SQUAMOUS CELL CARCINOMAS (SCC) of Skin
Squamous cell carcinoma (SCC) is the second most common skin cancer and approximately 250,000 new cases are diagnosed annually. Skin cancer along with basal cell carcinoma are collectively called nonmelanoma skin cancer.
This form of skin cancer occur most commonly in sun exposed areas of the body such as the head and neck, ears, hands, arms and legs. It is often associated with sun damaged skin, characterized by wrinkling, skin discoloration, and loss of elasticity.
Risk Factors for Squamous Cell Carcinoma:
Patients who are at high risk for developing a squamous cell skin cancer should perform self skin exams regularly. Risk factors include the following:
- Fair skin, light hair, and blue, green, or gray eyes
- History of increased cumulative sun exposure, including long hours outdoors or who spend extensive leisure time in the sun and indoor tanning
- History of basal cell carcinoma and/or pre-skin cancers called actinic keratosis.
- An inherited condition such as xeroderma pigmentosum, a highly UV light sensitive condition
- Weakened immune system
- History of radiation therapy.
- History of exposure to coal tar products or arsenic.
- The risk of developing squamous cell carcinomas increases with age because of accumulative sun exposure. They commonly arise at the ages of 50-70 years old and occur twice as frequently in men as in women.
Diagnosis and Treatment
Squamous cell carcinomas usually look like a red, crusted, or scaly patch on the skin, a non-healing ulcer, or a firm red nodule. Any suspicious skin growths should be evaluated by a physician. A tissue sample (skin biopsy) can be performed and will be examined under a microscope for skin cancer cells. Once a diagnosis of SCC has been determined, surgical and non-surgical treatment options are available. The type of treatment is dependent on location and size of the skin cancer, health of the patient, and other factors.
Squamous cell carcinomas detected at an early stage and treated promptly are almost always curable. However, left untreated, they can penetrate the deeper skin tissues and cause cosmetic disfigurement. A small percentage can metastasize (spread) to distant tissues and organs and become fatal.
Most treatment options are relatively minor, office-based procedures that require only local anesthesia.
Treatments include:
- Simple Surgical Excision
Remove the cancer and some of the surrounding healthy tissue. The removed specimen is examined under a microscope to determine if all of the skin cancer has been removed.
- Mohs Micrographic Surgery
Performed by a specially trained dermatologic surgeon, Mohs allows the surgeon to spare as much normal skin as possible while simultaneously removing the cancer.
- Electrodessication and Currettage
Remove the cancerous tumor by scraping (curetting) it off. The base of the tumor is burned (cauterized) with an electric needle (electrodesiccation).
- Cryosurgery
Remove the tumor by freezing it with liquid nitrogen.
- Radiation Therapy
Damages or kills the cancerous cells with high-energy x-rays, which also help to prevent continued growth.
- Topical Therapy
Medications such as imiquimod and 5-fluorouracil can be applied at home to treat the cancer.
Prevention
Sun protection is the primary form of skin cancer prevention. Guidelines and recommendations to optimize skin protection are as follows:
- Avoid outdoor activities during peak hours 10am – 4pm.
- If outside, try to take breaks from the sun by sitting under some shade with an umbrella. Protect children from sun exposure by playing in the shade.
- Wear sun protective clothing: wide-brimmed hat, long sleeve clothing. (www.sunprecautions.com.)
- Apply sun block every morning. Reapply throughout the day if you sweat or swim.
- The only safe tan comes out of a tube. Use make-up, self-tanning creams, or bronzers to get the tanned look.
Notes about sun block:
- Sunblock should provide both UVA and UVB protection with SPF of 15 or greater.
- Physical blocking agents provide broad spectrum of coverage. They include titanium dioxide and micronized zinc oxide.
References:
1. www.aad.org
2. www.skincancerfoundation.org
