Hook: Imagine you are in the sun on a hot sunny day. Feel the Burn? It is Called Skin Cancer.

Hello everyone, I am Mona Noormohammadi and I will be talking about my ISM experience as
well as my mentorship experience. My mentor is Dr. Cole at UTMB under plastic surgery.
To begin, I will show my portfolio. It is online, so anyone is welcome to look at it. If
anyone would like to visit this site, it will be on the second on your handout that you all have in
front of you. On my site you will be able to see my product and purpose paper, journal entries,
my interview assignment, my resume, midterm presentation items, my finial presentation items,
and lastly my invitation to my senior expo. Some of the information in this presentation comes
from outside sources and will be cited appropriately. Anyhow, my ISM experience started in
2018 of fall semester. I have learned so many skills from interviews to even my plan for the
future. In spring of 2018, I started off in Trauma surgery. I did enjoy this field, seeing
gallbladder surgeries and hernia repairs. However, I wanted to see something different. I wanted
to stay in surgery because I did always find this interesting. Surgery is hands on and this is how I
learn. Being able to work with my hands and with a team of other people is more convenient to
my learning abilities. I chose plastics eventually because it was originally my dream career.
When I in around middle school, I found this career interesting because of the cosmetic work.
Surgeons being able to alter people’s appearance and making them more confident about
themselves is fascinating. When we are born, we get our appearance from our parents and having
a surgeon being able to change this is why I wanted to go into this part of surgery.
Before meeting my mentor, I was worried I would not find a plastic surgeon. I was
contacting all the plastic surgeons in my area and no one was offering a program for surgeon or
taking in interns at the moment. Fortunately, I was volunteering at UTMB in Galveston and cross
paths with Doctor Cole. I am so glad he was my mentor because he showed me what plastic
surgery was really about. What I didn’t know was their being many elderly people parts of
plastics. Many elderly people have skin cancer and they do reconstruction on their noses and
varies parts of their face. If the surgeon has to reconstruct a nose or ear they can get cartilage
from the ribs and mold it to make the ear or nose. Speaking of nose jobs, when thinking of
plastic surgery, I thought of cosmetic work and I did not see much cosmetic work. I saw more
reconstruction than I thought. For example, if it was reconstructive surgery, it had to do with a
broken nose from an accident to skin cancers eating away the skin and cartilage. When seeing
babies in plastic surgery was shocking. Kids who were born without an ear or babies born with
multiple fingers was fascinating to see. My mentor said children have to be a certain age for the
surgery because anesthesia does not want to risk it with the babies. I even saw with the younger
babies have to have their head shaped because of deformities. Babies skulls not formed yet and
when they favor leaving on a side of their head the bone will grow flat on that side and the brain
will continue to grow but not as perfect as it should be.
What did I learn during my research? I learned that my mentor is determined to help
anyone get the surgery they need. I remember this man who had a tumor that was starting off on
the side of his face and then leading to his eye. My mentor was so determined to get his surgery
as soon as possible however the man had Medicaid and the insurance company was not
approving his biopsy needed for his surgery. The team at UTMB tried the best they could to get
his approval for surgery however it took another month and his cancer spread to his eye. Even
though he had lost his eye he is now able to live a healthier life. I also learned about patient care
being as important. My mentor makes sure that patients have all their question answered. He
treats his patient very nicely and wants the good for everyone. One last thing I learned was that
doctors may or may not know what a bump is. For example, a minor was having a in clinic
producer and my mentor did not know what exactly the bump was. After removing the bump
which I believe was a tumor he sent it off in lab to see what it was.
What I learned from this mentorship is that plastic surgery is so diverse. Plastic surgery
does not only one specialty, but it has many. Plastic surgery is done head to toe and from
newborns to the very elders. It has soft tissue as well as bony work – and there can involve a
mixture of reconstructive and cosmetic work. According to my mentor, this is why he wanted to
be in this field. Also seeing Doctor Cole do this job, it is truly about the people and not the
money. Seeing how my mentor is so motivated to help people. Seeing how he fights with the
insurance companies and seeing how he tries to help people without insurance means he truly
cares about his patients. However, challenges were meeting and terminology. Trying to meet
with my mentor was hard at time. Having school and other assignments to do while having this
mentorship can be difficult at times. Also seeing surgeries was very difficult when my mentors
and I’s schedule do not line up. For example, I only saw one surgery which I am grateful for
seeing however I wish I had the chance of seeing more. Terminology was difficult because
Having my mentor have residents and medical students, they usually have conversations while I
listen. When having these conversations, they use terms that I am not familiar with. I resolved
this issue by managing my time with a planner and talking to him about which days I am able to
meet with him. With the terminology issue I wrote them down and looked them up later or just
asked my mentor when he had time.
So, what is my product? It is 3 informational packets and a 3D model about basal cell
carcinoma, squamous cell carcinoma, and malignant melanoma.

