1. The client/caregiver can state general facts about skin cancer.
   1. Skin cancer usually develops on skin exposed to the sun, but it can also develop on areas of the skin not ordinarily exposed to sunlight.
   2. It is the most common form of cancer.
   3. Melanoma is the most serious form of skin cancer.
   4. Prevention or early detection is essential.
   5. One in seven Americans will develop skin cancer each year.
   6. More than 1 million new cases of skin cancer will be diagnosed in the United States this year.
2. The client/caregiver can list factors that increase the risk of skin cancer.
   1. Fair skin
   2. History of sunburns
   3. Excessive sun exposure
   4. Living in sunny or high-altitude climates
   5. Large number of moles or abnormal moles
   6. Precancerous skin lesions (most common on the face, lower arms, and hands of fair-skinned people)
   7. Family or personal history of skin cancer
   8. People with a weakened immune system
   9. Fragile or weakened skin such as psoriasis or skin that has been burned or injured
   10. Exposure to environmental hazards, chemicals, or herbicides
   11. Advanced age
3. The client/caregiver can list three main types of skin cancer.
   1. Basal cell is the most common type of skin cancer and is the easiest to treat.
   2. Squamous cells are also easily treated if found early.
   3. Melanoma is the most serious. It can develop in normal skin or in an existing mole. It accounts for only 4% of the cases of skin cancer but is the cause of 75% of skin cancer deaths.
4. The client/caregiver can use the A-B-C-D skin self-exam guide from the American Academy of Dermatology to detect skin cancers.
   1. A is for asymmetrical shape. Note any moles with irregular shapes or that do not match on each side.
   2. B is for irregular borders. Note any moles that have a notched, scalloped, or indistinct border.
   3. C is for change in color. Note any moles that are unusually dark or have variegated or uneven colors.
   4. D is for diameter. Note any moles that are larger than one-quarter inch in size or the size of a pencil eraser.
5. The client/caregiver can list the signs and symptoms of the three types of skin cancer.
   1. Basal cell carcinoma (cancer) symptoms are
      1. A pearly or waxy bump on the face, ears, or neck
      2. A flat, flesh-colored, or brown scar-like lesion on your chest or back
   2. Squamous cell carcinoma (cancer) symptoms are
      1. A firm, red nodule on your face, lips, ears, neck, hands, or arms
      2. A flat lesion with a scaly, crusted surface on the face, ears, neck, hands, or arms
   3. Melanoma symptoms are
      1. A large brownish spot with darker speckles located anywhere on your body
      2. A simple mole located anywhere on your body that changes in color, size, or feel or that bleeds
      3. A lesion with an irregular border and red, white, blue, or blue-black spots
      4. A shiny, firm, dome-shaped bump located anywhere on your body
      5. Dark lesions, on your palms, soles, fingertips, or toes
      6. Dark lesions on mucous membranes lining your mouth, nose, vagina, vulva, or anus.
6. The client/caregiver can list measures to prevent skin cancer.
   1. Avoid the sun between 10 a.m. and 4 p.m.
   2. Wear sunscreen.
      1. Use year round.
      2. Sunscreen with a protection factor of at least 15 is recommended.
      3. Do not miss the use of sunscreen on lips, ears, back of hands, and neck and tops of feet.
      4. Apply sunscreen 20 to 30 minutes before exposure, and reapply every 2 hours or after swimming or exercising.
      5. Check with the Food and Drug Administration for a list of currently approved sunscreen products.
   3. Wear protective clothing including a broad-brimmed hat, sunglasses, and so forth.
   4. Avoid tanning beds.
   5. Be alert to medications that can make your skin more sensitive to sunlight.
   6. Routine self-skin checks should include (using a mirror if necessary):
      1. Check face, neck, ears, and scalp.
      2. Examine both, front, and back of legs and feet (even between toes).
      3. Check the tops and undersides of arms and hands.
      4. Examine the chest and trunk of the body.
      5. Check genital areas.
   7. If you are older than 40 or have a high risk of developing skin cancer, consult your physician for annual skin exams.

Resource

American Academy of Dermatology
www.aad.org/

National Cancer Institute
www.cancer.gov/

U.S. Food and Drug Administration
www.fda.gov/

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. Philadelphia: Mosby Inc.
American Academy of Dermatology. 2007 Skin cancer fact sheet. Schaumburg, IL. Available from: www.aad.org/aad/Newsroom/2007+Skin+Cancer+Fact+Sheet.htm.
Canobbio, M. M. (2006). Mosby’s handbook of patient teaching. St. Louis: Mosby Inc.
Cohen, B. J., & Wood, D. L. (2000). Memmler’s the Human Body in Health and Disease (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Hunt, R. (2005). Introduction to community based nursing. Philadelphia: Lippincott Williams & Wilkins.
Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott Williams & Wilkins.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com