Treating Squamous Cell Carcinoma Of The Skin
Treatment options for squamous cell skin cancer depend on the risk of the cancer coming back, which is based on factors like the size and location of the tumor and how the cancer cells look under a microscope, as well as if a person has a weakened immune system.
Most squamous cell skin cancers are found and treated at an early stage, when they can be removed or destroyed with local treatment methods. Small squamous cell cancers can usually be cured with these treatments. Larger squamous cell cancers are harder to treat, and fast-growing cancers have a higher risk of coming back.
In rare cases, squamous cell cancers can spread to lymph nodes or distant parts of the body. If this happens, treatments such as radiation therapy, immunotherapy, and/or chemotherapy may be needed.
How Can You Prevent Squamous Cell Carcinoma
Practicing sun safety is the best way to prevent SCC and other skin cancers. Here are some tips:
- Avoid being in the sun from 10 am to 4 pm.
- Avoid tanning beds.
- Use a broad spectrum sunscreen with an SPF of 15 or higher each day. If you will be outside for longer periods of time, use a broad spectrum sunscreen that is water-resistant and has an SPF of 30 or higher. Put the sunscreen on 30 minutes before going outside. Put sunscreen on again every two hours, or more frequently if you have been swimming or sweating a lot.
- Use protective clothing that has built-in sun protection, which is measured in UPF. Also, use broad-brimmed hats and sunglasses.
- Do your own skin self-exam about once per month, and see a dermatologist about one time per year for a professional skin exam.
- Have any skin changes examined as soon as possible by a healthcare provider.
What Is The Outlook For People With Squamous Cell Cancer
Early detection of SCC is key to successful treatment. If SCC isnt treated in its early stages, the cancer may spread to other areas of the body, including the lymph nodes and organs. Once this occurs, the condition can be life threatening.
Those with weakened immune systems due to certain medical conditions, such as HIV, AIDS, or leukemia, have a greater risk of developing more serious forms of SCC.
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From The Harvard Health Letter May 2006
Summers the season for fun in the sunbut also for skin cancer. Of the three main types of skin cancer, melanoma is most deadly, and basal cell, most common. Squamous cell cancer falls in between. Its three times as common as melanoma . Though not as common as basal cell , squamous cell is more serious because it is likely to spread . Treated early, the cure rate is over 90%, but metastases occur in 1%5% of cases. After it has metastasized, its very difficult to treat.
What Causes Cutaneous Squamous Cell Carcinoma
More than 90% of cases of SCC are associated with numerous DNAmutations in multiple somaticgenes. ;Mutations in the p53 tumour suppressor gene are caused by exposure to ultraviolet radiation , especially UVB . Other signature mutations relate to cigarette smoking, ageing;and immune suppression . Mutations in signalling pathways affect the epidermalgrowth factorreceptor, RAS, Fyn, and p16INK4a signalling.;
Beta-genus human papillomaviruses are thought to play a role in SCC arising in immune-suppressed populations. -HPV and HPV subtypes 5, 8, 17, 20, 24, and 38 have also been associated with an increased risk of cutaneous SCC in immunocompetent individuals.;
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How Can Cutaneous Squamous Cell Carcinoma Be Prevented
There is a great deal of evidence to show that very careful sun protection at any time of life reduces the number of SCCs. This is particularly important in ageing, sun-damaged, fair skin; in patients that are immune suppressed; and in those who already have actinic keratoses or previous SCC.
- Stay indoors or under the shade in the middle of the day
- Wear covering clothing
- Avoid indoor tanning
Oral nicotinamide in a dose of 500 mg twice daily may reduce the number and severity of SCCs in people at high risk.
Patients with multiple squamous cell carcinomas may be prescribed an oral retinoid . These reduce the number of tumours but have some nuisance side effects.
What Is Squamous Cell Cancer
Squamous cell cancer , also known as squamous cell carcinoma, is a type of skin cancer that typically begins in the squamous cells.
