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.
How Is Squamous Cell Cancer Diagnosed
Your doctor will first perform a physical exam and inspect any abnormal areas for signs of SCC. Theyll also ask you about your medical history. If SCC is suspected, your doctor may decide to take a biopsy to confirm the diagnosis.
A biopsy usually involves removing a very small portion of the affected skin. The skin sample is then sent to a laboratory for testing.
In some cases, your doctor may need to remove a larger part or all of the abnormal growth for testing. Talk to your doctor about any potential scarring or biopsy concerns.
Treatment for SCC varies. Treatment is based on:
- the extent and severity of your cancer
- your age
- your overall health
- the location of the cancer
If SCC is caught early, the condition can usually be successfully treated. It becomes harder to cure once it has spread. Many treatments can be performed as in-office procedures.
Some doctors may also use photodynamic therapy, laser surgery, and topical medications to treat SCC. However, the Food and Drug Administration hasnt approved these methods for treating SCC:
Once SCC has been treated, its critical to attend all follow-up visits with your doctor. SCC can return, and its important to monitor your skin for any precancerous or cancerous areas at least once per month.
Ways To Protect Your Skin
- Avoid outdoor activities when the sun is strongest between 10am and 4pm from September to April in New Zealand.
- Wear sunscreen and lip balm daily that offer SPF 30 or higher sun protection.
- Use sunscreen that offers broad-spectrum protection and is water resistant.
- Apply the sunscreen and lip balm to dry skin 15 minutes before going outdoors.
- Apply the sunscreen to every part of your body that will not be covered by clothing. Reapply it every 2 hours if you are swimming or sweating.
- Whenever possible, wear a wide-brimmed hat, long sleeves and long pants.
- Wear sunglasses to protect the skin around your eyes.
- Avoid getting a tan and never use a tanning bed or sun lamp.
Skin cancer information The Skin Cancer Foundation, US, 2015
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Formation Progression Cell Of Origin
HNSCC originates from mucosal epithelial cells that line the oral cavity, pharynx, larynx and sinonasal tract. Histologically, progression to invasive HNSCC follows an ordered series of steps beginning with epithelial cell hyperplasia, followed by dysplasia , carcinoma in situ and, ultimately, invasive carcinoma . However, of note, most patients diagnosed with HNSCC do not have a history of an antecedent premalignant lesion. Given the heterogeneous nature of HNSCC, the cell of origin depends on anatomical location and aetiological agent . However, in each case, normal adult stem or progenitor cells are likely candidates for the cell of origin, giving rise, following oncogenic transformation, to cancer stem cells with properties of self-renewal and pluripotency. HNSCC CSCs with the capacity to generate tumours in transplantation assays constitute only a minor fraction of the cells in primary tumours but, despite their inherent resistance to conventional drugs, represent attractive targets for novel targeting agents.
Progression of HNSCC and key genetic events.
Growth Factor Receptor Antagonists
EGFR
EGFR is a member of the ERBB family of trans-membrane tyrosine kinase receptors . EGFR and their receptors are involved in signal transduction and tumor growth, thus blockade of these systems provides a therapeutic approach, through neutralizing ligands, inhibiting ligand binding, or blocking the tyrosine kinases of the receptors. Examples of EGFR inhibitors include monoclonal antibodies against the extracellular domain of the receptor and receptor tyrosine kinase inhibitors that target the intracellular domain . EGFR inhibitors have been applied in HNSCC, ESCC and extensively in NSCLC clinical trials. In HNSCC, patients with locally advanced disease have been shown to benefit from the addition of EGFR inhibition to radiotherapy . But, EGFR targeted therapy trials conducted in HNSCC to date still show various disadvantages such as low efficacy and significant toxicity . In ESCC, inhibition of EGFR-TK by erlotinib is promising through inducing growth inhibition and cell cycle arrest in human esophageal cancer cells and enhancing the antineoplastic effects of other targeted agents . Cetuximab and panitumumab are currently being investigated in NSCLC. Phase II trials showed that cetuximab improved survival in-chemo-naïve patients with advanced cancer and panitumumab is currently in phase II trial .
Other growth factor receptor antagonists
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Citation Doi And Article Data
Citation:DOI:Assoc Prof Frank GaillardRevisions:see full revision historySystems:
- Squamous cell carcinoma of lung
- Squamous cell carcinoma
- Squamous cell carcinoma of lungs
- Squamous cell carcinoma of the lungs
- Squamous cell lung cancer
- Squamous cell lung carcinoma
Squamous cell carcinoma is one of the non-small cell carcinomas of the lung, second only to adenocarcinoma of the lung as the most commonly encountered lung cancer.
