• SPOTS is an interactive program designed to introduce teenagers to the importance of sun
protection and its role in skin cancer
• SPOTS is an interactive program designed to introduce teenagers to the importance of sun
protection and its role in skin cancer
What is SPOTS?What is SPOTS?
•Medical Students (SLU & WU)
•Physicians/Nurses•Statisticians•School of Public Health
•Medical Students (SLU & WU)
•Physicians/Nurses•Statisticians•School of Public Health
Collaborative ProjectCollaborative Project
• 40 MD & 1 MPH students were trained
• 1939 secondary students were taught
• 6 middle schools/1 high school
• 40 MD & 1 MPH students were trained
• 1939 secondary students were taught
• 6 middle schools/1 high school
2006-2007 Synopsis2006-2007 Synopsis
Saint Louis University Hospital
Auxiliary
Grand Visions Grant
Whose Behind Us?Whose Behind Us?
•AACE Conference: J. of Cancer Education •Annual city-wide Dermatology Grand Rounds, WU •Surgical grand rounds, SLU•ACP state conference •Abstracts submitted to the AAD, AAS, and SSO •Presenting at National AAD conf in Feb 2008
•AACE Conference: J. of Cancer Education •Annual city-wide Dermatology Grand Rounds, WU •Surgical grand rounds, SLU•ACP state conference •Abstracts submitted to the AAD, AAS, and SSO •Presenting at National AAD conf in Feb 2008
Recognized in AcademiaRecognized in Academia
In the Publics’ Eye…In the Publics’ Eye…•The Record (WU newspaper) 01-25-07http://record.wustl.edu//news/page/normal/8542.html
•The Newsletter (SLU online news), 04-30-07, “Skin Cancer and Young People” http://www.slu.edu/x15217.xml
•St. Louis Post Dispatch, Health and Fitness Section, 05-14-07, “The Dark Side of the Sun.” News story and SPOTS video was online for entire summer at Post website.
• Melanoma is the 2nd most common cancer diagnosed in women aged 20-30
• Melanoma is the leading cause of cancer-related deaths in women aged 25-30 years in 2005
● Basal Cell skin cancer comprises 33% of all cancers
• Melanoma is the 2nd most common cancer diagnosed in women aged 20-30
• Melanoma is the leading cause of cancer-related deaths in women aged 25-30 years in 2005
● Basal Cell skin cancer comprises 33% of all cancers
Why Skin Cancer?Why Skin Cancer?
• Skin cancer statistics• Visual ID of skin cancers• Myths & Facts• Risk Factors• Preventative methods• Demonstration of sun protection methods
• Skin cancer statistics• Visual ID of skin cancers• Myths & Facts• Risk Factors• Preventative methods• Demonstration of sun protection methods
Information TaughtInformation Taught
DemonstrationDemonstration
• Program• Part 1: Early Detection• Part 2: Prevention
• Program• Part 1: Early Detection• Part 2: Prevention
Who We AreWho We Are
• Students in the health professions• Students interested in educating teens about sun protection
• Students in the health professions• Students interested in educating teens about sun protection
Part 1Part 1
Early DetectionEarly Detection
Start with a game to break the iceStart with a game to break the ice
or Fact?
or Fact?
MythMyth
Won’t a “healthy”
tan protect my skin?
Won’t a “healthy”
tan protect my skin?
A Tan: is your skin’s defensive reaction to radiation means that your skin has been damaged & is trying to protect itself with melanin is limited based on the color of your skin, hair and eyes (lighter = less protected)
MYTH!MYTH!
Getting a base tan will prevent a person from getting a sunburn
MYTH!MYTH!
A base tan is = SPF of 2for a skin type II
Lifetime Risk of Getting Melanoma
Lifetime Risk of Getting Melanoma
Over a 2000% increase-Increasing by 3-4% every year-
By 2010 projected to rise to 1/501
Over a 2000% increase-Increasing by 3-4% every year-
By 2010 projected to rise to 1/501
1935: 1/1500 people1960: 1/8001980: 1/2502002: 1/67
1935: 1/1500 people1960: 1/8001980: 1/2502002: 1/67
A shiny bump that is pearly in appearanceA shiny bump that is pearly in appearance
Basal Cell Skin Cancer Warning SignsBasal Cell Skin Cancer Warning Signs
**
** Purple ring is from a marking pen Purple ring is from a marking pen
Open sores that don’t heal within 3-4 wksOpen sores that don’t heal within 3-4 wks
Squamous Cell Skin Cancer Warning SignsSquamous Cell Skin Cancer Warning Signs
●Found on sun-exposed and non-sun-exposed areas●70% of skin cancer deaths
●Found on sun-exposed and non-sun-exposed areas●70% of skin cancer deaths
Melanoma Warning SignsMelanoma Warning Signs
●ABC method●Normal v Abnormal spot
●ABC method●Normal v Abnormal spot
AsymmetryAsymmetry
1/2 ≠ other ½ in size or shape1/2 ≠ other ½ in size or shape
Summer Youker, MD
NormalNormal AbnormalAbnormal
BorderBorderAbnormalAbnormalNormalNormal
edges are irregular, scalloped, not roundedges are irregular, scalloped, not round
ColorColorAbnormalAbnormal
NormalNormal
more than 1 color presence of blue, red, blue-black, white
more than 1 color presence of blue, red, blue-black, white
DiameterDiameter
NormalNormal AbnormalAbnormal
> size of pencil eraser (6mm)> size of pencil eraser (6mm)
Evolving/ElevationEvolving/ElevationDaniel Ring, MD
EvolvingEvolving
Elevation
Change, especially heightChange, especially height
All pictures are abnormal
#1 risk factor=change in an existing mole#1 risk factor=change in an existing mole
Change = itches, bleeds, crusts or changes size, shape or elevation
Change = itches, bleeds, crusts or changes size, shape or elevation
Estimated relative risk of >400% association in the development of melanomaEstimated relative risk of >400% association in the development of melanoma
Part 2Part 2
PreventionPrevention
Hands-on demosHands-on demos
●How to ID your skin type● How to choose and use a sunscreen● Tips for applying self-tanner● Problem with tanning beds● UVA/UVB radiation – what’s the big diff?● Other sun protective methods such as . . .
