Seth, a thirty-eight year-old white male of Scandinavian descent, has lived his entire life in SouthernFlorida. He is very concerned with maintaining a “healthy” appearance. Seth is very athletic and especiallyenjoys surfing. He has been surfing since the age of twelve and he started making surfboards while he was inhigh school. After obtaining a college degree in marketing Seth decided to start his own business makingsurfboards and giving surfing lessons for a local resort near his home. During a routine physical examinationthe physician assistant that Seth sees commented on the presence and appearance of a small growth(approximately 2-cm in diameter) above Seth’s right eyebrow. This growth was shiny with a pearly border, acentral ulcer and engorged surface blood vessels. The physician assistant was concerned that this might be atumor and asked Seth a number of questions to aid in the diagnosis. Seth reported that he noticed thisgrowth approximately six months ago but thought nothing about it since he often developed “pimples” whenhe was working on surfboards because of the heat and dust. Seth noticed that the growth would occasionallybleed, but he thought the bleeding most often occurred when he absently scratched above his eyebrows whenhe was working. Seth also reported that after bleeding the growth would “crust over” and appear to heal, butnot disappear. Seth also thinks the lesion has increased in size, but he can’t be certain.The physician assistant asks Seth to come back in two days to visit with the attending physician andencourages Seth to be sure to use sunscreen whenever possible, especially when he is surfing or teachingsurfing classes. Upon returning to see the physician, Seth is told that he probably has a basal cell carcinoma.This, the physician explains, is a cancer that while not benign, rarely metastasizes and grows very slowly.This type of cancer usually occurs in areas that have the greatest exposure to the sun (i.e. the face, head, andneck). While this cancer would probably not metastasize, the physician suggests surgical removal tominimize damage to any underlying tissues and a histological examination of the excised tissue to confirmthe diagnosis.Seth is concerned that if this is indeed cancer he will have to undergo radiation and/or chemotherapy andsuffer from both hair loss and nausea like his mother did when she was being treated for breast cancer 10years ago. The physician assures Seth that these treatments are not required for basal cell carcinoma andexplains that this cancer usually remains localized to the specific area of the skin and does not usually spreadto other tissues, so radiation and chemotherapy would not be necessary. Seth then asks why it is necessary toremove the tumor if it will not spread and is told that while the tumor does not spread to other body areas itwill continue to grow and also invade deeper layers of the skin, such as the dermis, and destroy normaltissues. Seth agrees to the procedure and schedules a follow-up appointment to discuss the results of thebiopsy the following week. At the follow-up appointment, Seth is told that the lesion was indeed a basal cellcarcinoma. He is told that it will be important for him to try to use both sunscreens, specifically thosecontaining para-aminobenzoic acid or PABA, and protective clothing as much as possible to minimize theeffects of the ultraviolet (UV) rays of the sunlight. Seth is also told that while he should not be overlyconcerned, he should also pay close attention for similar lesions in the future, since a person with a singlebasal cell carcinoma is likely to develop additional basal cell carcinomas in the future.http://emedicine.com/derm/topic47.htmhttp://www.skincancer.orgThe Case of the Aging Surfer:1) Define the bold terms in the text. 2) How are benign and malignant tumors similar and different from each other?3) Identify and briefly describe the three most common types of skin cancer and the risk to individuals whohave developed each of them.
4) What are oncogenes and how are they believed to be related to cancer?.
5) Identify both the primary risk factors that Seth presents with and other risk factors that may or may notrelate to Seth’s case.
6) The procedure that Seth experiences is called the Mohs Surgery. What does it involve?
7) How do chemotherapy and radiation therapy act as treatments for cancer?
8) Explain why tanning booths are actually more dangerous than sunlight exposure in increasing the risk ofdeveloping some form of skin cancer.
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