What Are The Similarities In Basal Cell Carcinoma Vs Squamous Cell Carcinoma
The majority of people who are diagnosed with basal cell carcinoma or squamous cell carcinoma are fair skinned and have signs of sun damage. These signs include deep wrinkles, age spots, and patches of discolored skin. However, people of all skin tones can be diagnosed with skin cancer.
You are at a higher risk of being diagnosed with skin cancer if you:
- Regularly use a tanning bed
- Spend time in the sun without protecting your skin using sunscreen or clothing
- Are fair skinned, have light colored eyes, or are a natural red head or blonde
- A history of skin cancer
- Experienced blistering sunburns
Risk Factors For Squamous Cell Carcinoma
Sun exposure and other risk factors
Sun exposure is the major known environmental factor associated with the development of skin cancer of all types however, different patterns of sun exposure are associated with each major type of skin cancer. Unlike basal cell carcinoma , SCC is associated with chronic exposure, rather than intermittent intense exposure to ultraviolet radiation. Occupational exposure is the characteristic pattern of sun exposure linked with SCC. Other agents and factors associated with SCC risk include tanning beds, arsenic, therapeutic radiation , chronic skin ulceration, and immunosuppression.
Characteristics of the skin
Like melanoma and BCC, SCC occurs more frequently in individuals with lighter skin than in those with darker skin. A case-control study of 415 cases and 415 controls showed similar findings relative to Fitzpatrick type I skin, individuals with increasingly darker skin had decreased risks of skin cancer . The same study found that blue eyes and blond/red hair were also associated with increased risks of SCC, with crude ORs of 1.7 for blue eyes, 1.5 for blond hair, and 2.2 for red hair.
Personal history of BCC, SCC, and melanoma skin cancers
Family history of squamous cell carcinoma or associated premalignant lesions
Skin Cancer Is Dangerous Or Not As Per Prognosis Of The Problem
Based on the aforementioned statistics, we should say that nonmelanoma skin cancer has a relatively good prognosis. However, if we talk about individually, the prognosis may depend on additional factors, which include the following-
- History of your health
- The specific type of cancer
- Location of your skin cancer
- The size and grade of the cancer
- The group of treatments or therapies you opt
The way, in which cancer responds to a specific treatment
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Who Is Most Likely To Have A Squamous Cell Carcinoma
The following groups of people are at greater risk of developing SCC:
- Immunosuppressed individuals either due to medical treatment, such as methotrexate, ciclosporin and azathioprine, or due to diseases which affect immune function, including inherited diseases of the immune system or acquired conditions such as leukaemia or HIV
- Patients who have had an organ transplant because of the treatment required to suppress their immune systems to prevent organ rejection
- People who are more susceptible to sunburn
- People who have had significant cumulative ultraviolet light exposure, for example:
- people who have lived in countries near to the equator, or who have been posted to work in these countries, e.g. military personnel, construction workers
- outdoor workers, such as builders, farmers
- people of advanced years, who have had a lifetime of frequent sun exposure
What Is A Squamous Cell Carcinoma Of The Skin
Squamous cell carcinoma is a tumor of skin cells. As shown in the illustration, the skin is made up of several layers of cells with the squamous layer at the top. Because this type of cancer arises from squamous cells, tumors can develop anywhere that these cells are present. This can include the nail bed, paw pads, abdomen, back, ears, or the nose, including the nasal planum .
Squamous cell carcinomas usually appear as a single, solitary lesion in one location, but there is a kind of SCC called multicentricsquamous cell carcinoma that presents as many lesions in multiple locations on the body. Multicentric SCC is very rare in dogs.
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What Does A Squamous Cell Carcinoma Look Like
SCC can vary in their appearance, but most usually appear as a scaly or crusty raised area of skin with a red, inflamed base. SCCs can be sore or tender and they can bleed but this is not always the case. They can appear as an ulcer.
SCC can occur on any part of the body, but they are more common on sun exposed sites such as the head, ears, neck and back of the hands.
Taking Care Of Yourself
After you’ve been treated for basal cell carcinoma, you’ll need to take some steps to lower your chance of getting cancer again.
Check your skin. Keep an eye out for new growths. Some signs of cancer include areas of skin that are growing, changing, or bleeding. Check your skin regularly with a hand-held mirror and a full-length mirror so that you can get a good view of all parts of your body.
Avoid too much sun. Stay out of sunlight between 10 a.m. and 2 p.m., when the sun’s UVB burning rays are strongest.
Use sunscreen. The suns UVA rays are present all day long — thats why you need daily sunscreen. Make sure you apply sunscreen with at least a 6% zinc oxide and a sun protection factor of 30 to all parts of the skin that aren’t covered up with clothes every day. You also need to reapply it every 60 to 80 minutes when outside.