Basal Cell Carcinoma:

What is Basal Cell Carcinoma?
Basal cell carcinoma is one of the top skin cancers. This type of cancer is a nonmelanoma skin
cancer which means it forms in the lower part of the epidermis. This is on the outer layer of the
skin (National Cancer Institute). Basal cell carcinoma starts off in basal cells, which is a skin cell
that produces new ones as old ones die off. It often shows up as a transparent bump on the skin.
It shows up in areas where the skin is exposed to sunlight like the face.

What are the symptoms?

This cancer occurs because of sun exposer. The parts of your body that are exposed which are
most likely to be your head and your neck have a high risk of getting Basel cell carcinoma. The
legs and other parts of the body have a lower chance of getting. It the beginning stages it shows
as a change on the skin by a type of growth or sore.
White, skin color or pink bump: This bump is able to be seen through a bit. The little
blood vessels are visible. People with darker skin tone, it may be a bit harder to see though the
surface. These dumps are most likely to appear on the anywhere on the face, neck, or ears. The
wound may pop and scab.
A brown, black or blue wound: This wound may have dark spots with a bump and see
through border around the area.
A flat, scabby, reddish area: The ended are bumpier and overtime it can worsen in size. It
is common it has it on the back or chest of the body.
 A white, waxy, scar-like wound: There is no actual border to the area. It is morpheaform
basal cell carcinoma. It is the least common out of all of the four appearances. It is easily
overlooked but it may be a sign of a cancer or even invasion of some sort.

*See a doctor if you see any of these appearances on your skin

What are the causes?

This skin cancer occurs because of one of skin basal cells develops a mutation. Basel cells are
found on the bottom of the epidermis which is the outer most layer of the skin. Basel cells make
the new skin cells and as the produce new skin, they push the old skin cells towards the surface
where they can fall off eventually. This process is controlled by the DNA of the basal cells. The
mutation causes DNA of the basal cell to grow rapidly and keep growing when it was usually it
should die off. The accumulation of the many basal cells turn into a cancerous tumor and the
dump appears on the skin.
Ultraviolet light and other causes: The mutation is caused by ultraviolet radiation which
is found from the sun, tanning booths, or even tanning lamps. Other reasons have an impact on
the reason why the mutation occurs however they still haven’t been discovered.

What are some risk factors?

Sun exposure: Chronic time spent in the sun or in tanning booths increases the chances of
getting this basal cell carcinoma. Living in an area where it is sunny most of the time will also
increase the chance. Having severe sunburn especially when you’re a child will raise the risk.
Radiation therapy: If a person has radiation therapy for psoriasis, acne, or other skin
conditions it may increase the chance.
Fair skin: People with freckles, easily burn, have light colored eyes, red, or blond hair
have a higher chance.
Gender: Men are most likely to get this cancer rather than women.
Age: After the age of 50 this cancer is most likely to develop.
Family history: This cancer is most likely to occur more than once. Also, if family history
shows skin cancers there is a high chance of developing this cancer.
Immune-suppressing drugs: Medications that slow down your immune system increase
the rise of cancer especially when having a transplant surgery. This will allow the cancer to
spread to other parts of the body.
Exposure to arsenic: Arsenic is a toxic metal that found in the environment. It is found in
the environment, so we are all exposed to it to some extent but if you are a farmer or work near
this metal then it is dangerous for the cancer.
Inherited syndromes: Race genetic diseases often lead to basal cell carcinoma. Nevoid
basal cell carcinoma syndrome makes multiple basal cell carcinomas and well as problems in the
bone, skin, nervous system, eyes, and endocrine glands. Xeroderma pigmentosum has sensitivity
to the sun and risk of skin cancer. People with this condition have basically cannot do anything
to repair damage to the skin from ultraviolet light.

