Skin Cancer

  1. General information
    1. Types of skin cancers
      1. Basal cell epithelioma: most common type of skin cancer; locally invasive and rarely metastasizes; most frequently located between the hairline and upper lip
      2. Squamous cell carcinoma (epidermoid): grows more rapidly than basal cell carcinoma and can metastasize; frequently seen on mucous membranes, lower lip, neck, and dorsum of the hands
      3. Malignant melanoma: least frequent of skin cancers, but most serious; capable of invasion and metastasis to other organs
    2. Precancerous lesions
      1. Leukoplakia: white, shiny patches in the mouth and on the lip
      2. Nevi (moles): junctional nevus may become malignant (signs include a color change to black, bleeding, and irritation); compound and dermal nevi unlikely to become cancerous
      3. Senile keratoses: brown, scalelike spots on older individuals
    3. Contributing factors include hereditary predisposition (fair, blue-eyed people; redheads and blondes); irritation (chemicals or ultraviolet rays)
    4. Occurs more often in those with outdoor occupations who are exposed to more sunlight
  2. Medical management: varies depending on type of cancer; surgical excision with or without radiation therapy most common; chemotherapy and immunotherapy for melanoma
  3. Assessment findings: characteristics depend on specific type of lesion; biopsy reveals malignant cells
  4. Nursing interventions: provide client teaching concerning
    1. Limitation of contact with chemical irritants
    2. Protection against ultraviolet radiation from sun
      1. Wear thin layer of clothing.
      2. Use sun block or lotion containing para-amino benzoic acid (PABA).
    3. Need to report lesions that change characteristics and/or those that do not heal.