Dress right. Wear a broad-brimmed hat and cover up as much as possible, such as long-sleeved shirts and long pants.
What Are The Four Main Types Of Melanoma Of The Skin
Superficial spreading melanoma
What you should know: This is the most common form of melanoma.
How and where it grows: It can arise in an existing mole or appear as a new lesion. When it begins in a mole that is already on the skin, it tends to grow on the surface of the skin for some time before penetrating more deeply. While it can be found nearly anywhere on the body, it is most likely to appear on the torso in men, the legs in women and the upper back in both.
What it looks like: It may appear as a flat or slightly raised and discolored, asymmetrical patch with uneven borders. Colors include shades of tan, brown, black, red/pink, blue or white. It can also lack pigment and appear as a pink or skin-tone lesion .
What you should know: This form of melanoma often develops in older people. When this cancer becomes invasive or spreads beyond the original site, the disease is known as lentigo maligna melanoma.
How and where it grows: This form of melanoma is similar to the superficial spreading type, growing close to the skin surface at first. The tumor typically arises on sun-damaged skin on the face, ears, arms or upper torso.
What it looks like: It may look like a flat or slightly raised, blotchy patch with uneven borders. Color is usually blue-black, but can vary from tan to brown or dark brown.
Acral lentiginous melanoma
What you should know: This is the most common form of melanoma found in people of color, including individuals of African ancestry.
What Is Basal Cell Carcinoma
Basal cell carcinoma is a cancer that grows on parts of your skin that get a lot of sun. It’s natural to feel worried when your doctor tells you that you have it, but keep in mind that it’s the least risky type of skin cancer. As long as you catch it early, you can be cured.
This cancer is unlikely to spread from your skin to other parts of your body, but it can move nearby into bone or other tissue under your skin. Several treatments can keep that from happening and get rid of the cancer.
The tumors start off as small shiny bumps, usually on your nose or other parts of your face. But you can get them on any part of your body, including your trunk, legs, and arms. If you’ve got fair skin, you’re more likely to get this skin cancer.
Basal cell carcinoma usually grows very slowly and often doesn’t show up for many years after intense or long-term exposure to the sun. You can get it at a younger age if you’re exposed to a lot of sun or use tanning beds.
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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
Basal Cell Carcinoma: Overview
Basal cell carcinoma is the most common type of skin cancer. Its also the most commonly diagnosed cancer in the United States. Every year, millions of people learn that they have BCC.
This skin cancer usually develops on skin that gets sun exposure, such as on the head, neck, and back of the hands. BCC is especially common on the face, often forming on the nose. It is possible to get BCC on any part of the body, including the trunk, legs, and arms.
People who use tanning beds have a much higher risk of getting BCC. They also tend to get BCC earlier in life.This type of skin cancer grows slowly. It rarely spreads to other parts of the body. Treatment is important because BCC can grow wide and deep, destroying skin tissue and bone.
References:American Cancer Society. Cancer Facts and Figures: 2016. Last accessed April 28, 2016.Carucci JA, Leffell DJ. Basal Cell Carcinoma In: Wolff K et al. Fitzpatricks Dermatology in General Medicine, 7th edition. USA. McGraw Hill Medical 2008, p. 1036-42.Ferrucci LM, Cartmel B, Molinaro AM et al. Indoor tanning and risk of early-onset basal cell carcinoma. J Am Acad Dermatol 2012 67:552-62.Jarell AD, Mully TW. Basal cell carcinoma on the ear is more likely to be of an aggressive phenotype in both men and women. J Am Acad Dermatol 2012 May 66:780-4.Wong CS, Stragne RC, Lear JT et al. Clinical review: Basal cell carcinoma. BMJ 2003 Oct 4 327:794-798.
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Major Genes For Basal Cell Carcinoma
Inherited pathogenic variants in the gene coding for the transmembrane receptor protein PTCH1, or PTCH, are associated with basal cell nevus syndrome , and somatic mutations are associated with sporadic cutaneous BCCs. PTCH1, the human homolog of the Drosophila segment polarity gene patched , is an integral component of the hedgehog signaling pathway, which serves many developmental and regulatory roles.
In the resting state, the transmembrane receptor protein PTCH1 acts catalytically to suppress the seven-transmembrane protein Smoothened , preventing further downstream signal transduction. Binding of the hedgehog ligand to PTCH1 releases inhibition of Smo, with resultant activation of transcription factors , cell proliferation genes , and regulators of angiogenesis. Thus, the balance of PTCH1 and Smo manages the essential regulatory downstream hedgehog signal transduction pathway. Loss-of-function pathogenic variants of PTCH1 or gain-of-function variants of Smo tip this balance toward activation, a key event in potential neoplastic transformation.
