What is squamous cell carcinoma?
Squamous cell carcinoma is a type of skin cancer that begins in the squamous cells, which are flat cells found in the outer layer of skin. Squamous cell carcinoma is the second most common type of skin cancer after basal cell carcinoma. It can occur anywhere on the body but is most often found on areas exposed to the sun, such as the face, ears, neck, lips, and backs of the hands.
Squamous cell carcinoma usually appears as a scaly red patch or an open sore that doesn’t heal. It may bleed easily and crust or scab over. As it grows, it can become disfiguring or life-threatening if not treated. Squamous cell carcinoma has a higher risk of spreading to other parts of the body than basal cell carcinoma.
What causes squamous cell carcinoma?
Squamous cell carcinoma is mainly caused by long-term sun exposure. Other risk factors include:
– Fair skin – People with less melanin have less natural protection against UV radiation.
– Older age – Most cases occur in those over 50.
– Male gender
– Weakened immune system – Organ transplant recipients or people with HIV/AIDS are at higher risk.
– HPV infection – Certain strains of human papillomavirus.
– Radiation exposure – People treated with radiation therapy are susceptible.
– Chemical exposure – Arsenic exposure increases risk.
– Chronic inflammatory skin conditions – Long-term skin inflammation or injury can lead to DNA damage.
– Smoking – Chemicals from smoking make squamous cell carcinoma more likely.
– Tanning beds – UV rays from indoor tanning damage skin and boost chances of skin cancer.
Actinic keratoses, precancerous skin lesions caused by sun exposure, may develop into squamous cell carcinoma in some cases. Squamous cell carcinoma in situ refers to cancer located only in the epidermis, the outermost layer of skin. Invasive squamous cell carcinoma means the cancer has spread to deeper layers of the skin.
What are the symptoms of squamous cell carcinoma?
Signs and symptoms of squamous cell carcinoma include:
– A firm, red nodule or bump on the skin that may bleed easily
– A flat, scaly patch that is crusty or bleeds
– An open sore that persists for weeks and does not heal
– A wart-like growth that crusts and occasionally bleeds
– A raised growth with a rough surface and irregular borders
– A white, yellow or waxy scar-like area
– Tenderness or pain in a bump that was not previously sore
– A small lump that feels itchy or irritated
– A sore with raised edges
– Mouth lesions or ulcers that persist for over 2 weeks
– A red or white patch in the mouth that does not go away
– Difficulty swallowing or chewing
Squamous cell carcinomas often look like scaly red patches, open sores, elevated growths with a rough surface, or warts. They may crust or bleed. Symptoms can vary from person to person. See your doctor for any new skin growths, sores, bumps or patches that do not go away within 2 weeks. Also get any nonhealing mouth sores or unusual oral lesions examined. Catching squamous cell carcinoma early offers the best chance for a cure.
How is squamous cell carcinoma diagnosed?
To diagnose squamous cell carcinoma, a doctor will first perform a physical exam, inspecting all skin to look for abnormalities. They will closely examine any suspicious areas by looking at their characteristics, feeling for thickness and firmness, and testing sensitivity to touch.
The doctor may also take a small sample of tissue from the concerning spot in a procedure called a biopsy. The sample is sent to a lab, where a pathologist will examine the cells under a microscope to determine if they are cancerous.
Additional tests may include:
Imaging tests:
– An X-ray uses small amounts of radiation to create detailed images inside the body. It can detect cancer spread to tissues and bones.
– A CT scan combines multiple X-ray images taken from different angles to show cross-sectional views of internal organs. It visualizes cancer in the lymph nodes, lungs and other areas.
– An MRI scan uses magnetic fields to produce detailed images of the body’s organs and structures. It can determine how far cancer has progressed.
– A PET scan involves injecting a radioactive substance that accumulates in cancer cells. A scanner detects that signal to identify malignant areas. It can reveal metastasis.
– Ultrasound uses sound waves to examine internal tissues. It can aid in needle biopsies.
Lab tests:
– Blood tests check blood cell counts and blood chemistry. They can point to cancer markers in the blood or issues like low blood counts.
– A sentinel lymph node biopsy detects cancer spread to lymph nodes. Dye is injected at the tumor site, then the first lymph nodes to receive drainage are removed and analyzed.
The stage of cancer is determined based on the tumor size, location, whether it has spread to lymph nodes or organs, and other factors from test results. Early diagnosis leads to better outcomes.
What are the stages of squamous cell carcinoma?
Squamous cell carcinoma is staged from 0 to 4 based on how far the cancer has spread within the skin and to other parts of the body:
Stage 0
This stage is also called carcinoma in situ. Cancer cells remain only in the epidermis, the outer layer of skin, without invading deeper layers.
