Cancer Stage Determines Risk Of Spreading And Line Of Treatment
A cancer of the upper layers of the skin in the epidermis, SCC is the second most common form of skin cancer after basal cell carcinoma and affects an estimated 1 million new people every year in the United States alone. Cancer staging is done for SCC with the intention of categorizing the size of cancer and to judge how much it has grown. And theres a clear line of treatment and way forward for each stage.1
With skin cancers like basal cell carcinoma, the likelihood of cancer spreading to other parts of the body is very low and early diagnosis and treatment usually tackles the problem before it spreads. SCC, however, is a little trickier. While the risk of spreading is still quite small, there is a relatively higher chance of it progressing depending on what stage the cancer is at. For those with weakened immune systems, say, people whove had organ transplants or anyone infected with HIV, the risk is a little higher. Also, when the cancer is in the head and neck region, it may have a slightly higher risk of recurring or spreading.2
The actual stage of this form of cancer is determined based on the TNM protocol devised by the American Joint Commission on Cancer.3
- T : The size/extent of the tumor
- N : Whether it has spread to lymph nodes
- M : Whether it has spread to other parts of the body
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Basal Cell Carcinoma Overview
Basal cell carcinoma, also called epithelioma, is the uncontrolled growth of the skin’s basal cells. These are the cells that line the deepest layer of the epidermis, the skin’s outermost layer. This type of cancer rarely spreads to other parts of the body.
It is mainly caused by repeated long-term exposure to sunlight. Light-skinned people who spent a lot of time in the sun as children, or who spend time in tanning booths, are especially susceptible. X-ray treatments for acne and exposure to industrial pollutants such as arsenic and hydrocarbons also increase the risk of developing basal cell carcinoma.
Basal cell carcinoma is the most common skin cancer in the United States, with nearly 3 million cases diagnosed each year.
Symptoms Of Squamous Cell Carcinoma
A key factor used to identify a Squamous Cell Carcinomas is any ongoing change that persists beyond a few weeks in a lesion on the skin.
Squamous Cell Carcinomas typically appear as persistent, thick, rough, scaly patches that can bleed if bumped, scratched or scraped.
If you observe two or more of the signs below, you should consult the Bondi Junction Skin Cancer Clinic immediately.
Squamous Cell Carcinoma can sometimes resemble non-cancerous skin conditions such as psoriasis or eczema.
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Can Basal Cell Carcinoma Invade Bone
Metastasis of BCC is extremely uncommon with an estimated rate ranging from 0.0028% to 0.55%. Only around 300 cases of metastatic BCC have been reported since the first reported case by Beadles in 1894. While bone invasion by BCC is well reported in the head and neck region,812 direct long bone invasion is not.
What Are The Causes Of Infiltrating Basal Cell Carcinoma Of Skin
- The exact cause of development of Infiltrating Basal Cell Carcinoma of Skin is not completely known, in a majority of cases
- Although, genetic mutations have been detected in Basal Cell Carcinomas, which are currently being characterized
- Most BCCs are sporadic in origin i.e., they occur in a random fashion
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How Does The Doctor Know I Have Skin Cancer
Basal and squamous skin cancer may look like:
- Flat, firm, pale or yellow areas that look a lot like a scar
- Raised reddish patches that might itch
- Rough or scaly red patches, which might crust or bleed
- Small, pink or red, shiny, pearly bumps, which might have blue, brown, or black areas
- Pink growths or lumps with raised edges and a lower center
- Open sores that dont heal, or that heal and then come back
- Wart-like growths
Tests That May Be Done
The doctor will ask you questions about when the spot on your skin first showed up and if it has changed in size or the way it looks or feels. The rest of your skin will be checked. During the exam your doctor will check the size, shape, color and texture of any skin changes. If signs are pointing to skin cancer, more tests will be done.
Skin biopsy
In a biopsy, the doctor takes out a small piece of tissue to check it for cancer cells. A biopsy is the only way to tell for sure if you have skin cancer and what kind it is.
There are many types of skin biopsies. Ask your doctor what kind you will need. Each type has pros and cons. The choice of which type to use depends on your own case.
In rare cases basal and squamous cell skin cancer can spread to the nearby lymph nodes Ask your doctor if your lymph nodes will be tested.
Basal and squamous cell cancers don’t often spread to other parts of the body. But if your doctor thinks your skin cancer might spread, you might need imaging tests, such as MRI or CT scans.
