Squamous Cell Carcinoma

Alternative names :- Cancer - skin - squamous cell; Skin cancer - squamous cell

Squamous cell carcinoma (SCC) of the skin is an invasive tumor that arises from keratinizing epidermal cells and has a high metastatic potential to distant parts of the body. It's the second most common skin cancer, the third most common cancer in men, and the fourth most common cancer in women. It usually occurs in fair-skinned white males over age 60. Outdoor employment and residence in a sunny, warm climate (southwestern United States and Australia, for example) greatly increase the lisk of developing sec. However, the incidence of see affecting the skin and oral cavities in women is rising as more women are frequenting tanning salons, drinking alcoho. and smoking.

Patients with fair skin and a history of sun exposure (e.g., sunburn) are at increases risk for SCC, as well as other forms of skin cancer. These people lack pigmentation, which protects the skin from damaging ultraviolet rays.

What causes Squamous cell carcinoma ?

Predisposing factors associated with see include overexposure to the sun's ultraviolet rays, the presence of premalignant lesions (such as actinic keratosis or Bowen's disease), X-ray therapy, ingestion of herbicides containing arsenic, chronic skin irritation and inflammation, exposure to local carcinogens (such as tar and oil), and hereditary diseases (such as xeroderma pigmentosum and albinism). Women who use tanning lamps and tanning beds were also found to be at increased risk for see - 2 % times the risk of women who didn't use them. Smoking has recently been linked to skin cancer and may increase the risk of developing skin cancer threefold, independent of age, gender, sun exposure, and other predisposing factors
that are listed above. Rarely, see may develop on the site of smallpox vaccination, psoriasis, or chronic discoid lupus erythematosus.

Signs and symptoms of Squamous cell carcinoma

SCC begins in the upper part of the epidermis and commo;l1ly develops on sun-exposed areas of the body, such as the face, ears, dorsa of -the hands and forearms, and other SU$1-damaged areas. Lesions on sun-daOlaged skin tend to be less invasive and .ess likely tometastasize than lesioos on unexposed skin. Squamous cell lesions may also begin within scars and skin ulcers that aren't neces:sariIy in sunexposed areas. Notable ,.exceptions to this tendency are squamous cell lesions on the lower lip and the ears. These are almost invariably markedly invasive metastatic lesions with a generally poor prognosis.

Transformation from a premalignant lesion to see may begin with induration and inflammation of the preexisting lesion. When see arises from normal skin, the nodule grows slowly on a firm, indurated base. If untreated, this nodule eventually ulcerates and invades underlying tissues. Metastasis can occur to the regional lymphnodes, producing characteristic systemic symptoms of pain, malaise, fatigue, weakness, and anorexia.

Diagnosis information

An excisional biopsy provides definitive diagnosis of squamous cell carcinoma. Other appropriate laboratory tests depend on systemic

Treatment of Squamous cell carcinoma

The size, shape, location! and invasiveness of a squamous cell tumor and the condition of the underlying tissue determine the treatment method used; a deeply invasive tumor may require a combination of techniques. All major treatment methods have excellent cure rates. In general, the prognosis is better with a well-differentiated lesion than with a poorly differentiated one in an unusual location. Depending on the lesion, treatment may consist of:

• wide surgical excision
• electrodesiccation and curettage (offers good cosmetic results for small lesions)
• cryosurgery (not for large invasive tumors or those tumors on certain parts of the body, such as the nose, eyes, ears, head, or legs)
• Mohs surgery (has the highest cure rate for tumors greater than 2 em, recurring tumors, or certain cancers found along the nerves under the skin, face, or genital areas)
• radiation therapy (generally for older or debilitated patients and for those areas where surgery is difficult, such as the eyes, ears, nose, and throat)
• lymph node removal (for very large and deeply invasive tumors)
• chemosurgery (reserved for resistant or recurrent lesions)
• systemic chemotherapy (when the cancer has spread to lymph nodes or distant organs).

Special considerations and Prevention

The care plan for patients with SCC should emphasize meticulous wOund care, emotional support, and thorough patient instruction:

• Coordinate a consistent plan of care for changing the patient's dressings. Establishing a standard routine helps the patient and family learn how to care for the wound.
• Keep the wound dry and clean.
• Try to control odor with balsam of Peru, yogurt flakes, oll of cloves, or other odor masking substances, although they're commonly ineffective for long-term use. Topical or systemic antibiotics also temporarily control odor and eventually alter the lesion's bacterial flora.
• Minimize sun exposure. Protect skin from the sun by wearing protective clothing such as hats, long-sleeved shirts, long skirts or pants.
• Be prepared for other problems that accompany a metastatic disease (pain, fatigue, weakness, anorexia).
• Arrange for a complete skin examination from time to time.
• Apply the sunscreen at least a half hour before exposure and re-apply frequently. Use a sunscreen throughout the year, even for winter sun exposure.
• Help the patient and family set realistic goals and expectations.
• Disfiguring lesions are distressing to both the patient and you. Try to accept the patient as she is to increase her self-esteem and strengthen a caring relationship.