●How to ID your skin type● How to choose and use a sunscreen● Tips for applying self-tanner● Problem with tanning beds● UVA/UVB radiation – what’s the big diff?● Other sun protective methods such as . . .
UVA ▪Aging rays/skin cancer ▪penetrates deeper (dermis)/glass ▪more skin components can absorb UVA ▪no warning sign ▪20 X more reaches earth than UVB ▪tanning bed bulbs
UVA ▪Aging rays/skin cancer ▪penetrates deeper (dermis)/glass ▪more skin components can absorb UVA ▪no warning sign ▪20 X more reaches earth than UVB ▪tanning bed bulbsUVB
▪Burning rays/skin cancer ▪penetrates epidermis but not clouds, glass ▪warning sign = sunburn
UVB ▪Burning rays/skin cancer ▪penetrates epidermis but not clouds, glass ▪warning sign = sunburn
blocked by atmosphereblocked by atmosphere
The Ultraviolet SpectrumThe Ultraviolet Spectrum
10% sun’s rays
90% sun’s rays
▪ Bulbs are 93-98% UVA 2-12 X more UVA than summer noontime sun
▪ Face insert - emits more UVA than the bed
▪ Tanning indoors adds 30-300% more UVA to one’s annual solar exposure
▪ Higher level tanning beds emit more radiation in shorter time period
▪ Bulbs are 93-98% UVA 2-12 X more UVA than summer noontime sun
▪ Face insert - emits more UVA than the bed
▪ Tanning indoors adds 30-300% more UVA to one’s annual solar exposure
▪ Higher level tanning beds emit more radiation in shorter time period
NO Indoor TanningNO Indoor Tanning
Horizontal bedHorizontal bedVertical bedVertical bed
Inside tanning bedInside tanning bed
Skin Analyzer Machine (SAM)Skin Analyzer Machine (SAM)
Photos provided courtesy of David H. McDaniel, MD and with permission from the American Academy of Dermatology, all rights reserved.
Photos provided courtesy of David H. McDaniel, MD and with permission from the American Academy of Dermatology, all rights reserved.
• Volunteer in community• Communicate health risks and guide behaviors of teens • Build own knowledge base about skin cancer Med students are inconsistently taught to recognize skin cancers ▪ 23% had never observed a skin cancer exam [SCE] ▪ 27% had never been trained to perform an SCE ▪ 43% had never examined a patient for skin cancer ▪ 69% agreed there was insufficient emphasis placed on learning to
do an SCE in their medical training. ▪ This program takes advantage of the fact that teaching a subject is a profound learning experience and all drs, no matter their specialty, should be doing SCE’s as a part of their routine H&P.
• Volunteer in community• Communicate health risks and guide behaviors of teens • Build own knowledge base about skin cancer Med students are inconsistently taught to recognize skin cancers ▪ 23% had never observed a skin cancer exam [SCE] ▪ 27% had never been trained to perform an SCE ▪ 43% had never examined a patient for skin cancer ▪ 69% agreed there was insufficient emphasis placed on learning to
do an SCE in their medical training. ▪ This program takes advantage of the fact that teaching a subject is a profound learning experience and all drs, no matter their specialty, should be doing SCE’s as a part of their routine H&P.
.
Benefits to TeachersBenefits to Teachers
Moore M, Geller A, Zhang Z, et al. Skin cancer examination teaching in US medical education. Archives of Dermatology, Apr 2006; 142: 439 - 444.
• Session #1• Overview of skin cancer
• presented by a Dermatologist
• Teen behavior basics• presented by Adolescent Med MD orPhD in Public Health Professor
• Session #2• Run-through of SPOTS presentation
• presented by nurse educator
• Session #1• Overview of skin cancer
• presented by a Dermatologist
• Teen behavior basics• presented by Adolescent Med MD orPhD in Public Health Professor
• Session #2• Run-through of SPOTS presentation
• presented by nurse educator
.
Training sessionsTraining sessions
• PowerPoint Lecture• Lecture script• Training manual• Video
available online at
http://spots.wustl.edu
• PowerPoint Lecture• Lecture script• Training manual• Video
available online at
http://spots.wustl.edu
.
Ready to go…Ready to go…
CITI CertificationCITI CertificationThe CITI Program is a subscription service providing ethics education to all members of the research community. To participate fully, learners must be affiliated with a CITI participating organization.
1. Go to www.citiprogram.orgComplete biomedical if med student, social behavioral if public health student Due Dec 192. Email Steph copy of completion report sheet
Contacts
Fatima Ali - [email protected] Leonard - [email protected] Nelson - [email protected] Greenwood- [email protected]