Skin Cancer Flashcards
(118 cards)
1
Q
Squamous cell carcinoma account for about ______ of non-melanoma skin cancers
A
20%
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
3
Q
Melanin gives color to
A
Eyes
Hair
Iris
4
Q
In African American, _____ is more common
A
Squamous cell carcinoma
5
Q
Women have higher rates of non-melanoma skin cancer on which body part
A
Legs
6
Q
Smoking causes ____ of the lip
A
SCC
7
Q
What is the number 1 cause of non-melanoma skin cancer
A
UV Ray exposure
8
Q
The connective tissue layer of the skin is the
A
Dermis
9
Q
The epithelial layer of the skin is the
A
Epidermis
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
11
Q
Germ cells give rise to keratinocytes in the
A
Stratum basale
12
Q
Melanin protects the cells by
A
Positioning itself inside the keratinocytes between the nucleus and the UV rays
13
Q
These are skin cancers of the sebaceous glands
A
Adenocarcinoma
14
Q
This skin cancer resembles eczema and is often treated with TSEB/TSET (total skin electron therapy)
A
Mycosis fungoides
15
Q
The technique used to treat TSEB/TSET is known as
A
Stanford technique
16
Q
Which skin cancer has the highest mortality rate
A
Melanoma
17
Q
Transmission for blocking material should not exceed
A
5%
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
19
Q
What margins are usually used for non-melanoma Electron treatment
A
2cm margin
20
Q
What is the most common skin cancer
A
Basal cell carcinoma
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
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
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)
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
25
Non-melanoma out numbers melanoma by what ration
22:1 (non-melanoma:melanoma)
26
Beside skin being fair, what other skin type have a higher risk of developing skin cancer
Albinos
Freckles
Light colored eyes
People with xeroderma pigmentosum
27
What is xeroderma pigmentosum
A defect in genetics where the cell/skin cannot repair DNA damage by UV light
28
What is the purpose of melanin
Acts as a protective substance that gives color to skin,hair, and iris
29
____ is more commonly seen in African Americans
Squamous cell carcinomas
30
_____ occurs more often in exposed body parts
Squamous cell carcinoma
31
Non-melanoma is 3x more in which sex
Men
| However women have higher incidence of non-melanoma on the legs
32
Melanoma is twice as high in men over the age of
65
33
Major cause of skin cancer is
UV exposure (sunlight)
34
T/F
| Risk of melanomas increase4-5times after 5 times or more blistering sun burns during adolescence
True
35
"______" people develop melanoma more often
Indoor people
36
"_____" people are more likely to get BCC or SCC
Outdoor people
37
Sunlight contains 2 types of UV rays that are harmful to the skin. What are they
UVA and UVB
38
Risk factor for SCC
HPV
Immunosuppression
Burns or chronic heat exposure
Scar
39
Melanoma develops from
Melanocytes
40
What produces melanin
Melanocytes
41
What are the 2 categories of moles
Those at birth
| This acquired later in life
42
What is the function of the skin
Regulate the body temp
Acts as a protective barrier
Works in the production of Vitamin D
Provides receptors for external stimuli
43
The skin is an ______ membrane
Epithelial membrane
44
The connective tissue is the _____ layer
Dermis
45
The epithelial layer is the _______. This layer is extremely thin, outer layer and has 4-5 layers, depending on location
Epidermis
46
Both the dermis an epidermis is held together by an intermediate layer called
Basement membrane
47
The _____ is the deep layer, connective tissue that contains blood and lymphatic vessels;nerves and nerve endings, sweat glands and hair follicles
Dermis
48
Melanin serves to protect the skin by protecting the _____ of the keratinocytes
Nucleus of the keratinocytes
49
Describe the characteristic of the keratinocytes
Stratified epithelial cells
90% of epidermal cells
Provide a barrier
Can be damaged by UV rays
50
The melanin lies between
The skin surface and the cell nucleus
51
Malignant melanoma arise from melanocytes located in the
Stratum basale
52
Malignant melanoma is commonly seen in which body part
Legs of women
| Trunk an face of men
53
Describe BCC
Slow growing and does not tend to metastasize
Most common
Arise from stem cells in stratum basale
54
Describe SCC
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
Skin cancer of the sebaceous glands are called
Adenocarcinoma
56
This types of skin cancer resembles eczema, disease of the T-lymphocytes and AKA myosis fungoides
Cutaneous T-cell lymphoma
57
Kaposi's sarcoma are
Slow growing
Purple lesions
Common in AIDS patients
*sarcomas arise from connective tissues
58
Mycosis fungoides can be treated with
TSEB/TSET
59
The technique use for TSEB/TSET is known as
Stanford technique
60
What is the ABCD rule for detecting melanoma
A-asymmetry
B-border
C-color
D-diameter
61
Melanomas have what kinds of borders
Notched, uneven borders
62
Most melanoma have a diameter that is
Greater than 6cm
63
Melanoma pre-cursors
```
Color
Surface
Texture
Sensation
Change in surrounding and normal skin