Stage 1
The tumor is 2 centimeters across or smaller, about 4/5 of an inch. It has not reached nearby lymph nodes or organs.
Stage 2
The tumor is larger than 2 centimeters but smaller than 4 centimeters. It has not spread to nearby lymph nodes or organs.
Stage 3
The cancerous tumor is 6 centimeters across or smaller but has spread to facial bones or one lymph node on the same side as the cancer. It has not metastasized to distant parts of the body.
Stage 4
The tumor has invaded other organs, such as the muscle, bone, soft tissue, or blood vessels underneath the skin. Or the cancer has spread to multiple lymph nodes or other organs like the lungs, liver or brain. Stage 4 means distant metastasis.
Higher stages indicate more advanced progression of the disease. Staging helps determine the outlook and most suitable treatment options.
How is squamous cell carcinoma treated?
Treatment options for squamous cell carcinoma include:
Surgery
The cancerous tumor and surrounding margin of skin is surgically removed. This may leave a scar. Mohs surgery involves progressively removing thin layers of skin and examining them under a microscope until no cancer cells remain. It aims to remove all cancer while preserving healthy tissue.
Radiation Therapy
High energy x-rays are used to kill cancer cells and shrink tumors. Traditional external beam radiation aims radiation from outside the body. Brachytherapy places radioactive seeds inside the tumor.
Chemotherapy
Drugs are administered orally or intravenously to kill cancer cells. Topical chemotherapy applies drugs directly on the skin. Chemotherapy may be combined with radiation.
Photodynamic Therapy
A light-sensitizing medication is applied to cancer spots, then activated by a special light source to destroy cancer cells.
Immunotherapy
Medications boost the immune system to better detect and destroy cancer cells. Some examples are interferons, imiquimod, or checkpoint inhibitors.
Targeted Drug Therapy
Newer drugs that specifically target cancer cell mechanisms help limit damage to healthy cells. Some target EGFR, a protein causing cancer growth.
The stage, size and location of the tumor determine which treatments are recommended by your care team. Early stage cancers can often be treated with surgery alone. More advanced stages may require a combination of surgery, radiation, chemotherapy or other systemic drugs.
What is the prognosis and outlook for squamous cell carcinoma?
The prognosis for squamous cell carcinoma depends on various factors:
Stage of cancer
If detected early, the 5-year survival rate is over 95%. For later stage 4 disease that has spread, the 5-year survival rate drops to around 39%.
Location of tumor
Tumors on the lips, ears or other sun-exposed areas have a better prognosis than cancers arising in the mouth, genitals or anus.
Tumor depth
Deeper tumors invading fat, muscles or cartilage have a poorer outlook than those contained within the skin’s outer layers.
Regional lymph node involvement
Spread to nearby lymph nodes reduces survival rates compared to cancers that have not metastasized.
Distance of spread
If cancer spreads to distant organs like the lungs, survival rates are lower than if contained locally.
Recurrence
There is a risk of squamous cell carcinoma recurring after treatment, either locally or elsewhere. Recurrent cancer lowers chances for a cure.
Overall health
Age, immune function and other existing medical problems can also impact prognosis.
With early detection and prompt treatment, many cases of squamous cell carcinoma can be cured. Talk to your doctor about your specific situation for a more personalized outlook. Maintaining vigilance for new lesions after treatment is important.
Can squamous cell carcinoma be prevented?
While not always possible to prevent, these measures may help lower your risk of developing squamous cell carcinoma:
– Limit sun exposure by wearing sunscreen, hats, sunglasses and protective clothing outside. Seek shade during peak hours.
– Never use tanning beds or sun lamps.
– Examine skin regularly for new or changing moles or lesions.
– Avoid tanning or burning.
– Treat precancerous actinic keratoses promptly.
– Quit smoking and avoid secondhand smoke.
– Get HPV and Hepatitis B vaccines.
– Avoid UV light therapy for skin conditions like eczema or psoriasis.
– Wear SPF lip balm for sun protection.
– Eat a healthy diet with antioxidants like vitamin C and E.
– Get any sores, ulcers or oral lesions evaluated quickly.
– Limit alcohol which can increase risk.
– Practice safe sex and avoid multiple partners if high risk HPV positive.
While sun avoidance and sunscreen use provide the best protection, it’s still important to monitor skin for any unusual changes. Seek medical attention promptly for nonhealing or growing lesions. Early detection and treatment provides the highest cure rates for squamous cell carcinoma.
What are the risks or complications from squamous cell carcinoma?
