• 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 - alikf@slu.eduKate Leonard - leonardk@slu.eduChad Nelson - cnelso17@slu.eduTaylor Greenwood- tgreenwo@slu.edu