```
64
What kind of biopsy is performed for suspicion of SCC or melanomas to determine depth of tension
Wide excisional biopsy
65
What is Clark's level
It is different level describing disease invasion
66
What is Breslow's system
System that characterize melanomas based on tumor thickness
67
What are the 2 important prognostic indicators
Tumor thickness
| Ulceration
68
Only chance of spread for melanoma is
Direct extension
69
What is the order of spread for melanoma
```
Direct extension into subcutaneous tissue
Regional lymphatics
Distant skin and subcutaneous tissues
Lung
Liver,bone, brain
```
70
Treatment of choice for melanoma
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
T/F
| Melanomas typically are radioresistant
True
72
Appearance of SCC
Scaly, ulcerated or modular and may contain characteristics of BCC
73
T/F
| Early non-melanoma lesions are considered to be 100% curable
True
74
Treatment of choice for non-melanoma
Several options
| Depends on location, risk of reoccurrence, volume of invasion and cosmetic reasons on
75
Margins for non-melanoma
Small 3-5mm
| Large 1cm
76
What is Moh's surgery
Removal of a layer of tumor at a time and look under microscope and repeat until margins are negative
77
T/F
| XRT is used for non-melanoma when cosmetic outcome is important
True
78
T/F
| Early non-melanoma lesions are considered to be 100% curable
True
79
A form of surgery for non-melanoma that uses liquid nitrogen or CO2 -50 degrees C freezes and kills tumor cells
Cryosurgery
80
When is XRT for non-melanoma
When surgery is not an option. Used when cosmetic outcome is important
81
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
True
82
Electrons and kV treatments both uses a _____ to Collimator the electron beam for non-melanoma XRT
A cone
83
Cerrobend is also called
Lipowids metal
84
What is the cerrobend to lead ratio
1.25cm cerrobend for 1cm of lead
85
Regardless of the radiation used, transmission should not be more than _____
5%
86
The field for electron treatment should cover how much
Entire lesion plus 2cm
| And 1cmm may be used for small superficial lesions
87
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
With a shield covered in wax or vinyl
88
Shield should be coated with _____ material in order to prevent scatter to the eyelid
Low z materials
89
At what dose can cause cataracts
200cGy
90
Inner ear should not exceed what dose
1000cGy
91
What chemotherapy is used and its side effects
Topical 5FU. It can cause inflammation and irritation during treatment but does not scar
92
What is telangiectasia
Also known as spider veins. Are small dilated blood vessels near the surface of the skin
93
What is the NCCN guidelines for BCC/SCCgreater than 2cm
1.5cm-2cm margin using 55-66Gy
94
What is the NCCN guideline for BCC/ SCC less than 2cm
1cm-1.5cm margin with 35-64Gy
95
What is the NCCN guideline dose for BCC/ SCC post op
50-60Gy
96
SCC accounts for about ___ of non-melanoma skin cancer
20%
97
Why is there such a wide range of estimates on how many skin cancer occurrence in the US
Doctors are not required to report the incidence to cancer registries
98
In the past 60 years, what skin cancer has increased more than any other
Melanoma
99
This is a genetic condition cause by a defect in mechanism that repair DNA damage caused by UV light
Xeroderma pigmentosum
100
In black people ____ is more common
SCC
101
Women have higher rates of non-melanoma skin cancers on the ____
Legs
102
T/F
| Overall, women are 3 times more likely than men to have BCC or SCC
False. Men are 3 times more likely to develop BCC or SCC
103
Melanomas primarily occur with people who are
In people who stay indoors with occasional intense sun exposure
104
The propensity of a mole to develop into melanoma is greatest in :
Junctional nevi and compound nevi
105
What is thought to be the reason for moles in the junctional nevi and compound nevi to become melanomas?
They are exposed to more UV rays
106
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
100.5cm
107
The connective tissue of the skin is the
Dermis
108
The epithelial layer of the skin is the ?
**hint: "epi"**
Epidermis
109
Melanin protects the cell by
Positioning itself inside the keratinocyte between the nucleus and the UV rays
110
When is radiation used for treatment of melanoma
It can be used as an adjuvant or for palliative measures
111
This procedure uses mineral oil o allow the stratum cornermen to become visible which allows a dermatologist to view the dermal-epidermal junction
Dermatoscopy and epiluminescence microscopy
112
Which skin cancer has the highest mortality rate
Merkel cell carcinoma
113
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
Isolated limb perfusion
114
Moh's surgery is used mostly for
SCC
115
Dmax for electron skin treatment is generally no less than
90%
116
What is an effective way to protect nasal cartilage when treating the nose with electrons
Use lead wrapped with wax inserted into the nasal cavity
117
Which UV rays are thought to cause most skin cancers
UVB
118
What is the largest margin usually used for non-melanoma electron treatment.
2cm