Potential risks and complications of squamous cell carcinoma include:
– Recurrence after treatment, either locally or elsewhere on the body
– Metastasis or spread to nearby lymph nodes, distant lymph nodes or organs like the lungs, liver, bones or brain. This greatly impacts survival.
– Invasion into cartilage, bone, nerves or blood vessels. Deep penetration reduces outlook.
– Disfigurement or scarring from surgical removal of the tumor
– Required removal of all or part of an organ if cancer spreads
– Grafting or reconstructive surgery if large portions of skin need removal
– Chronic pain or numbness from nerve damage
– Difficulty eating or swallowing if mouth or throat cancer impacts muscles
– Bleeding, infections and slow wound healing after procedures
– Low red blood cell, white blood cell or platelet counts after chemotherapy or radiation
– Nausea, vomiting, appetite changes, fatigue and hair loss during systemic treatments
– Skin reactions like redness, rashes, itching or peeling during radiation or photodynamic therapy
– Immunosuppression, kidney problems or other side effects from anti-cancer drugs
Ongoing screening and monitoring are important even after treatment to quickly address any recurrence. Let your care team know if you experience worrisome symptoms in between follow up visits. Promptly treating complications improves quality of life.
What should I know about living with squamous cell carcinoma?
Living with squamous cell carcinoma, its treatment and aftermath involves making adjustments to care for your health:
– Attend all treatment sessions and follow your care team’s recommendations closely
– Tell your doctor about any side effects or symptoms you experience
– Have regular follow up exams to check for recurrence as advised
– Examine skin and lymph nodes yourself periodically for new growths or changes
– Use high SPF sunscreen daily and protective clothing outside
– Continue cancer-fighting lifestyle choices like not smoking, eating well, exercising
– Manage stress with meditation, therapy, journaling or support groups
– Join a support community to connect with others facing similar challenges
– Ask loved ones for practical help with meals, errands, transportation or childcare
– Allow yourself time to rest and heal both during and after treatment
– Receive recommended vaccines on schedule, especially flu and COVID vaccines
– Monitor for issues like infection and get medical care quickly when concerned
– Speak up about cancer-related work accommodations if needed
– Seek help from mental health resources if feeling anxious or depressed
– Explore reconstructive options if you are self-conscious about changes to appearance
– Communicate openly with loved ones about your needs and feelings
Living with squamous cell carcinoma can be challenging. Be proactive about your care and don’t hesitate to enlist help. Connecting with others and focusing self-care promotes quality of life on the cancer journey.
What are the latest advancements in squamous cell carcinoma treatment?
Exciting innovations are on the horizon for squamous cell carcinoma care, including:
Improved early detection
New imaging devices using electrical impedance technology or multiphoton microscopy can better visualize precancerous skin changes, allowing earlier diagnosis and treatment.
Advanced surgical techniques
Robotic surgery and innovations like fluorescence-guided imaging help surgeons better distinguish cancerous from normal tissue for more precise, scar-free tumor removal.
Targeted therapy
Novel drugs that specifically exploit mechanisms in squamous skin cancer cells show promise alone or combined with immunotherapy.
Immunotherapy advances
Check point inhibitors and combination treatments boost the immune response against cancer for better outcomes.
Nanotherapy
Tiny customized nanoparticles deliver chemotherapy drugs right to tumor sites while reducing side effects. Similar designs also enhance radiation therapy effectiveness.
Photodynamic therapy upgrades
Newer light sensitizing agents and light delivery methods enhance precision in eradicating cancer cells with this low-impact approach.
Supportive care improvements
Better medications help manage treatment side effects like pain, nausea and skin irritation for improved quality of life. Virtual reality also lessens discomfort.
Researchers are constantly working to develop less invasive, targeted treatments, improve early detection, reduce recurrence, and boost survival rates through innovative solutions. The future is bright when it comes to advancing care for squamous cell carcinoma.
Conclusion
Squamous cell carcinoma is a common skin cancer with a good prognosis when detected early. It appears as scaly patches, warts, sores or tumors on sun-exposed areas and can become invasive if not treated promptly. Advanced cases may spread to lymph nodes or organs, requiring systemic therapies and reducing outlook. Preventing squamous cell carcinoma starts with sun protection and self-exams. Avoiding tanning and smoking also helps lower risk. Treatments like surgery, radiation and chemotherapy have high success rates, especially for early stage disease. Patients should monitor skin and lymph nodes for recurrence and discuss any questionable lumps, sores or growths with their doctor right away. Exciting advances hold promise for improving squamous cell carcinoma screening, treatments, side effect management and outcomes. With proper care and vigilance, most people have an excellent chance of cure and long-term survival.