Med-Surg Immune System, part 12: Integumentary and Hematologic Cancers

by Cathy Parkes October 09, 2020

In this video

Skin cancers (integumentary system)

  • Prevention
  • Three types of skin cancer
    • Basal cell carcinoma
    • Squamous cell carcinoma
    • Melanoma
  • ABCDE assessment to check for melanoma
  • Treatment

Blood cancers (hematologic)

  • Leukemia
  • Lymphoma (Hodgkin's vs. Non-Hodgkin's)
  • Multiple Myeloma
  • Treatment
  • Patient teaching

Full transcript

Hi, I'm Cathy and in this video, I'm going to talk about cancers of the integumentary system, so that's the skin, as well as cancers associated with the hematologic system, or the blood. If you're following along with cards, I'm card number 27.

We're first going to talk about skin cancer and let's touch a bit on prevention. So you need to teach your patient to avoid midday sun. They should wear sunscreen and protective clothing and perform regular skin checks. They should also see a dermatologist about once a year to get a comprehensive skin check from a professional.

There are three main types of skin cancer that I'm going to talk about here in this video. Those include basal cell carcinoma, squamous cell carcinoma, and melanoma. So I'm going to bring up photos of each of these types of cancers so you can get a good feeling for what they look like.

This is an example of basal cell carcinoma which originates in the basal layer of the epidermis. It's the most common type of skin cancer, and you can see it kind of presents as a waxy type nodule with pearly borders. All right.

This is an example of squamous cell carcinoma. So this type of skin cancer originates in the upper layer of the epidermis and it presents as an oozing, crusting type of lesion.

Here's an example of melanoma, which this type of cancer arises out of the melanocytes, which are the melanin-producing cells in the epidermis. This is the most deadly form of skin cancer. And it is highly metastatic, meaning it will spread to other areas of the body very rapidly. So when you see a lesion like this that is highly irregular with color changes throughout the lesion, then that is definitely a red flag and indicative of possible melanoma.

Alright. Let's talk now about our ABCDE assessment of a patient's lesion or mole to check for melanoma.

A stands for asymmetry. So if the mole or lesion is asymmetric, that is concerning.

B stands for border. If the mole has irregular borders, then that is also suspect.

C stands for color. So if pigmentation kind of varies across the mole or lesion, that is also suspicious.

D stands for diameter. So if the mole is big like over 6 millimeters, which is the width of a pencil eraser, then it should definitely be checked out by a dermatologist.

And then E stands for evolving. So if the mole has changed in appearance over time, or there's new bleeding, then it should also be checked out by a dermatologist.

In terms of treatment of skin cancer, we can do an excision. So it's surgical removal of the skin cancer.

We can do topical chemotherapy. So this medication is called 5-fluorouracil.

Or we can do something called Mohs surgery. This is where they go in and take kind of a layer off at a time and send it to the laboratory. And when they're sure they've gotten all the cancer, then the surgery can be completed.

And then cryosurgery is also an option. This is basically freezing the lesion off.

Alright. Let's now turn our attention to hematologic cancers. I'm going to touch on leukemia, lymphoma, and multiple myeloma.

With leukemia, we have cancer of the bone marrow, which causes overgrowth of cancerous white blood cells. And this, in turn, prevents the growth of red blood cells, of platelets, and of normal white blood cells.

Then we have lymphoma. This is where we have a solid tumor in the lymphoid tissue. So it may be in a lymph node or in the spleen, and it causes the overgrowth of lymphocytes.

There are two types of lymphoma. We have Hodgkin's and non-Hodgkin's.

With Hodgkin's, we have the presence of Reed-Sternberg cells, which are these really large cells with more than one nucleus.

With non-Hodgkin's lymphoma, there are no Reed-Sternberg cells.

Then we have multiple myeloma. This is a cancer that causes the overgrowth of plasma cells in the bone marrow. And this in turn results in excess secretion of cytokines as well as antibodies. And this prevents the growth of red blood cells, platelets, and normal white blood cells.

So in terms of treatment options for hematologic cancers, we can use chemotherapy, radiation, targeted therapy, as well as a stem cell transplant.

As a nurse, it's going to be important to remember that when any of these blood cancers, the patient's going to be at risk for anemia, neutropenia, and thrombocytopenia because these blood cancers inhibit the growth of normal red blood cells, normal platelets, and normal white blood cells.

So you're definitely going to want to implement precautions and do some patient teaching because of these risk factors. And I did go over that teaching in my previous video. So if you haven't watched that then definitely go back and watch that so you know those important nursing care items and important teaching that you need to provide to keep your patients safe. So that's it for this video. I will pick it up with more cancers in my next video. Thank you so much for watching.

[BLOOPER:] Cancers of the blood...Psh...I don't know what I'm saying?? Sorry!


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