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cancer Flashcards

(43 cards)

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1
Q

Skin cancer w worst prognosis

A

Melanoma

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2
Q

2 types of skin cancer

A
  • Non melanoma (Basal Cell Cancer, SCC)
  • Melanoma
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3
Q

Questions asked to patients we suspect have skin cancer

A
  1. HISTORY
    - Duration
    - Change
    - Symptoms
    - Risk factor assessment
    - PMHx, DHx, allergies
  2. EXAMINATION
    - Site, size, flat/raised, borders, surface features
    - Pigmented - ABCDE
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4
Q

ABCDE - skin

A

A- Asymmetry
B- irregular Border
C- Colour variation
D- Diameter >6mm
E- Evolution/Elavation

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5
Q

What time of sun exposure is common in patients with BCC/Melanoma

A

Intense intermittent sun exposure

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6
Q

What time of sun exposure is common in patients with SCC and their precursors

A

Chronic cumulative (eg. live abroad, work outside)

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7
Q

BASAL CELL CARCINOMA
- Originate from?
- Hx
- Prognosis

A
  • Basal keratinocytes
  • Slowly growing, asymptomatic
  • Good as don’t metastasise + are locally invasive
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8
Q

BCC Clinical features

A
  • Rolled, pearly, shiny edge
  • central ulceration
  • telangiectasia
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9
Q

BCC
- 3 subtypes + treatment

A
  1. Nodular: Routine excision (3-4mm round it)
  2. Infiltrative: Mohs surgery/ Wide excision
  3. Superficial:
    - Freeze (liquid nitrogen),
    - Creams (i.e: efudex- cytotoxic cream, imiquimod cream)
    - Photodynamic therapy
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10
Q

Diagnostic tool used to look at skin cancer lesions

A

Dermatascope

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11
Q

what type of bcc

A

Inflitrative
- Wide margin

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12
Q

what type of bcc

A

Nodular
- Golf ball
- Well defined

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13
Q

what type of bcc

A

superficial
- flat

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14
Q

SCC
- Originate from
- Hx
- Prognosis

A
  • Supra-basal keratinocytes
  • Fast growing (changes over 2-3 months), tender
  • Meh, could metastasise - most do not
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15
Q

Most common cancer in immunosuppressed population

A

SCC

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16
Q

Clinical features of SCC

A
  • Depends on how well-differentiated cells are
  • Scaly lumps/ ulcerated lumps
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17
Q

Precursors to SCC + their definitions

A
  • Actinic keratosis (solar keratosis): partial thickness of keratinocyte dysplasia of epidermis
  • Bowens disease: full thickness keratinocyte dysplasia of epidermis
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18
Q

Prognosis/Treatment for actinic keratosis and bowens disease

Study These Flashcards
A
  • Treated non-surgically (eg. liquid nitrogen, effudix + education)
  • Non life-threatening (as superficial)
19
Q

actinic keratosis presentation

Study These Flashcards
A
  • scale
  • common on sun exposed areas
20
Q

Bowens disease presentation

21
Q

What % of:

  1. Actinic
  2. Bowens disease

progress into scc

Study These Flashcards
A
  1. around1%
  2. around 5%
22
Q

risk factors for ssc round mouth

Study These Flashcards
A
  • smoking
  • sun exposure
23
Q

Melanoma
- Arrises from
- Hx
- Prognosis

Study These Flashcards
A
  • Melanocytes
  • Changing pigmented lesion, itchy/bleeding
  • Poor, all invasive melanomas can metastasise
24
Q

Melanoma risk factors

Study These Flashcards
A
  • Multiple atypical moles
25
Multiple atypical moles worrying sign
'Ugly duckling sign' - one mole different to the rest (probably a melanoma)
26
Major + Minor criteria for analysing moles
MAJOR Change in: shape, size, colour MINOR Diameter >6mm, bleeding, sensory change, inflammation
27
Most common type of melanoma
Superficial spreading melanoma
28
Walk me thru growth of melanoma
1. Horizontal growth - confined to epidermis (no metastatic potential) - normally flat 2. Vertical growth (break thru basement membrane + can metastasise) - nb look for lumpy melanoma
29
Types of melanoma
- Superficial spreading melanoma - Nodular melanoma - Lentigo maligna (melanoma) - Acral lentiginous melanoma NB- All can be amelanotic melanoma (no pigment)
30
what type of melanoma is this
31
Prognosis of nodular melanoma + why
- poor as they grow vertically straight away
32
Lentigo maligna
- horizontal growth phase lasts years - Name changes to lentigo malgina once vertical phase is commenced
33
What type of melanoma is this
34
What type of melanoma is this
35
What type of melanoma is this
36
Where is acral MM commonly seen
palms soles nails
37
Risk factors for acral MM
genetic mutation
38
What type of melanoma is this
39
What's Breslow thickness used for
to measure deepest tumour cell from granular layer of epidermis - related to tumour prognosis (deeper tumour = poorer prognosis)
40
Breslow thickness >3.00mm survival
60% 5 year survival
41
Breslow thickness <0.76 survival
90% 5y survival
42
Breslow thickness confined to epidermis survival
100% 5y survival
43
Malignant melanoma treatment
1. Surgical excision +/- sentinel node biopsy ( done if Breslow thickness > 0.8) 2. Advanced MM (difficult to treat): - Targeted therapies - Immunotherapy (to get immune system to attack cancer more)

Derm (8 decks)

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