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Squamous Cell Carcinoma: Information on Causes, Diagnosis & Treatments

Skin Development Skin Cancer Squamous cell carcinoma (SCC) is the result of an uncontrolled growth of skin cancer (abnormal cells) that developed as promised cells in the outer (upper) and middle layers of the skin. While typically not life-threatening, squamous cell carcinoma of the skin can be aggressive. If left untreated, the cells can grow large and spread (travel) to other areas of the body and cause serious complications.

These types of cells are found in many locations on the body, meaning the carcinoma can occur in any area where squamous cells grow. The condition often appears as an open sore, scaly red patch, wort, or elevated growth that has a central depression. Often, the area can bleed or crust over and can cause a disfiguring appearance if allowed to progress.

The condition is thought to occur when thin, flat squama cells develop a mistake in their DNA. Typically, before an old cell dies often sloughs away from the body, it will reproduce and create new cells. However, when a mistake in the DNA or abnormality in cell formation disrupts the common pattern, the cells begin to grow uncontrollably by continuously reproducing, causing squama cell carcinoma to develop on the middle and outer layers of the skin.

Who Is at Risk for Squamous Cell Carcinoma?

According to statistics maintained by the CDC (Centers for Disease Control and Prevention), more than a million individuals in the United States are diagnosed with squama cell carcinoma every year. Out of that, nearly 9000 individuals will die from the disease. Over the last three decades, the numbers of cases involving squama cell carcinoma have risen more than 200 percent.

While anyone can develop squamous cell carcinoma, there are specific risk factors that tend to increase the potential risk of developing the condition. Some of these risk factors include:

  • Fair Skin – Individuals with fair skin, gray, green, or blue eyes, and light hair tend to be at the highest risk for developing squamous cell carcinoma.

  • Sun Exposure – People that have had extensive exposure to the sun's rays are also at an increased risk of developing the disease.

  • Some Occupations – Any job, recreation, or leisure activity where the individual spends long hours outside in the sun, especially playing sports like golf or baseball jeopardizes the skin's integrity that could lead to squamous cell carcinoma.

  • Basal Cell Carcinoma – Anyone who has been diagnosed with basal cell carcinoma has a higher risk of developing squamous cell carcinoma.

  • Genetic Predisposition – People who have inherited ultraviolet light sensitivity including xeroderma pigmentosa are at risk for developing squama cell carcinoma.

  • Gender – Men are more likely to develop the disease compared to women, probably because many more men than women spend significant amounts of time in the sunshine.

  • Age – Individuals who are 50 years and older tend to develop the condition more than those who are younger than 50. However, the incident rate of individuals between the ages of 20 and 40 who develop the disease has risen significantly in recent years.

  • Skin inflammations and chronic infections also increase the risk of developing the disease.

  • Immunodeficiency Diseases – Diseases including HIV, antirejection medication taken by organ transplant patients, chemotherapy, and even excessive exposure to the sun can weaken the body's immune system and make it more challenging to fight off squamous cell carcinoma and other cancers of the skin.

  • Spontaneous Development – In rare cases, squamous cell carcinoma can spontaneously develop on healthy, normal skin. Medical science believes that this form of cancer is caused by an inherited genetic mutation.

Common Symptoms

There are specific areas of the body to tend to develop squamous cell carcinoma more than others. This includes any skin area that is regularly exposed to the sun, especially the scalp, lips, ears, and back of the hands. However, it can also develop in areas unseen by the sun including the genitals, anus, and inside the mouth.

The most common squamous cell carcinoma symptoms include:

  • Scaly, crusty, flat sore

  • Red, firm, nodule

  • Rough patch or red sore inside the mouth

  • Raised ulcerated skin, old scar or new sore

  • Scaly, rough patch on the lip that could develop into a painful open sore

  • Wart-like raised patches of red skin appearing on the genitals or in the anus

Diagnosing Squamous Cell Carcinoma

Diagnosing squama cell carcinoma of the skin is easy with the numerous procedures and tests. The doctor will perform a comprehensive physical examination and asked questions about the patient's health history. A thorough examination of the skin by a competent dermatologist can detect the obvious signs of squamous cell carcinoma.

In addition to the physical examination of all areas of the skin on the body, the doctor will likely take a biopsy by removing a portion of tissue that can be examined and analyzed under a microscope. The biopsy requires a tool to cut away any suspicious looking area of skin that can be sent to the laboratory for a comprehensive examination.

When the doctor has verified a diagnosis of squamous cell carcinoma, they can develop an effective plan of care to ensure a successful outcome and avoid further progression of the cancerous disease.

Squamous Cell Carcinoma Treatments

Upon verification of the diagnosis of squama cell carcinoma of the skin, the easiest treatment of a small area is the complete removal of the affected site. This often requires a minor surgical procedure or a topical medication that destroys the cancerous cells. The type of treatment the doctor recommends will be based on the location, size, and aggressiveness of the damaged tissue as well as the patient's preferences. These treatments can include:

  • Electrodesiccation and Curettage – This treatment removes the cancerous skin surface using a curet (scraping instrument) followed by searing the area using an electric needle. Typically, this treatment is available only if the squamous cell cancer is localized in a very small area on the skin.

  • Laser Therapy – The doctor can use an intense beam of energy to vaporize the cancerous growth. This treatment usually results in minimal damage to the surrounding tissue and minimizes the potential risk of scarring, swelling, or bleeding. Lasers are highly effective for treating very superficial skin lesions.

  • Curettage and Cryotherapy – This procedure is similar to electrodesiccation and curettage except that liquid nitrogen is used to treat the biopsy site after the tumor has been removed using a scraping instrument.

  • Freezing – Liquid nitrogen can freeze cancer cells in a procedure known as cryosurgery that is highly effective at treating superficial skin lesions.

  • Photodynamic Therapy – The doctor can prescribe total sensitizing medications that react to light when treating superficial skin cancer. The liquid drug is applied to the skin, making cancer cells extremely sensitive to the light, which destroys the affected area.

  • Medicated Lotions and Creams – In cases involving superficial cancer, the doctor may recommend applying a lotion or cream that contains anti-cancer drugs. These lotions and creams are applied directly on the skin at the affected site.

If excising (cutting away), freezing, or using medicated creams on the skin are not available or effective, high-energy x-ray beams can be used to destroy cancer cells immediately.

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