Squamous Cell Carcinoma Causes
Exposure to ultraviolet rays, like the ones from the sun or a tanning bed, affects the cells in the middle and outer layers of your skin and can cause them to make too many cells and not die off as they should. This can lead to out-of-control growth of these cells, which can lead to squamous cell carcinoma.
Other things can contribute to this kind of overgrowth, too, like conditions that affect your immune system.
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What Do Squamous Cell Carcinomas Look Like
Squamous cell carcinomas often appear as a raised, crusty, non-healing sore.
They may also appear as a:
- flat sore with or without a scaly crust
- new sore or raised area on an existing scar or ulcer
- rough, scaly patch on your lip that may evolve to an open sore
- red sore or rough patch inside your mouth
- red, raised patch or wart-like sore on or in your anus or on your genitals.
How Is Squamous Cell Carcinoma Of The Skin Diagnosed
Your doctor will ask questions about your health history and examine your skin to look for signs of squamous cell carcinoma of the skin. Removing a sample of tissue for testing. To confirm a squamous cell carcinoma of the skin diagnosis, your doctor will use a tool to cut away some or all of the suspicious skin lesion .
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How Are Squamous Cell Carcinomas Treated
Treatment of squamous cell carcinoma depends on its type, size and location and other factors, such as your preference.
Options include:
- surgical removal of the cancer
- freezing it with liquid nitrogen
- topical therapies
- radiotherapy
If you have a squamous cell carcinoma, talk with your doctor about which treatment option is best for you. Treatment has a high success rate, provided the skin cancer is found at an early stage. Your doctor may want to schedule a future appointment to check for new lesions.
Read more about skin cancer treatment.
What Is Squamous Cell Carcinoma Lung Cancer
Squamous cell carcinoma of the lung, also known as epidermoid carcinoma, is a cancer that originates from the squamous cells. These are thin, flat cells that line the airways, much like the lining of a pipe. They provide a barrier between the air in the lungs and the lungs themselves. Squamous cell lung cancer develops when these cells become damaged, or abnormal, and begin to multiply. The majority of cases of squamous cell carcinoma start in the center of the lung compared to other parts of the respiratory system.
Squamous cell lung cancer is a subtype of non-small cell lung cancer , along with adenocarcinoma and large cell carcinoma. Squamous cell carcinomas make up 25 30% of all lung cancers, and are the most common lung cancers found in smokers. Conversely, it is very uncommon to find squamous cell carcinomas in non-smokers.
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When To Seek Medical Care
If you have developed a new bump on sun-exposed skin, or if you have a spot that bleeds easily or does not seem to be healing, then you should make an appointment with your primary care physician or with a dermatologist. You should also make an appointment if an existing spot changes size, shape, color, or texture, or if it starts to itch, bleed, or become tender.Try to remember to tell your doctor when you first noticed the lesion and what symptoms, if any, it may have . Also be sure to ask your parents, siblings, and adult children whether or not they have ever been diagnosed with skin cancer, and relay this information to your physician.
Stages Of Squamous Cell Carcinoma
- Stage 0: the cancer is found only in the top lining of the lung and has not spread outside the lung
- Stage I : the cancer has not spread to the lymph nodes or other parts of the body. The difference between each sub-stage is based on the size of the tumor and whether it has spread to the lung lining
- Stage II : the cancer is larger than Stage I and has begun to spread to nearby lymph nodes or tissues, but not to distant organs. The difference between each sub-stage is based on the size of the tumor, its location, and whether it has spread to the lymph nodes or not
- Stage III : the cancer may be difficult to remove via surgery. The difference between each sub-stage is based on the size of the tumor, its location, and how much it has spread
- Stage IV: the cancer has spread to other areas of the body outside the lungs
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Changes In Existing Spots
Warts and moles are rarely cause to worry. Though they may cause some irritation, most warts and moles are completely harmless. Because squamous cell carcinoma sometimes develops in existing skin lesions, its important to monitor moles, warts, or skin lesions for changes. Any observable change should raise a red flag and warrant a trip to the doctor for further examination.
The prognosis for SCC depends on a few factors, including:
- how advanced the cancer was when it was detected
- the location of the cancer on the body
- whether the cancer has spread to other areas of the body
The sooner SCC is diagnosed, the better. Once found, treatment can begin quickly, which makes a cure more likely. Its important to treat precancerous lesions, like Bowens disease or actinic keratosis, early before they develop into cancer. See your doctor right away if you notice any new or unusual skin lesions.
Make regular appointments with your doctor for a skin check. Perform a self-examination once every month. Ask a partner or use a mirror to check places you cant see, like your back or the top of your head.