Squamous cells are the thin, flat cells that make up the epidermis, or the outermost layer of the skin.
SCC is caused by changes in the DNA of these cells, which cause them to multiply uncontrollably.
According to the Skin Cancer Foundation, cutaneous SCC is the second most common form of skin cancer. Approximately 700,000 people in the United States are diagnosed with this type of skin cancer each year.
People with SCC often develop scaly, red patches, open sores, or warts on their skin. These abnormal growths can develop anywhere, but theyre most often found in areas that receive the most exposure to ultraviolet radiation, either from sunlight or from tanning beds or lamps.
The condition usually isnt life threatening, but it can become dangerous if it goes untreated. When treatment isnt received promptly, the growths can increase in size and spread to other parts of your body, causing serious complications.
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How Widespread Is Scc
While SCC is less common than basal cell carcinoma , the number of reported SCC cases in the U.S. has steadily increased.
- An estimated;1.8 million cases of SCC are diagnosed each year, which translates to about 205 cases diagnosed every hour.
- SCC incidence has increased up to 200 percent in the past three decades.
Recurrent Basal Cell Carcinoma
Basal cell carcinomas are the most common type of skin cancer, according to the American Cancer Society. These cancers develop within the basal cell layer of the skin, in the lowest part of the epidermis.
Patients who have had basal cell carcinoma once have an increased risk of developing a recurrent;basal cell cancer. Basal cell cancers may recur in the same location that the original cancer was found or elsewhere in the body. As many as 50 percent of cancer patients are estimated to experience basal cell carcinoma recurrence within five years of the first diagnosis.
Basal cell carcinomas typically grow slowly, and it is rare for them to metastasize or spread to nearby lymph nodes or other parts of the body. But early detection and treatment are important.
After completing treatment for basal cell carcinoma, it is important to perform regular self-examinations of the skin to look for new symptoms, such as unusual growths or changes in the size, shape or color of an existing spot. Skin cancers typically develop in areas of the body that are exposed to the sun, but they may also develop in areas with no sun exposure. Tell your oncologist or dermatologist about any new symptoms or suspicious changes you may have noticed.
- Have a history of eczema or dry skin
- Have been exposed to high doses of UV light;
- Had original carcinomas several layers deep in the skin
- Had original carcinomas larger than 2 centimeters
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What Are The Clinical Features Of Cutaneous Squamous Cell Carcinoma
- They grow over weeks to months
- They may ulcerate
- They are often tender or painful
- Located on sun-exposed sites, particularly the face, lips, ears, hands, forearms and lower legs
- Size varies from a few millimetres to several centimetres in diameter.
Cutaneous squamous cell carcinoma
Scc Is Mainly Caused By Cumulative Uv Exposure Over The Course Of A Lifetime
If youve had a basal cell carcinoma you may be more likely to develop a squamous cell skin carcinoma, as is anyone with an inherited, highly UV-sensitive condition such as xeroderma pigmentosum.
Chronic infections, skin inflammation, HIV and other immune deficiency diseases, chemotherapy, anti-rejection drugs used in organ transplantation, and excessive sun exposure can all lead to a risk of squamous cell carcinoma.
Occasionally, squamous cell carcinomas arise spontaneously on what appears to be normal, healthy skin. Some researchers believe the tendency to develop these cancers can be inherited.
SCCs may occur on all areas of the body including the mucous membranes and genitals, but are most common in areas frequently exposed to the sun:
- Previous BCC or SCC
- Chronic inflammatory skin conditions or chronic infections
But anyone with a history of substantial sun exposure is at increased risk. Those whose occupations require long hours outside or who spend their leisure time in the sun are also at risk.
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What Are Head And Neck Cancer Symptoms
Head and neck cancer symptoms may include a lump in the neck or a sore in the mouth or the throat that does not heal and may be painful, a sore throat that does not go away, difficulty in swallowing, and a change or hoarseness in the voice. These symptoms may also be caused by other, less serious conditions. It is important to check with a doctor or dentist about any of these symptoms.