What are complications?

Recurrence: It is common for basal cell carcinoma to recur, often in the same spot.
Increase chance of other types of cancers: History of basal cell carcinoma lead to cancers
like squamous cell carcinoma.
 Cancer that spreads: Rare cases of basal cell carcinoma may destroy muscle, nerves, and
even bone. This can spread to other parts of the body.

What are some preventions?

Avoid sunlight: When the sun rays are at its highest, it must be avoided. Even during
winter, the hours of 10am to 4pm should be avoided.
Use sunscreen: A sunscreen of at least 15 SPF, blocks both UVA and UVB types of
radiation from the sun should be good. You should reapply the sunscreen every two hours or
even more often.
Wearing protective clothing: Sunscreen doesn’t provide full coverage from UV rays, so
clothing is the best way of covering up. Wearing sunglasses also help to provide full protection.
Avoid tanning beds: The UV rays is the reason why this cancer occurs, and tanning beds
are full of these rays. The best thing is to avoid them.
Familiarity with your skin: Seeing changes with your skin is important when having the
symptoms of basal cell carcinoma. Knowing what is normal and what is not is helpful.

What is the treatment?

First dermatologists ask a series of questions then they do a skin exam. The treatment is:
Electrodesiccation and curettage: ED&C is used to remove smaller basal cell carcinomas.
Surgeons remove the surface of the cancer with a blade and then control the bleeding with
electric needle.
Surgical excision: The doctor cuts out the cancerous lesion and a bit of the healthy skin
surrounding it. They look at it under the microscope to make sure the cancer is all taken out.
Freezing: This kills the cancerous cells by freezing them with liquid nitrogen
(cryosurgery). It is good for cancer that are on the surface. It has to be done in multiple cessions
so there is no nerve damage.
Mohs surgery: The doctor removes the cancer cells layer by layer, examining each layer
under the microscope until the cancer is gone. This is usually the most effective for cancers that
are on the face and that are deep.
Creams: Basal cell carcinoma that is on the surface can be treated with imiquimod and
fluorouracil.
Medications: Basal cell carcinoma that advanced to other parts of the body may need
vismodegib or sonidegib. These block the signals from making anymore basal cell carcinoma.

Squamous Cell Carcinoma:

What is Squamous Cell Carcinoma?

It is a common skin cancer that develops in the middle and outer layer of the skin. Usually not
life threatening but may be in some cases. It may grow when not treated and cause other
complications. Usually caused by the skin being in prolonged exposure to ultraviolet (UV)
radiation, from sunlight, from tanning beds, or tanning lamps. Avoiding this radiation helps
avoid this cancer. It is found anywhere on the body and can be dangerous as time grows.

What are the symptoms?

The symptoms are most often form sun exposed skin such as your face, hands, ears, and/ or lips.
However, this cancer can occur anywhere on the body. The signs are:
 Firm, red bump
A flat sore that is scabby
A sore or bump on or under a scar
Scabby patch on the lip that can be later an open sore
A red sore inside the mouth
A red patch in anus or genitals

*If the sore or scab did not heal in 2 month you should see a doctor

What are the causes?

Squamous cell carcinoma occurs when squamous cell develops a mutation. In a regular
squamous cell, new cells will push old cells to the surface and the old will die off. DNA errors
will cause the cells to grow out of control and cause squamous cell carcinoma.
Ultraviolet light and other causes: The mutation is caused by ultraviolet radiation which
is found from the sun, tanning booths, or even tanning lamps. Other reasons have an impact on
the reason why the mutation occurs however they still haven’t been discovered. There is other
reason why this cancer occurs like being exposed to toxic substances or a weakend immune
system.

What are some risk factors?

