Home' Australian Pharmacist : Australian Pharmacist July 2015 Contents Australian Pharmacist July 2015 I ©Pharmaceutical Society of Australia Ltd.
CONTINUING PROFESSIONAL DEVELOPMENT
COUNSELLING IN PRACTICE
1. What is the most common type of
b) Squamous cell carcinoma.
c) Basal cell carcinoma.
d) Actinic keratosis.
2. Approximately what proportion of
skin cancers in Australia are caused
by exposure to ultraviolet radiation?
a) Accounts for about 25% of skin cancers
b) Is more likely to develop with
intermittent exposure to high-intensity
sunlight than chronic sunlight exposure.
c) Is nearly always fatal.
d) Can be treated with vismodegib.
4. Squamous cell carcinoma:
a) Often develops from solar keratoses.
b) Is the least dangerous type of skin cancer.
c) Commonly begins as a small, shiny,
pink lump that gradually enlarges over
months or years.
d) Can be treated with topical imiquimod.
5. Which of the following counselling
points regarding application of
sunscreens is CORRECT?
a) The sunscreen should be applied
immediately before going out in the
b) About 35 mL of sunscreen should be
used for a full-body application on an
c) The sunscreen should be re-applied
every 4 hours and after swimming.
d) Sunscreen should never be used on
babies under 6 months of age.
(or higher) sunscreen should be applied
20 minutes before going out in the
sun. The sunscreen should be applied
liberally – e.g. for an average-sized adult,
at least half a teaspoon of sunscreen
(about 3 mL) on each arm and the
face/neck (including the ears), and just
over one teaspoon (6 mL) on each leg,
the front of the body and the back of the
body. Approximately 35 mL of sunscreen
should be used for one full-body
application. The sunscreen should
be re-applied every 2 hours and after
swimming or excessive sweating.
The randomised controlled Nambour
skin cancer prevention trial showed that
regular use of sunscreen can prevent
the development of skin cancers.21
Regular application of sunscreen
produced a significant reduction in
the number of precancerous actinic
keratoses and SCCs after five and
eight years. After 10 years, there was a
significant reduction in the number of
new melanomas. BCCs decreased, but
not to a statistically significant extent –
possibly because they generally result
from damage caused early in life, and
the study only included adults.
Babies’ skin is especially susceptible
to the sun’s damaging effects, and
sun protection strategies should be
rigorously applied. Physical protection
measures such as shade, clothing and
broad-brimmed hats are the preferred
strategies for babies. Sunscreen can
be applied to small areas of exposed
skin,6,22 but the widespread regular use of
sunscreens on babies <6 months of age is
not recommended.23 The sunscreen should
first be tested on a small area of the baby’s
skin to check for any reaction.22
Where can I find more
The following websites have useful skin
cancer information for consumers:
• Cancer Council Australia
• Sun Smart – www.sunsmart.com.au
• Skin Cancer Foundation
• Cancer Research UK
Advice for Joan
Because Joan’s sister has developed skin
cancer, Joan also has an increased risk
of developing it. Her physical attributes
(e.g. skin, hair and eye colour) will also
influence her likelihood of developing
skin cancer. However, the greatest factor
affecting her risk of skin cancer is her
history of sunburn and exposure to UV
radiation. The best strategy that Joan can
employ to reduce her risk of skin cancer
is to avoid solariums and protect her skin
from the sun. She can do this by seeking
shade when she is outdoors, wearing
protective clothing, and applying
sunscreen regularly to exposed skin areas.
If Joan does develop skin cancer, her
best chance of a cure is early diagnosis
and treatment. She should therefore try
and get into the habit of examining her
skin each month to detect any new or
changing moles or lumps. In addition
to telling Joan about the different types
of skin cancer, you can provide her with
details of websites where she can find
• Australia has one of the highest rates of
skin cancer in the world – two in every
three Australians will be diagnosed with
skin cancer by the time they are 70.
• By far the greatest risk factor for skin
cancer is exposure to UV radiation from
the sun (or solariums).
• The most effective way to prevent skin
cancer is to protect the skin against
• The earlier skin cancer is diagnosed and
treated, the greater the likelihood that it
can be cured.
• Early diagnosis can best be achieved
by regularly examining the skin (e.g. on
a monthly basis) to detect any new or
References located on page 76.
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