Moffitt Cancer Centers Approach To Squamous Cell Carcinoma Treatment
Both surgical and nonsurgical treatments are available at Moffitt Cancer Center, and no referrals are required. We take a multispecialty approach to treatment, pairing each patient with a skilled team of surgeons, medical oncologists, radiation oncologists, supportive care providers and other medical professionals. This unique approach allows us to achieve encouragingly high survival rates, as well as ensure that each patient sustains an exceptional quality of life throughout treatment.
To learn more about squamous cell carcinoma treatment at Moffitt Cancer Center, call or submit a new patient registration form online.
What Are The Stages Of Squamous Cell Carcinoma
There are five stages of this form of skin cancer:
Most squamous cell carcinomas show up as Stage 0 or Stage 1.
- Stage 0 Also known as carcinoma in situ, this stage is not considered to be invasive. The abnormal cells are only in the upper layer of the epidermis, the outer skin.
- Stage 1 and Stage 2 Designation in these stages depends on how big the cancer is and if there are any high-risk features in the tumor.
- Stage 3 This stage has spread to areas below the skin, such as into the lymph nodes or other local structures like muscle, bone, or cartilage.
- Stage 4 The cancer has spread to distant sites in this stage.
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
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References And Information Sources Used For The Article:
Wolff, K., & Johnson, R. A. . Fitzpatricks color atlas and synopsis of clinical dermatology. McGraw-Hill Medical.
Thiers, B. H. . Year Book of Dermatology 1988. Archives of Dermatology, 125, 1150.
Burns, T., & Breathnach, S. . Rooks Textbook of dermatology Vol 4. London: Blackwell Scientific Publications, 1992.
Bolognia, J. L., Schaffer, J. V., Duncan, K. O., & Ko, C. J. . Dermatology Essentials E-Book. Elsevier Health Sciences.
What Is The Normal Structure Of The Lung
When you breathe in, air enters through your mouth or nose and goes into your lungs through the trachea . The trachea divides into 2 tubes called the bronchi , which divide into smaller branches called bronchioles. At the end of the bronchioles are tiny air sacs known as alveoli or acini.
Many tiny blood vessels run through the alveoli. They absorb oxygen from the inhaled air into your blood and pass carbon dioxide from the body into the alveoli. This is expelled from the body when you breathe out. Taking in oxygen and getting rid of carbon dioxide are your lungs main functions.
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Surgery: Endoscopic Endonasal Approach
Squamous cell carcinomas of the sinuses and skull base can be approached directly through the Endoscopic Endonasal Approach . This state-of-the-art, minimally invasive approach allows surgeons to access the tumor through the natural corridor of the nose, without making an open incision. Surgeons then remove the tumor through the nose and nasal cavities.
EEA offers the benefits of no incisions to heal, no disfigurement, and a faster recovery time.
UPMC’s neurosurgical team may recommend a combination of surgical and non-surgical approaches to treat squamous cell carcinomas.
How To Tell If Squamous Cell Carcinoma Has Spread
While its not common for squamous cell carcinoma to spread, it is helpful to be mindful of the signs. First, there are certain known risk factors to be aware of, as these characteristics have been associated with a higher stage of squamous cell carcinoma. Risk factors for squamous cell spreading include:
- The tumor is thicker than 2 millimeters.
- The tumor has grown into the lower dermis or subcutis layers of the skin.
- The tumor has grown into the nerves in the skin.
- The tumor is present on the ear or on a hair-bearing lip.
Knowing the stage of your cancer will help your medical team understand how serious it is and how best to treat it. Staging squamous cell carcinoma is based on a physical exam, detailed history, skin biopsy, lymph node biopsy, and imaging studies.
To determine if your cancer has spread, your physician may recommend several diagnostic tests. A skin or lymph node biopsy can show how far cancer cells have spread in the region of the primary tumor. Your medical team may also recommend a computed tomography scan to determine the spread.
You may also be able to recognize squamous cell carcinoma spreading by its appearance. Possible symptoms of squamous cell carcinoma include:
- A thick, red, scaly patch of skin
- An open sore or scar
- An elevated growth that is usually pink, red, or the color of your flesh.
- A wartlike nodule with raised edges
While most squamous cell carcinoma lesions are painless, it is possible to experience pain or numbness at the site.
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Incidence Prevalence And Mortality
Global incidence of head and neck squamous cell carcinoma.