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How Does Basal Cell Carcinoma Originate In The Skin
Posted on November 21, 2014 in Skin Cancer, Mohs Micrographic Surgery, How to Protect Yourself From the Sun, Men’s Health, Skin Tumor, Sunscreen, Skin Lesions, Surgery, Inflammation, Basal Cell Carcinoma
Weve heard about sunburns and sunscreen, fair complexions and temperate climates, but this does not explain how these risks lead to the development of basal cell carcinoma in the skin.
Its not as big of a black box as it used to be, says Dr. Adam Mamelak, skin cancer specialist and Mohs micrographic surgeon in Austin, Texas. In fact, years of research have taught us a lot of how these risk factors lead to actual the development of skin cancer. After performing laboratory bench research on skin cancer during his years as a Research Fellow at Johns Hopkins University, Dr. Mamelak says there are some basic things that are known about these tumors.
Where in the skin do Basal Cell Carcinoma Develop?
There is a strong relationship between basal cell carcinoma and hair follicles, explains Dr. Mamelak. We do not tend to see these tumors developing on non-hair bearing skin. Dr. Mamelak notes that it is exceedingly rare to find basal cell carcinomas developing on the palms or soles . Even when these cancers involve the lips, there is usually some involvement of the skin just adjacent to the mouth.
What about UV?
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How Does Radiation Therapy Kill Cancer Cells
Radiation therapy is used to treat many types of cancer, including skin cancer. Radiation works by damaging the DNA inside cancer cells which causes them to die or stop reproducing. Healthy cells are less sensitive to radiation because they have ways of repairing any damage that occurs in their own DNA. There are two different kinds of radiation therapies used for cancer treatment. External beam radiation therapy uses a machine outside the body to direct intense beams of energy at cancer cells. This type of treatment is used for skin cancer and other types that affect only part or just one area of the body. Internal radiation, also known as brachytherapy, places radioactive material inside your body near where it started growing in order to kill the cancer cells. This type of treatment is used for skin cancers on the face or neck, and it involves moving healthy tissue out of harms way during radiation therapy. Cancer patients who are undergoing this kind of treatment need to avoid exposing their normal skin to sunlight during the course of treatment in order to prevent sunburns which can result in nasty scars. Cancer patients also need to wear sunscreen and protective clothing when outside during times of the day that radiation therapy is used.
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What Are The Symptoms Of Basal Cell Cancer Of The Head And Neck
Basal cell cancers usually present as an abnormal growth on the skin. The growth may have the appearance of a wart, crusty spot, reddish patch, mole, nodule or bump, or a sore that does not heal. It may or may not bleed and can sometimes be painful. These are usually slow-growing tumors that begin as small spots on sun-exposed areas of the face. Because they can have such a range of appearances, any new persistent skin lesion should be evaluated.
Johns Hopkins Head and Neck Cancer Surgery Specialists
Our head and neck surgeons and speech language pathologists take a proactive approach to cancer treatment. Meet the Johns Hopkins specialists who will work closely with you during your journey.
How Are Basal Cell Carcinomas Treated
How we treat your basal cell carcinoma will often be dictated by its location. There are numerous treatment options.
Surgery is the typical treatment method. Depending on the size and location of the removed growth, the wound may be sutured closed, covered with a skin graft, or allowed to heal on its own.
These are the surgical procedures:
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How Serious Is My Cancer
If you have skin cancer, the doctor will want to find out how far it has spread. This is called staging.
Basal and squamous cell skin cancers don’t spread as often as some other types of cancer, so the exact stage might not be too important. Still, your doctor might want to find out the stage of your cancer to help decide what type of treatment is best for you.
The stage describes the growth or spread of the cancer through the skin. It also tells if the cancer has spread to other parts of your body that are close by or farther away.
Your cancer can be stage 0, 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread beyond the skin. Be sure to ask the doctor about the cancer stage and what it means for you.
Other things can also help you and your doctor decide how to treat your cancer, such as:
- Where the cancer is on your body
- How fast the cancer has been growing
- If the cancer is causing symptoms, such as being painful or itchy
- If the cancer is in a place that was already treated with radiation
- If you have a weakened immune system
Squamous Cell Carcinoma Screening
Diagnosis and management of Squamous Cell Carcinoma is best performed via a Full Body Scan. In the first incidence, this process includes
- Digitally Mapping a patients entire body for any suspicious skin damage or lesion
- Followed by a detailed Dermoscopic Examination by a trained skin cancer Specialist
- Recording and combining all images and skin metrics into the patient record
Our expert Doctors at Bondi Junction Skin Cancer Clinic will then clearly identify and diagnose any skin cancers. Having a digital molemap or a baseline of all your skins sun damage for all family members with
- any suspicious sun damage,
- those with a large number of moles, or
- have been diagnosed with melanoma is recommended.