Sun exposure: Chronic time spent in the sun or in tanning booths increases the chances of
getting this squamous cell carcinoma. Living in an area where it is sunny most of the time will
also increase the chance. Having severe sunburn especially when you’re a child will raise the
risk. If you do not cover your skin with clothing or sunblock it will lead to a higher chance.
Using tanning beds: These beds have a lot of ultraviolet radiation which will lead to
squamous cell carcinoma.
Fair skin: People with freckles, easily burn, have light colored eyes, red, or blond hair
have a higher chance.
A history of precancerous skin lesions: Having actinic keratosis or Bowen's disease for
example will cause squamous cell carcinoma.
Family history: This cancer is most likely to occur more than once. Also, if family history
shows skin cancers there is a high chance of developing this cancer.
Personal history: Having squamous cell carcinoma once will cause the chances of
recurring to occur.
Weakened immune system: Weakened immune systems, leukemia, lymphoma, take
medication that slow down the immune system or even have had a transplant have a risk of
getting squamous cell carcinoma.
Rare genetic disorder: Xeroderma pigmentosum caused extreme sensitivity to sunlight
and increase the chance of getting cancers.

What are some preventions?

Avoid sunlight: When the sun rays are at its highest, it must be avoided. Even during
winter, the hours of 10am to 4pm should be avoided.
Use sunscreen: A sunscreen of at least 15 SPF, blocks both UVA and UVB types of
radiation from the sun should be good. You should reapply the sunscreen every two hours or
even more often.
 Wearing protective clothing: Sunscreen doesn’t provide full coverage from UV rays, so
clothing is the best way of covering up. Wearing sunglasses also help to provide full protection.
Avoid tanning beds: The UV rays is the reason why this cancer occurs, and tanning beds
are full of these rays. The best thing is to avoid them.
Familiarity with your skin: Seeing changes with your skin is important when having the
symptoms of basal cell carcinoma. Knowing what is normal and what is not is helpful.

What is the treatment?

First dermatologists ask a series of questions then they do a skin exam. The treatment is:
Electrodesiccation and curettage: ED&C is used to remove smaller squamous cell
carcinomas. Surgeons remove the surface of the cancer with a blade and then control the
bleeding with electric needle.
Curettage and cryotherapy: Similar to ED&C after the tumor removed, the base and
edges are treated with liquid nitrogen.
Laser therapy: A beam of light stops the growth and with some damage but have a risk of
bleeding, swelling, or scaring.
Surgical excision: The doctor cuts out the cancerous lesion and a bit of the healthy skin
surrounding it. They look at it under the microscope to make sure the cancer is all taken out.
Radiation therapy: Using high beams to kill cancer cells. May be an option for deep
tumors and people would cannot go under surgery.
Freezing: This kills the cancerous cells by freezing them with liquid nitrogen
(cryosurgery). It is good for cancer that are on the surface. It has to be done in multiple cessions
so there is no nerve damage.
Mohs surgery: The doctor removes the cancer cells layer by layer, examining each layer
under the microscope until the cancer is gone. This is usually the most effective for cancers that
are on the face and that are deep.
Creams: Squamous cell carcinoma that is on the surface can be treated with imiquimod
and fluorouracil.
Medications: Squamous cell carcinoma that advanced to other parts of the body may need
vismodegib or sonidegib. These block the signals from making anymore basal cell carcinoma
(Squamous cell carcinoma of the skin).

Malignant Melanoma:
What is Malignant Melanoma?
This cancer is serious, and it affects the part where the cells produces melanin. Melanin is the
pigment that gives your skin color. Ultraviolent radiation increases the chances of getting
melanoma. The reason why is unknown. Limiting sunlight helps prevent melanoma. It is
increasing in people under 40 and in women. Knowing in the begging stages of melanoma is
most likely curable.

What are the symptoms?

