Skin Cancer

Squamous Cell Carcinoma

 

 

What is squamous cell carcinoma?
Squamous cell carcinomas are tumors on the skin that result from prolonged exposure to UV radiation. Although they usually develop on sun-exposed skin, they can occur anywhere on your body. Slow growing and often difficult to spot, they typically come in the following forms:

• A firm, red swelling on your face, lower lip, ears, neck, hands or arms
• A flat lesion with a scaly crust on your face, ears, neck, hands or arms
• A new ulceration or raised area on a pre-existing scar or ulcer
• An ulcer or flat, white patch inside your mouth
• A red, raised patch or ulcerated sore in the anus or on your genitals

Causes
Squamous cell carcinomas form when cell death and renewal no longer occur as they should. New cells usually push older cells toward the skin's surface, and the older cells die and are rubbed off, but this pattern becomes disrupted when DNA gets damaged, causing cells to grow uncontrollably. Although sun exposure causes most cases of squamous cell carcinoma, other factors include:

• Therapeutic radiation. Psoralen UVA (PUVA) treatments for psoriasis and X-rays to the head or neck increase your risk of squamous cell carcinoma.
• Chemical toxins. Arsenic may cause squamous cell carcinoma and other cancers. Most people are exposed to arsenic through food, such as chicken, beef and fish, and in wine grapes.
• Human papilloma-virus (HPV). This group of viruses has more than 100 strains, about a third of which are sexually transmitted. Researchers believe certain types of HPV may also play a role in the development of squamous cell skin cancers.
• Immunosupressant drugs. Most people who take medications to prevent organ rejection after transplant surgery develop squamous cell carcinoma. Typically, the higher the dosage, the more risk of getting squamous cell carcinoma.

Risk factors
Frequent sun exposure or living in a sunny or high-altitude location increases your UV exposure. Other risk factors include fair skin that sunburns easily, a personal history of skin cancer, smoking, skin infections or injuries, weakened immune systems, and rare genetic disorders. Also, men are more likely to develop the tumors than women.

Prevention
To help prevent squamous cell carcinoma, avoid the midday sun, use sunscreen year-round, wear protective clothing such as hats and long pants, avoid tanning beds. be aware of sun-sensitizing medications. receive regular skin checks, get enough vitamin D, and eat more green vegetables.

Tests and diagnosis
The earlier diagnosed, the better. See your doctor if you have a sore or scab that doesn't heal after two weeks or a flat patch of scaly skin that won't go away. For diagnosis, after taking a complete medical history and checking the affected area of skin, your doctor may remove a small skin sample for examination by shaving off the top layers of skin with a surgical blade. Tumors that have spread deeper into the skin may be partially or completely removed.

Complications
Although rare, untreated tumors can spread to nearby lymph nodes or to other organs. Tumors on the lips and ears as well as large tumors, are more likely to spread to other sites or recur after treatment.

Treatments and drugs
Most squamous cell carcinomas can be removed with minor surgery. Treatment usually depends on the size, location and aggressiveness of the tumor. Some options include:

• Freezing the cancerous cells: may effective for small and early squamous cell carcinomas, but not recommended for larger tumors or those on your nose, ears or eyelids.
• Simple excision: cutting out the cancerous tissue and surrounding margin of healthy skin. The plastic flap is usually needed to close the wound after a large cancer is removed.
• Laser therapy: beam of light vaporizes growths, more expensive, not better than surgery.
• Mohs' surgery: removing the tumor layer by layer, examining each layer under the microscope until no abnormal cells remain, considered the most effective method
• Radiation therapy: option for treating large cancers on the eyelids, lips and ears, areas that are difficult to treat surgically, or tumors too deep to cut out
• Topical chemotherapy: for very superficial cancers, creams or lotions containing anti-cancer agents may be applied directly to your skin, but severe inflammation and scarring can occur