Counselling Skin Lesion

Name of the station Skin lesion
Open question Please tell me more about your skin lesion

Closed question Where is the lesion ?
When did u first notice it ?
Did u notice in any change in shape?
Color change ?
Size change ?
Is it painful ?
Any itchiness?
Any bleeding?
Did it become crusty?
Any ulcer ?
Approximately how many moles do you have?

Have you ever been severely sunburnt, with blistering and pain afterwards?
How often do you use sunbeds?
Similar lesion in any other part of the body ?

Did u ever have any skin condition before ?
Do u have to do any outdoor work that may lead to exposure to sun ?
Red flags Any weightloss ?

Lumps and bumps in ur body ?
ICE So have u given any thoughts about what’s been going on

Do u any any particular concern regarding this lesion ?
Are u expecting anything particular from us regarding this lesion ?
Psychosocial What do you do for a living?

Who lives with u at home?
Is it affecting ur life in any way ?
MAFTOSA Any medical condition ?

Are u on any medication
Any recent travel history ?
Any family history of skin problem
Summary
Examination Examine the lesion
Examine other part of the body to look for similar lesion
Diagnosis
Investigation
Treatment We would like to refer you to a skin specialist. He will assess you and if needed order a biopsy test .
The specialist will examine your skin and may carry out a biopsy to confirm a diagnosis of skin
cancer.
A biopsy is a procedure where some of the affected skin is removed so it can be studied under a
microscope.
If the results come positive,

For non melanoma :
Surgical excision
Surgical excision is an operation to cut out the cancer along with surrounding healthy tissue to
ensure the cancer is completely removed.
Mohs micrographic surgery
Mohs micrographic surgery (MMS) is a specialist form of surgery used to treat non-melanoma skin
cancers when:
 it's felt there's a high risk of the cancer spreading or returning
 the cancer is in an area where it would be important to remove as little skin as possible,
such as the nose or close to the eyes
The treatment used will depend on the type, size and location of the non-melanoma skin cancer you
have.
Treatment for non-melanoma skin cancer is usually successful as, unlike most other types of cancer,
there's a considerably lower risk that the cancer will spread to other parts of the body.
Basal cell carcinoma doesn't usually spread to other parts of the body. There's a small risk (up to 5%)
of squamous cell carcinoma spreading to other parts of the body, usually the lymph nodes (small
glands found throughout your body).
However, for both BCC and SCC there can sometimes be considerable skin damage if the tumour
isn't treated.
At least 9 out of 10 (90%) non-melanoma skin cancer cases are successfully cured.
Cryotherapy
Cryotherapy uses cold treatment to destroy the cancer. It's sometimes used for non-melanoma skin
cancers in their early stages.
Liquid nitrogen is used to freeze the cancer, and this causes the area to scab over.
After about a month, the scab containing the cancer will fall off your skin. Cryotherapy may leave a
small white scar on your skin.
Radiotherapy
Radiotherapy involves using low doses of radiation to destroy the cancer. The level of radiation
involved is perfectly safe. However, your skin may feel sore for a few weeks after radiotherapy.
Radiotherapy is sometimes used to treat basal cell and squamous cell carcinomas if:
 surgery would be unsuitable
 the cancer covers a large area
 the area is difficult to operate on

For melanoma :
Surgery is the main treatment for melanoma.
If you have melanoma skin cancer you'll be cared for by a team of specialists that should include a
dermatologist, a plastic surgeon, an oncologist (a radiotherapy and chemotherapy specialist), a
pathologist and a specialist nurse.
When helping you decide on your treatment, the team will consider:
 the type of cancer you have
 the stage of your cancer (its size and how far it has spread)
 your general health
Help and support

Being diagnosed with melanoma can be difficult to deal with. You may feel shocked, upset, numb,
frightened, uncertain and confused. These types of feelings are natural.
You can ask your treatment team about anything you're unsure about.
Your family and friends can be a great source of support. Talking about your cancer and how you're
feeling can help both you and members of your family cope with the situation.
Some people prefer to talk to people outside their family. There are a number of UK-based charities
that have specially trained staff you can speak to on their free helplines:
 Cancer Research UK – 0808 800 4040 (Monday to Friday, 9am to 5pm)
 Macmillan – 0808 808 0000 (Monday to Friday, 9am to 8pm)
 Melanoma UK – 0808 171 2455 or you can use their online form
Cancer Research UK also has a section about living with melanoma.
Follow up
Follow-up
After your treatment, you'll have regular follow-up appointments to check whether:
 there's signs of the melanoma coming back
 the melanoma has spread to your lymph nodes or other areas of your body
 there's signs of any new primary melanomas
Your doctor or nurse will examine you, they'll ask about your general health and whether you have
any questions or concerns.
Safety netting New melanoma / BCC /SCC can occur . so need to maintain some precaution
You can protect yourself from sunburn by using high-factor sunscreen, dressing sensibly in the sun,
and limiting the amount of time you spend in the sun during the hottest part of the day.
Sunbeds and sunlamps should also be avoided.
Regularly checking your skin for signs of skin cancer can help lead to an early diagnosis and increase
your chances of successful treatment.
It's important to check your moles regularly for any changes.

Counselling Skin Lesion

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Counselling Skin Lesion

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Name of the station Skin lesion

Open question Please tell me more about your skin lesion

Approximately how many moles do you have?

Similar lesion in any other part of the body ?

Do u have to do any outdoor work that may lead to exposure to sun ?

Red flags Any weightloss ?

ICE So have u given any thoughts about what’s been going on

Psychosocial What do you do for a living?

MAFTOSA Any medical condition ?

Any recent travel history ?

Any family history of skin problem

If the results come positive,

Help and support

It's important to check your moles regularly for any changes.

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