Melanomas can occur anywhere on the body. They are most likely to occur anywhere where
there is a lot of sun exposer like legs, face, and back. Melanomas can also occur on the soles of
your feet even though it doesn’t get sun exposer. Common signs are:
Change in a mole
New pigment growth
Normal moles usually look tan, brown, or black with a border around the normal skin. Usual an
oval and ¼ inch. Many moles develop by the age of 50 and existing moles many change in color.
Unusual moles usual helps when thinking of ABCDE
Asymmetrical shape: moles with irregular shape
Border: moles with irregular borders like notched or scalloped
Change in color: Uneven color
Diameter: New growth larger than ¼ inch
Evolving: looking for changes such as inching and or bleeding
Hidden melanomas: Parts of your body that do not get much sun exposer are like toes, feet, and
genitals. Hidden areas include:
Under the nail: Acral-lentiginous melanoma is a rare. Found on palms of hands or soles
of the feet. More common in darker skin tones.
In mouth, digestive tract, urinary tract or vagina: Mucosal melanoma occurs in the
mucous membrane. This lines the nose, mouth, esophagus, anus, urinary tract and vagina.
In the eye: Eye melanoma may cause vision changes and can be caught during an eye
exam.

*See a doctor if you see changes in the skin

What are the causes?

Occurs when something goes wrong in melanin-producing cells. Skin cell that produces new
ones as old ones die off. When mutations occur it often shows up as a bump on the skin because
of the cancerous cells.
Ultraviolet light and other causes: The mutation is caused by ultraviolet radiation which
is found from the sun, tanning booths, or even tanning lamps. Other reasons have an impact on
the reason why the mutation occurs however they still haven’t been discovered.

What are some risk factors?

Sun exposure: Chronic time spent in the sun or in tanning booths increases the chances of
getting this melanoma. Living in an area where it is sunny most of the time will also increase the
chance. Having severe sunburn especially when you’re a child will raise the risk. If you do not
cover your skin with clothing or sunblock it will lead to a higher chance.
Using tanning beds: These beds have a lot of ultraviolet radiation which will lead to
squamous cell carcinoma.
Fair skin: People with freckles, easily burn, have light colored eyes, red, or blond hair
have a higher chance.
A history of precancerous skin lesions: Having actinic keratosis or Bowen's disease for
example will cause squamous cell carcinoma.
Family history: If family history shows skin cancers there is a high chance of developing
this cancer.
Having many moles or unusual moles: Having more than 50 normal moles increase
melanoma risk. It may be hard to know changes due to this.
 Weakened immune system: Weakened immune systems, leukemia, lymphoma, take
medication that slow down the immune system or even have had a transplant have a risk of
getting melanoma.
Rare genetic disorder: Xeroderma pigmentosum caused extreme sensitivity to sunlight
and increase the chance of getting cancers.

What are some preventions?

Avoid sunlight: When the sun rays are at its highest, it must be avoided. Even during
winter, the hours of 10am to 4pm should be avoided.
Use sunscreen: A sunscreen of at least 15 SPF, blocks both UVA and UVB types of
radiation from the sun should be good. You should reapply the sunscreen every two hours or
even more often.
Wearing protective clothing: Sunscreen doesn’t provide full coverage from UV rays, so
clothing is the best way of covering up. Wearing sunglasses also help to provide full protection.
Avoid tanning beds: The UV rays is the reason why this cancer occurs, and tanning beds
are full of these rays. The best thing is to avoid them.
Familiarity with your skin: Seeing changes with your skin is important when having the
symptoms of basal cell carcinoma. Knowing what is normal and what is not is helpful.

What is the treatment?

First dermatologists ask a series of questions then they do a skin exam. The treatment is:
Chemotherapy: Uses drugs to destroy cancer cells. It can also be given in a vein in your
arm or leg called isolated limb perfusion.
Surgical excision: The doctor cuts out the cancerous lesion and a bit of the healthy skin
surrounding it. They look at it under the microscope to make sure the cancer is all taken out.
Radiation therapy: Using high beams to kill cancer cells. May be an option for deep
tumors and people would cannot go under surgery.
Biological therapy: Boots to fight cancer by using the immune system. Side effects may
be flu, chills, fever, and muscle aches.
Targeted therapy: Uses mediations designed to target cancers. Side effects may be fever,
chills, dehydration, and skim problems.

Here are pictures of each type of cancer.

Here is a picture of each type pf cancer side by side

Here are my citations

And that concludes my presentation. I would like to thank Mrs. Kahlich and Doctor Cole
for this opportunity, teaching me about my future career, and both being so kind to me. Also
Mrs. Breish thank you for being here and I appreciate your help for getting my badge being
approved so I can work with Doctor Cole.

*HANDS GIFT*