Medical-surgical Nursing Demystified

(Sean Pound) #1

(^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.

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