Any changes can be more easily spotted and understood.
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How Fast Does Squamous Cell Carcinoma Spread
Squamous cell carcinoma rarely metastasizes , and when spreading does occur, it typically happens slowly. Indeed, most squamous cell carcinoma cases are diagnosed before the cancer has progressed beyond the upper layer of skin. There are various types of squamous cell carcinoma and some tend to spread more quickly than others.
What Are The Different Types Of Squamous Cell Carcinoma
People assume there is just a single type of squamous cell carcinoma, but there are actually several different types. Some are more likely to spread than others, but in general, most types share similar characteristics. The primary difference between the following types is related to the unique characteristics of the cancerous cells.
The primary types of squamous cell carcinoma are:
- Adenoid/pseudoglandular squamous cell carcinoma
- Small cell keratinizing squamous cell carcinoma
- Spindle cell squamous cell carcinoma
- Verrucous squamous cell carcinoma
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Squamous Cell Carcinoma Warning Signs
At the Bondi Junction Skin Cancer Clinic we use the adage The faster a Squamous Cell Carcinoma grows the faster it needs to go.
Faster growing Squamous Cell Carcinoma are more likely to be
- aggressive,
- Invade and potentially penetrate the skin
- spread .
If they do spread this high growth rate is often maintained leading to a rapidly progressive clinical course which is associated with higher fatality rates.
Any rapidly growing lump or change in a pre-existing or new skin growth, should prompt an immediate visit to a Bondi Junction Skin Cancer Clinic.
How Is Basal Cell Cancer Of The Head And Neck Diagnosed
Diagnosis is made by clinical exam and a biopsy. Basal cell cancers are staged by size and extent of growth. These cancers rarely metastasize to lymph nodes or other organs, but they can grow quite large and invade small nerves and local structures.
Biopsy can help determine if the basal cell cancer is a low-risk tumor or a high-risk tumor that requires more aggressive treatment. Low-risk tumors are often nodular and do not have nerve involvement. High-risk tumors in the head and neck are those that involve the central face, nose and eye area, as well as those tumors that are greater than or equal to 10 millimeters on the cheeks, scalp and neck tumors that are recurrent or arising from previously radiated tissue and tumors arising in patients who are immunosuppressed. An aggressive growth pattern on the pathology evaluation and perineural invasion are also features of high-risk basal cell cancers.
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Squamous Cell Carcinoma Prevention
Anyone who has had one Squamous Cell Carcinoma has an increased chance of developing another, especially in the same skin area or nearby. That is usually because the skin has already suffered irreversible sun damage.
Thus, it is crucial to pay particular attention to any previously treated site, and any changes noted should be shown immediately to your Doctor at the Bondi Junction Skin Cancer Clinic.
Squamous Cell Carcinomas on the nose, ears, and lips are especially prone to recurrence.
Even if no suspicious signs are noticed, regularly scheduled follow-up visits including total-body skin exams are an essential part of post-treatment care every 6 months.
To prevent Squamous Cell Carcinoma make sure you follow the recommendations below:
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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.
What Are The Risk Factors For Infiltrating Basal Cell Carcinoma Of Skin
The risk factors that contribute to Infiltrating Basal Cell Carcinoma of Skin formation include:
- Prolonged sun exposure, exposure to ultraviolet light
- Use of tanning beds, tanning parlors
- Arsenic exposure
- Ionizing radiation
- Smoking
- The presence of certain genetic syndromes such as basal cell nevus syndrome increases the risk
- Caucasians are more vulnerable compared to other darker-toned individuals
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
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What Is The Success Rate For Treating Squamous Cell Carcinoma
Unlike basal cell carcinoma, squamous cell carcinoma tends to be more invasive and is likely to spread if left untreated. As with basal cell carcinoma, Mohs micrographic surgery has the best success rates, at 97 percent. Excision has a 92 percent success rate. For low-risk, small tumors, curettage, and electrodesiccation is successful in 96 percent of cases, but it cannot be used for larger, deeper growths.
Squamous cell carcinoma is generally not considered life-threatening if treated early. However, if left untreated, squamous cell carcinoma can spread and it can then become life-threatening. Reliable statistics are not available, however, because most of these cancers are treated in a dermatologists office.
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