WORKSHOP: 1. Identify the clinical presentation that suggests this could be skin cancer. · Vasculature, crust in the centre, (scaly) can indicate sarcomona, pearly appearance, doesn't heal, not uniform, telangiectasia (blood vessels) 2. What layer of the skin is affected in BCC? What is the natural course of BCC if left untreated? Fig 1. Cross-section through the skin Sweat gland · Epidermis - has 5 layers in thick skin and 4 in thin. The basale layer divides the most Frequently and the rate of division lessens superficially Molanocytos Capillaries Sweat Epidermis- Hai Oil Stratum corneum F(keratin) Basement membrane If a cancer cell was to go into the dermis it would invade the bone and other tissues or metastasis (travel throughout the body) Dermis- Fat layer Nerve Sebaceous gland Har follicle =- Blood vessels Cells that divide Frequently are more promise to develop tumours. · Vascularised cancer cells can metastasis into the Following organs and become secondary tumours: liver, lungs, heart (rare), brain & bones as they all have high blood supply and are areas of low pressure · Basel cell carcinoma very rarely progresses past stage 1. Stage o BCC confirmed to epidermal region of skin. Stage 1 localised disease, only in skin and very thin and has a low chance of metastasis Basal cell carcinoma (BCC) Stage 0 BCCconfined to epidermal region of skin Staging of Melanoma Tumour - size, layers, Stage 0 Stage II Localized disease thicker than Mage 4 Stage IV Spread to other orgens Melanoma confined to epidermal region of skin Epidermas Epidermas Nodes - lymph nodes and if they are involved Dermis Dermis Subcutaneous Tissue Subcutaneous Tissue Stage I Localized disease. N Stage I Localized disease, only in skin and very thin Stage III Spread to lymph nodes Metastasis - to other organs after breaking the basal layer STAGE 2 only in skin and verythin M 3. What individuals have an increased risk For developing skin cancers? Age, prolonged uv exposure, genetics, Family & personal history of cancer, pigmentation of skin, smoking, toxins (asbestos, alcohol, smoking, arsenic Free radicals, reactive oxygen species), obesity, environmental Factors, infection and inflammation (chronic), Tumour suppressor genes, apoptosis regulatory genes, DNA repair genes, oncogenes (regulate growth 4. Compare and contrast BCC, squamous cell carcinoma (SCC) and melanoma in terms of the site of origin, the comparative incidence rate, metastatic capacity, and treatment outcomes . BCC Basal cell carcinoma SCC squamous cell carcinoma Melanoma Site of origin Melanocytes in stratum basale Stratum basale Stratum spinosum Frequency Most Frequent Metastasis Very rarely Treatment strategies Surgical excision, chemotherapy, cryotherapy, radiation therapy In between, less than BCC In between Least Frequent More commom Treatment outcomes Excellent especially if detected early It's better resolved when detective early