Mitigating melanoma

Early detection and intervention is key for higher survival rates. Late identification and recognition of melanoma lead to worsening health outcomes. Nursing patient education requires that nurses understand skin cancer risks, detection, and prevention. Nurses are in key positions to provide the education patients need to self-detect potential skin cancer and take preventive steps.

Skin cancer risk factors

According to the American Cancer Society, patient factors that influence the risk for skin cancer, including melanoma, are UV radiation exposure from natural (excessive sun exposure) and artificial (tanning bed) sources, personal history of blistering sunburns, family or personal history of skin cancer, genetic predisposition, and other hereditary factors including light skin and red or blonde hair.

Skin cancer signs

The most common sign of skin cancer is change, including changes to a current nevus, a skin lesion that’s bleeding, ulcerated, or won’t heal; a satellite mole; a new skin lesion that stands out on inspection of the skin; or a growth that meets the ABCDE mnemonic criteria, which describes clinical signs of melanoma: Asymmetry, Border irregularity, Color variation, Diameter, and Evolving.

The mnemonic can be combined with the ugly duckling sign, which refers to a spot that’s different from other cutaneous lesions and should prompt suspicion of melanoma. Nurses can use these indicators to improve early melanoma detection and teach them to patients to increase awareness and identification of potential melanomas. Nurses also need to know the difference between nevi and the various subtypes of melanoma.

Nursing implications

Nurses play a key role in preventing and detecting melanoma and other types of skin cancer, as well as in caring for patients who’ve been diagnosed with the condition.

Counseling patients can help them understand the steps they can take to keep themselves safe and increase adherence to skin cancer prevention practices. The education you provide about sun protection and skin self-exams can help reduce a patient’s risk of skin cancer and increases the chances of early detection.

Protection for prevention

Skin protection measures can help reduce the risk of skin cancer, including melanoma. Advise patients to take these precautions to reduce their exposure to ultraviolet radiation when outdoors.

• Avoid sun exposure at peak times (10 am to 4 pm).
• Decrease the amount of time spent in the sun.
• Seek shade while outdoors.
• Wear sunscreen (at least 30 SPF).
• Reapply sunscreen every 2 hours with heavy sweating or swimming.
• Wear protective clothing, including hat, sunglasses, long sleeve shirts, and pants.
• Avoid tanning beds.

Epidemiologic data suggest that using sun protection and reducing sun exposure have the greatest impact on reducing the incidence of melanoma.

Skin self-exam

Advise patients to perform monthly skin self-exams, especially if they’re at risk for skin cancer (for example, if they have a compromised immune system, family history of skin cancer, excessive tanning, or repeated sunburns). All they need is a well-lit room and a mirror.

Because skin cancer comes in many shapes and sizes, patients should learn to recognize skin changes and new spots and to contact their provider about any concerns. Instruct patients in skin self-exam best practices, and explain that examining their skin regularly will help in early cancer identification.

The best time to perform a skin self-exam is after a bath or shower. Check for moles, blemishes, or birthmarks from the top of the head to the toes.

Step 1: Do the following while standing and facing a mirror.

• Check face, ears, neck, chest, and belly (women should lift their breasts to check underneath).
• Check underarm areas, both sides of the arms, tops and palms of hands, in between fingers, and under fingernails.

Step 2: Do the following while sitting down.

• Check the front of thighs, shins, tops of feet, in between toes, and under toenails.
• Use a hand mirror to look at the bottoms of the feet, calves, and backs of thighs (first checking one leg and then the other).
• Use a hand mirror to check buttocks, genital area, lower and upper back, and the back of neck and ears (it may be easier to look at the back in a wall mirror using a hand mirror).
• Use a comb or hair dryer to part hair and check the scalp.

 

Slovníček

health outcomes – výsledky v oblasti zdraví
UV radiation exposure – expozice UV záření
excessive – nadměrný
tanning bed – solárium
blistering – doprovázený puchýři
nevus – névus, znaménko
mole – znaménko
to stand out – vyniknout
cutaneous – kožní
awareness –povědomí o něčem
counseling – poradenství
precautions – bezpečnostní opatření
to seek – hledat, vyhledávat
well-lit – dobře osvětlený
blemishes – vady, skvrny
palm – dlaň
thigh – stehno
shin – holeň
buttocks – hýždě

Source: Boozer K. Mitigating melanoma. American Nurse Journal, 2021. [online]. Available from: https://www.myamericannurse.com/mitigating-melanoma/. Shorted.

 

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