Radiation Multiple nevi, especially dysplastic Family history Light skin, light eyes Skin that burns easily History of blistering sunburns, including childhood Chronic sores or inflammation
  5. 5. The Skin
  6. 6. Basal Cell Carcinoma Most common type of skin cancer with 80% of lesions presenting on the head and neck Three main types: superficial, nodular and infiltrative Local invasion is the key risk in untreated cases or delayed diagnoses Presents with waxy, pearly, skin-colored, pink or red patches or plaques. Look out for red or scaly patches; red, flesh-colored or pink bumps or growths
  7. 7. Basal Cell Carcinoma: Images
  8. 8. Squamous Cell Carcinoma Presents most commonly in heavily sun-exposed areas Associated with chronic inflammation or ulceration Can present in a precancerous stage (actinic keratosis); a non-invasive stage (in-situ or Bowen’s disease) or invasive SCC. Main symptom is a red, dry scaly patch or a growing bump that is red, pink or flesh-colored.
  9. 9. Squamous Cell Carcinoma: Images ;;
  10. 10. Melanoma Melanoma is the leading cause of death from skin disease A disorder of melanocytes, melanoma can begin in normal skin, within a mole, or within a freckle Four commonly defined subtypes are superficial spreading, nodular, lentigo maligna, and acral lentiginous Rarely can occur in the eye (iris or retina)
  11. 11. Melanoma: Clinical Images ;;
  12. 12. ABCDE’s of Melanoma ABCDE’s of melanoma  -Asymmetry  -Border irregularity  -Color Variegation  -Diameter >6mm  -Evolution Abbasi, NR et al. JAMA 2004 Dec 8 ;292 (22):2771-6.
  13. 13. Some Benign Skin;;;
  14. 14. Treatment of Skin Cancer Prevention and early detection are key factors in patient success Topical creams/chemotherapeutic agents (5-fluorouracil, imiquimod, etc.) Radiation in rare instances Surgery is the mainstay  Electrodessication and curettage  Traditional excision  Mohs micrographic surgery Advanced melanoma treatments (interferon, chemotherapy)
  15. 15. Prevention of Skin Cancer Sun avoidance Sunscreens  SPF = sun protection factor, a measure of UVB protection  UVA blockers of significance are avobenzone, titanium dioxide, zinc oxide  Sunscreens should be applied liberally and reapplied every 2-3 hours if skin is getting wet Protective clothing
  16. 16. Conclusions Skin cancer is a common problem whose incidence is increasing in the US Understanding the appearance of skin cancer aids the public in early detection While most forms of skin cancer are treatable, disease can and does present in advanced states Since skin cancer is largely preventable, physicians and the lay public must strive to increase awareness and modify destructive behaviors
  17. 17. For more information Call (908) 273.4300Visit: Connect with us on Facebook/SummitMedicalNJ Twitter: @SummitMedicalNJ