The estimated age-standardized rate of HNSCC incidence worldwide is shown for men and women combined. Data from GLOBOCAN, 2018 . Map was generated using the GLOBOCAN website mapping tool by selecting the hypopharynx, larynx, lip, oral cavity, nasopharynx and oropharynx cancer sites.
How Common Is Squamous Cell Carcinoma
Over 1 million people are diagnosed with SCC in the US each year. The incidence of SCC has risen about 200 percent over the past 30 years. There are more than 15,000 deaths each year in the US from SCC. Excluding head and neck SCC and CSCC in situ, about 200,000-400,000 new cases of SCC are diagnosed in the US every year, resulting in about 3,000 deaths.
Men are about two times more likely than women to develop SCCs. People over the age of 50 are most likely to get SCCs, but the incidence has been rising in younger people.
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How Is Squamous Cell Carcinoma Of Tongue Treated
Early diagnosis and treatment of Squamous Cell Carcinoma of Tongue is important to avoid complications such as metastasis to other regions. The treatment measures may include:
- In most cases, a wide surgical excision and removal of the entire tumor is the preferred treatment option . This may be followed by radiation therapy and/or chemotherapy
- If the tumor has metastasized , then a combination of chemotherapy, radiation therapy, and invasive procedures may be used to treat the tumor
- Targeted therapy medications are generally used for locally infiltrated or metastatic SCCs. This therapy destroys the tumor cells by acting against the proteins that are responsible for tumor growth
- Post-operative care is important: One must maintain minimum activity levels, until the surgical wound heals
- Follow-up care with regular screening and check-ups are important and encouraged
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What Are The 5 Stages Of Skin Cancer
Staging is an important tool used to treat skin cancer. Your stage helps the medical team determine where the tumor is, how large it is, where it has spread, your prognosis, and the most effective treatment plan.
The five stages of squamous cell carcinoma include:
- Stage 0: Also known as carcinoma in situ, in this stage cancer is present in the epidermis. It has not spread to deeper layers.
- Stage 1: The tumor is smaller than 2 centimeters and has not spread to nearby lymph nodes or other organs. The individual has one or fewer risk factors for spread.
- Stage 2: The tumor is wider than 2 centimeters and has not spread to nearby lymph nodes or other organs. This stage also applies to any sized tumor when the individual has two or more risk factors.
- Stage 3: The tumor has spread into nearby facial bones or one lymph node. It has not spread to other organs.
- Stage 4: The tumor is of any size and has metastasized to one or more of the lymph nodes. It may have spread to the bones and other distant organs.
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What Is Squamous Cell Cancer
Squamous cell carcinoma of the skin is a common skin cancer that typically develops in chronic sun-exposed areas of your body. This type of skin cancer is usually not nearly as aggressive as melanoma and is uncontrolled growth of cells in the epidermis of your skin.
It can become disfiguring and sometimes deadly if allowed to grow. Squamous cell carcinomas are at least twice as frequent in men as in women. They rarely appear before age 50 and are most often seen in individuals in their 70s.
An estimated 700,000 cases of SCC are diagnosed each year in the United States, resulting in approximately 2,500 deaths.
How Is Invasive Squamous Cell Carcinoma Treated
An exact diagnosis will dictate what method of invasive squamous cell carcinoma treatment will be most effective. Options include:
- Mohs surgery: using a scalpel, this procedure surgically removes cancerous cells while leaving behind unaffected areas.
- Chemotherapy: using intravenous drugs, this treatment floods the body with medicine designed to break down and destroy infected cells.
- IG-SRT: using radiotherapy technology, this method uses low-level doses of radiation to target cancer from the surface down, achieving results without cutting or drugs.
Talk with your dermatologist to determine whats best for you.
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What Are The Signs And Symptoms Of Squamous Cell Carcinoma Of Cervix
Usually, there are no symptoms, during the pre-cancer and early cancer stages . Once, Squamous Cell Carcinoma of Cervix has sufficiently progressed and the presence of large-sized tumors is seen, the following set of signs and symptoms may be observed:
- Abnormal vaginal bleeding
- Loss of weight, loss of appetite
During the advanced stages of Squamous Cell Carcinoma of Cervix, the following signs and symptoms may be observed:
- Lower back pain
- Frequent urination
- Urinary bladder pain and blood in urine
- The tumor may spread from the cervix to the ureters leading to decreased urine production by the kidneys and increased blood urea levels
- Involvement of the pelvic muscles by tumor cells can cause pain radiating along the leg
- Occasionally, swollen lymph nodes in the groin and lower extremities, may be noted due to tumor metastasis
- If the urinary bladder is involved, then it may obstruct the bladder and lead to retention of urine
- Urinary retention can cause the abnormal formation of a fistula in the urogenital area
- Rectal tenesmus or the urge to keep emptying the bowel, even after it is emptied
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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Obtaining Some Cancer Cells
There are a few ways your doctor can obtain these cells. They may take a sputum sample. If there is any fluid around your lungs, it will usually have some cancer cells, too. Your doctor may obtain a sample with a needle inserted through your skin . Then, your cells are examined under a microscope for signs of cancer.
