(^406) Medical-Surgical Nursing Demystified
amounts of x-rays also increase the risk for skin cancers, as does arsenic which is
a metal found in the environment and in our food. People who take immunosup-
presant medications are at a greater risk for skin cancers as are fair-skinned peo-
ple and those with a family history of skin cancer.
PROGNOSIS
If the lesion is identified and treated early, prognosis is excellent. Follow-up care
with frequent skin assessments is mandatory. Basal cell cancers are unlikely to
have a poor prognosis. Squamous cell tumors may spread if left unchecked. Mela-
noma is staged by determining thickness of the lesion, and the extent to which it
has spread. Stage 0 is a confined tumor. The other stages mean the cancer has
spread to other tissues, and organs.
HALLMARK SIGNS AND SYMPTOMS
- Basal cell—pearly white, waxy-appearing papule or a flat, brown patch
- Squamous cell—firm red nodule; a flat scaly lesion; a change in a scar
- Melanoma—any mole that is new, that has changed, and/or that meets any
of the ABCDE criteria
INTERPRETING TEST RESULTS
- Biopsy with an interpretation by a pathologist.
TREATMENT
Treatment is dependent upon the type of cancer, location, and size of the tumor.
- Surgical excision involves removing the tumor and surrounding healthy tis-
sue to ensure all the cancerous tissue has been extracted. - Cryosurgery in which the cells are killed by freezing with liquid nitrogen.
- Mohs’ surgery where the tumor is removed layer by layer. Each surface area
is evaluated microscopically, to ascertain that no cancer cells are present in
the remaining tissue. - Laser treatments to vaporize the cancer cells.
- Topical creams and ointments.