Truncating pathogenic variants in PTCH2, a homolog of PTCH1 mapping to chromosome 1p32.1-32.3, have been demonstrated in both BCC and medulloblastoma. PTCH2 displays 57% homology to PTCH1. While the exact role of PTCH2 remains unclear, there is evidence to support its involvement in the hedgehog signaling pathway.
Looking After Your Skin After Treatment
After treatment, you may need follow-up appointments with your dermatologist or GP to see if you need any further treatment.
If you had surgery, you may need to have any stitches removed at your GP surgery a few weeks later.
- see a GP if an existing patch starts to bleed, change in appearance or develops a lump do not wait for your follow-up appointment
- see a GP if you notice any worrying new patches on your skin
- make sure you protect your skin from the sun wear protective clothing and use a sunscreen with a high sun protection factor of at least 30
Page last reviewed: 21 May 2019 Next review due: 21 May 2022
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What Changes In The Skin Occur Due To Exposure To The Sun
Exposure to sun causes most of the wrinkles and age spots on our faces. People think a glowing complexion means good health, but skin color obtained from being in the sun can actually speed up the effects of aging and increase the risk of developing skin cancer.
Sun exposure causes most of the skin changes that we think of as a normal part of aging. Over time, the sun’s ultraviolet light damages the fibers in the skin called elastin. When these fibers break down, the skin begins to sag, stretch, and lose its ability to go back into place after stretching. The skin also bruises and tears more easily in addition to taking longer to heal. So while sun damage to the skin may not be apparent when you’re young, it will definitely show later in life. The sun can also cause issues for your eyes, eyelids, and the skin around the eyes.
Changes in the skin related to sun exposure:
- Precancerous and cancerous skin lesions caused by loss of the skin’s immune function.
- Benign tumors.
- Fine and coarse wrinkles.
- Freckles discolored areas of the skin, called mottled pigmentation and sallowness, yellow discoloration of the skin.
- Telangiectasias, the dilation of small blood vessels under the skin.
- Elastosis, the destruction of the elastic tissue causing lines and wrinkles.
How Dangerous Is Melanoma
Melanoma is usually curable when detected and treated early. Once melanoma has spread deeper into the skin or other parts of the body, it becomes more difficult to treat and can be deadly.
- The estimated five-year survival rate for U.S. patients whose melanoma is detected early is about 99 percent.
- An estimated 7,180 people will die of melanoma in the U.S. in 2021.
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What Causes A Squamous Cell Carcinoma
The most important cause is too much exposure to ultraviolet light from the sun or other sources. This can cause the DNA of skin cells in the outer layer of the skin to change. Sometimes this alteration in DNA allows the skin cells to grow out of control and develop into an SCC. Ultraviolet light damage can cause SCC directly, or sometimes it can induce a scaly area called an actinic keratosis or Bowens disease. These can change into SCC if they are not treated.
Squamous cell carcinomas can also develop in skin damaged by other forms of radiation, in burns and persistent chronic ulcers and wounds and in old scars. Certain human viral wart viruses can also be a factor. However, SCC itself is not contagious.
Infiltrative Basal Cell Carcinoma Treatment
Due to the visually challenging element of this kind of skin cancer, the most recommended infiltrative basal cell carcinoma treatment method is Mohs surgery. This surgical procedure aims to remove unhealthy cells from the skin by cutting them out with a scalpel, allowing the healthy tissue to heal around the area. Depending on the patients circumstances, other non-melanoma skin cancer treatments include topical creams, chemotherapy, and IG-SRT, a radiotherapy treatment that helps avoid surgery but with similar results.
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Feline Oral Squamous Cell Carcinoma Fact Sheet
Oral squamous cell carcinoma is a nasty disease in cats. Frequently, these tumours are not identified until the lesion has progressed significantly with associated oral pain and halitosis due to bacterial infection.
What is oral squamous cell carcinoma?
Oral squamous cell carcinoma is a cancer that arises from the cells that produce the lining of the mouth and throat including the gums, tongue, cheeks and tonsils. This cancer has an ability to grow invasively into the surrounding tissues and the visible part of the tumour is all too often just the proverbial tip of the iceberg.
The average age for diagnosis of this disease is 11-12 years, although it has been described in cats from 2-18 years old. Presenting complaints commonly include facial deformity, loose teeth, weight loss and halitosis. Other, more subtle signs include oral pain and dribbling. Picture 1 shows an oral lesion from a patient whose only presenting complaint was a slightly reduced appetite.
Right: Oral eosinophilic granuloma in a cats mouth. An important differential diagnosis for feline oral squamous cell carcinoma.
Other conditions can affect the oral cavity that might resemble squamous cell carcinoma, such as eosinophilic granuloma complex, see picture 2. There are of course countless other causes of oral inflammation that must also be discounted.
Right: An invasive feline oral squamous cell carcinoma .
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