Symptoms of cancers in specific areas of the head and neck include:
Oral cavity. A white or red patch on the gums, the tongue, or the lining of the mouth; a growth or swelling of the jaw that causes dentures to fit poorly or become uncomfortable; and unusual bleeding or pain in the mouth.
Throat . Pain when swallowing; pain in the neck or the throat that does not go away; pain or ringing in the ears; or trouble hearing.
Voice box . Trouble breathing or speaking, pain when swallowing or ear pain.
Paranasal sinuses and nasal cavity. Sinuses that are blocked and do not clear; chronic sinus infections that do not respond to treatment with antibiotics; bleeding through the nose; frequent headaches, swelling or other trouble with the eyes; pain in the upper teeth; or problems with dentures.
Salivary glands. Swelling under the chin or around the jawbone, numbness or paralysis of the muscles in the face, or pain in the face, the chin, or the neck that does not go away.
How Common Are Head And Neck Cancers
Head and neck cancers account for nearly 4% of all cancers in the United States .;
These cancers are more than twice as common among men as they are among women . Head and neck cancers are also diagnosed more often among people over age 50 than they are among younger people.;
Researchers estimated that more than 68,000 men and women in the United States would be diagnosed with head and neck cancers in 2021 . Most will be diagnosed with mouth, throat, or voice box cancer. Paranasal sinus and nasal cavity cancer and salivary gland cancer are much less common.;
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Squamous Cell Skin Cancer
SCC is generally faster growing than basal cell cancers. About 20 out of every 100;skin cancers are SCCs. They begin in cells called keratinocytes, which are found in the epidermis.
Most SCCs develop on areas of skin exposed to the sun. These areas include parts of the head, neck, and on the back of your hands and forearms. They can also develop on scars, areas of skin that have been burnt in the past, or that have been ulcerated for a long time.
SCCs don’t;often spread. If they do, it’s;most often to the deeper layers of the skin. They;can spread to nearby;lymph nodes;and other parts of the body, but this is unusual.
Where Do Skin Cancers Start
Most skin cancers start in the top layer of skin, called the epidermis. There are 3 main types of cells in this layer:
- Squamous cells: These are flat cells in the upper part of the epidermis, which are constantly shed as new ones form. When these cells grow out of control, they can develop into squamous cell skin cancer .
- Basal cells: These cells are in the lower part of the epidermis, called the basal cell layer. These cells constantly divide to form new cells to replace the squamous cells that wear off the skins surface. As these cells move up in the epidermis, they get flatter, eventually becoming squamous cells. Skin cancers that start in the basal cell layer are called basal cell skin cancers or basal cell carcinomas.
- Melanocytes: These cells make the brown pigment called melanin, which gives the skin its tan or brown color. Melanin acts as the bodys natural sunscreen, protecting the deeper layers of the skin from some of the harmful effects of the sun. Melanoma skin cancer starts in these cells.
The epidermis is separated from the deeper layers of skin by the basement membrane. When a skin cancer becomes more advanced, it generally grows through this barrier and into the deeper layers.
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Stage Ii Squamous Cell Carcinoma
Once the tumor grows bigger than 2 cm, it moves into the zone of stage II SCC. It has at this stage, spread into the dermis or lower, deeper layers of the skin from the epidermis. However, it is still contained within the skin and does not affect the bone, cartilage or muscle. It may, however, have two or more high-risk features.8
What Is A Squamous Cell
One of three main types of cells in the top layer of the skin , squamous cells are flat cells located near the surface of the skin that shed continuously as new ones form.
SCC occurs when DNA damage from exposure to ultraviolet radiation or other damaging agents trigger abnormal changes in the squamous cells.