This is especially important for higher risk individuals, such as those with light skin, blond hair, and light-colored eyes. Anyone who spends prolonged time in the sun unprotected is also at risk.
Questions To Ask Your Doctor
- I spent a lot of time in the sun as a child. Am I at higher risk of developing skin cancer?
- One of my parents had skin cancer. Am I more likely to get it?
- What should I look for when I do a self-examination of my skin?
- I have darker skin. Can I still get skin cancer?
- What can I do to protect my child from the sun?
- Is there anything I can do to keep the cancer from coming back after treatment?
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Exam By A Health Care Professional
Some doctors and other health care professionals do skin exams as part of routine health check-ups.
Having regular skin exams is especially important for people who are at high risk of skin cancer, such as people with a weakened immune system or people with conditions such as basal cell nevus syndrome or xeroderma pigmentosum . Talk to your doctor about how often you should have your skin examined.
How Is Squamous Cell Carcinoma Diagnosed
The first step in diagnosing squamous cell carcinoma is regular self-examination. By checking your skin and skin spots regularly, you become familiar with what is normal for you. Then, if you see something abnormal, you can see your doctor.
Your doctor will examine your skin. He or she will look at the size, shape, color, and texture of any concerning areas. If you have changes that could be skin cancer, your doctor will remove a piece of the affected skin. This is called a biopsy. The piece of skin will be sent to a lab for testing.
If skin cancer is diagnosed, you may need to undergo more tests to see if the cancer cells have spread. These tests could include a CT scan, MRI, or lymph node biopsy.
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What Are The Different Types Of Skin Cancer
Your skin has multiple layers. The outer, protective layer of the skin is known as the epidermis. The epidermis is made up of squamous cells, basal cells, and melanocytes. These cells are constantly shedding to make way for fresh, new skin cells.
However, when certain genetic changes occur in the DNA of any of these cells, skin cancer can occur. The main types of skin cancer are squamous cell carcinoma, basal cell carcinoma, and malignant melanoma.
Who Is Most At Risk Of Developing A Squamous Cell Carcinoma
You are at highest risk of developing a squamous cell carcinoma if you:
- are older
- have pale skin and burn easily
- have spent a lot of time outdoors for work or leisure
- have a history of sunburns, sunbathing or using sun beds
- live in a sunny climate
- have previously had a squamous cell carcinoma or other type of skin cancer
- have a condition or take medications that affect your immune system .
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What Causes Squamous Cell Cancer
Skin cancer is caused by mutations that occur in skin cell DNA. These changes cause abnormal cells to multiply out of control. When this occurs in the squamous cells, the condition is known as SCC.
UV radiation is the most common cause of the DNA mutations that lead to skin cancer. UV radiation is found in sunlight as well as in tanning lamps and beds.
While frequent exposure to UV radiation greatly increases your risk of skin cancer, the condition can also develop in people who dont spend much time in the sun or in tanning beds.
These people may be genetically predisposed to skin cancer, or they may have weakened immune systems that increase their likelihood of getting skin cancer.
Those who have received radiation treatment may also be at greater risk of skin cancer.
Risk factors for SCC include:
- having fair skin
- having light-colored hair and blue, green, or gray eyes
- having long-term exposure to UV radiation
- living in sunny regions or at a high altitude
- having a history of multiple severe sunburns, especially if they occurred early in life
- having a history of being exposed to chemicals, such as arsenic
Squamous Cell Carcinoma Of The Cervix
What is squamous cell carcinoma?
Squamous cell carcinoma is a type of cervical cancer. The tumour starts from the squamous cells on the surface of the cervix. Most tumours arise from a pre-cancerous disease called high grade squamous intraepithelial lesion .
The cervix
The cervix is part of the female genital tract. It is found at the bottom of the uterus where it forms an opening into the endometrial cavity. The cervix is lined by specialized cells called squamous cells that form a barrier on the surface of the cervix called an epithelium. The tissue below the epithelium is called the stroma.
What causes squamous cell carcinoma?
Almost all cases of squamous cell carcinoma and HSIL in the cervix are a result of the normal squamous cells in the cervix becoming infected with a high-risk type of virus called human papillomavirus . Pathologists often indirectly look for HPV by performing a test called immunohistochemistry for a protein called p16. Cells infected with HPV will be positive for p16.
How do pathologists make this diagnosis?
The diagnosis of squamous cell carcinoma is usually made after a small sample of tissue is removed from the cervix during a Pap test. The diagnosis can also be made after a larger sample of tissue is removed in a biopsy or resection.
What to look for in your report after the tumour has been removed
Tumour size
Extent of disease
Tumour extension
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