What Is The Treatment For Advanced Or Metastatic Squamous Cell Carcinoma
Locally advanced primary, recurrent or metastatic SCC requires multidisciplinary consultation. Often a combination of treatments is used.
- Experimental targeted therapy using epidermal growth factor receptor inhibitors
Many thousands of New Zealanders are treated for cutaneous SCC each year, and more than 100 die from their disease.
Electronic Skin Surface Brachytherapy
Some skin cancers that do not require very deep radiation may be treated with a new form of radiation therapy applied directly to the skin, called electronic skin surface brachytherapy .
In ESSB, we apply smooth, round disks to the skin these disks are attached to a radiation therapy machine. They are left in place for just a few minutes while the radiation is delivered, allowing the tumor to be treated. The approach spares underlying healthy skin from the effects of the radiation.
What Are The Signs And Symptoms Of Invasive Squamous Cell Carcinoma Of Anus
Anal Invasive Squamous Cell Carcinoma signs and symptoms may include:
- The presence of a poorly-defined, single red lesion on the anus
- The lesion or tumor may grow and there may be itching sensation, ulceration, and bleeding
- The malignant lesion is not confined to the skin surface, but may have invaded adjacent tissues and structures or metastasized
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What If My Report Mentions Margins
The margin is the edge or the boundary of the specimen that was removed by the surgeon. It is where the surgeon has sectioned across the lung to remove the tumor.
The margin may be free of the tumor that is, a rim of uninvolved tissues may surround the tumor, indicating that the tumor has been removed completely. This is sometimes referred to as a negative margin.
Alternatively, the tumor could extend to the edge of the specimen , implying that the tumor has not been completely removed. This is sometimes referred to as a positive margin.
The status of the margin is an important indicator of the potential for the tumor to recur and of the need for further treatment. Talk with your doctor about the best approach for you if cancer is found at the margins.
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Types Of Endometrial Cancer
Endometrial cancer starts in the cells of the inner lining of the uterus . This is the most common type of cancer in the uterus
Endometrial carcinomas can be divided into different types based on how the cells look under the microscope. They include:
- Transitional carcinoma
- Serous carcinoma
Clear-cell carcinoma, mucinous adenocarcinoma, undifferentiated carcinoma, dedifferentiated carcinoma, and serous adenocarcinoma are less common types of endometrial adenocarcinomas. They tend to grow and spread faster than most types of endometrial cancer. They often have spread outside the uterus by the time theyre diagnosed.
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Invasive Squamous Cell Carcinoma
as this has started to spread into the deeper tissues, complete excision is usually required. However, there are exceptions such as patients of advanced age or with medical conditions that may preclude them from surgery. In these cases, less invasive treatment options can be considered.
- Wide Excision in our office:
- an elliptical shape of tissue is used to remove the skin cancer as well as a margin of healthy tissue. Both internal and external sutures are usually required to close the incision.
- The surgical specimen is sent to the lab to be analyzed. Our goal is to obtain clear margins, confirming that the cancer has been removed with an adequate margin of healthy skin. Results will be received in approximately 2-3 weeks.
What Is The Prognosis Of Invasive Squamous Cell Carcinoma Of Anus
- The prognosis of Invasive Squamous Cell Carcinoma of Anus depends upon many factors, such as the age of the individual, their health status, and stage of tumor at diagnosis
- Without treatment , invasive carcinomas can metastasize aggressively and this may result in a poor prognosis
- The outcomes are excellent with early diagnosis and treatment of squamous cell carcinoma in situ
Effective Options For Early Stage Scc
Most squamous cell carcinomas of the skin can be cured when found and treated early. Treatment should happen as soon as possible after diagnosis, since more advanced SCCs of the skin are more difficult to treat and can become dangerous, spreading to local lymph nodes, distant tissues and organs. Find out more about treatment options for advanced or recurring SCCs here.
If youve been diagnosed with an SCC that has not spread, there are several effective treatments that can usually be performed on an outpatient basis. The choices available to you depend on the tumor type, size, location and depth, as well as your age and overall health.