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Squamous Cell Carcinoma Stages
Squamous cell carcinoma stages represent the size of a tumor and how far it has spread. However, squamous cell carcinoma is usually very slow to metastasize; most cases are diagnosed while the cancer is still confined to the upper layer of the skin. As a result, these tumors may not be staged if it is clear that the cancer has not invaded nearby tissues at the time of diagnosis.
If a squamous cell carcinoma does require staging, oncologists will evaluate a number of factors, including:
- The size of the tumor
- Whether the tumor has grown into the dermis or subcutis levels of the skin
- Whether the cancer has invaded the bones
- Where on the body the tumor developed
- How the cells appear when viewed under a microscope
- Whether the cancer has spread to lymph nodes or distant organs
After evaluating these factors, the oncologist will assign one of the following squamous cell carcinoma stages to the tumor:
- Stage 0 Cancer is only present on the epidermis .
- Stage 1 Cancer has grown deep into the skin, but has not spread to nearby lymph nodes or healthy tissues.
- Stage 2 Cancer has grown deep into the skin and displays one or more high-risk features , but has not spread to nearby lymph nodes or healthy tissues.
- Stage 3 Cancer has grown into lymph nodes, but has not spread to any organs other than the skin.
- Stage 4 Cancer has spread to one or more distant organs, such as the lungs, liver, brain or distant parts of the skin.
Can Squamous Cell Carcinoma Be Cured
The majority of SCC tumors are found early and treated while they are still small. Treatment at an early stage can usually remove SCC.2
SCC is more likely than BCC to invade deeper layers of skin and spread to other parts of the body.2 This is uncommon. However, about 5% to 10% of SCC tumors are considered aggressive.2,4 It is more difficult to treat aggressive SCC. By one estimate, between 3,900 and 8,800 white individuals died from SCC in 2012.1 In the Midwest and southern United States, SCC may cause as many deaths as melanoma.1
Your dermatologist may recommend regular follow up for several years after treating any SCC. Most of the cases that return do so with 2 years of initial treatment.5
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Squamous Cell Carcinoma Risk Factors
Certain things make you more likely to develop SCC:
- Older age
- Blue, green, or gray eyes
- Blonde or red hair
- Spend time outside, exposed to the sun’s UV Rays
- History of sunburns, precancerous spots on your skin, or skin cancer
- Tanning beds and bulbs
- Long-term exposure to chemicals such as arsenic in the water
- Bowens disease, HPV, HIV, or AIDS
Your doctor may refer you to a dermatologist who specializes in skin conditions. They will:
- Ask about your medical history
- Ask about your history of severe sunburns or indoor tanning
- Ask if you have any pain or other symptoms
- Ask when the spot first appeared
- Give you a physical exam to check the size, shape, color, and texture of the spot
- Look for other spots on your body
- Feel your lymph nodes to make sure they arent bigger or harder than normal
If your doctor thinks a bump looks questionable, theyll remove a sample of the spot to send to a lab for testing.
What Are Cancers Of The Head And Neck
Cancers that are known collectively as head and neck cancers usually begin in the squamous cells that line the mucosal surfaces of the head and neck . These cancers are referred to as squamous cell carcinomas of the head and neck. Head and neck cancers can also begin in the salivary glands, sinuses, or muscles or nerves in the head and neck, but these types of cancer are much less common than squamous cell carcinomas .
Cancers of the head and neck can form in the:;
Oral cavity: Includes the lips, the front two-thirds of the tongue, the gums, the lining inside the cheeks and lips, the floor of the mouth under the tongue, the hard palate , and the small area of the gum behind the wisdom teeth.
Voice box : The voice box is a short passageway formed by cartilage just below the pharynx in the neck. The voice box contains the vocal cords. It also has a small piece of tissue, called the epiglottis, which moves to cover the voice box to prevent food from entering the air passages.
Paranasal sinuses and nasal cavity: The paranasal sinuses are small hollow spaces in the bones of the head surrounding the nose. The nasal cavity is the hollow space inside the nose.
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