Squamous cell carcinoma is a common form of skin cancer that develops in the squamous cells that make up the middle and outer layers of the skin. For more information, you can read the article below.

What is squamous cell carcinoma?

Squamous cell carcinoma (spinal cell carcinoma) is a malignant tumor that grows locally destructively, but often does not metastasize (spread). Squamous cell carcinoma is the second most common skin cancer after basal cell carcinoma and is also called “white skin cancer”.

The most important reason for this formation is chronic UV exposure for years, especially in people who are sensitive to sunlight. This condition is preceded by actinic keratosis . Carcinoma manifests itself as increasingly rough patches on slightly contaminated skin, especially on the scalp and face.

Who is it seen in?

After basal cell carcinoma, squamous cell carcinoma is almost the second most common cancer worldwide. Men are affected more often than women, and the average age is around 70.

Since this cancer is often undetected, only estimates of the number of diseases are available. In Switzerland, for example, these are between 3,500 and 5,500 people newly diagnosed each year. Five out of a hundred affected people develop metastases (the spread of cancer).

What causes squamous cell carcinoma?

Squamous cell carcinomas most often develop from actinic keratoses. These skin changes are caused by strong UV radiation that repeatedly and permanently affects the skin. Damage to the skin is caused by sunlight, as can artificial UV rays from solariums.

Normally, the top layer of skin can protect itself quite well; it repairs the damage itself and corrects the skin changes. However, if the exposure to UV radiation is too high, the skin can no longer repair itself. Diseased skin cells first form actinic keratosis, and then squamous cell carcinoma develops.

In rare cases, it also develops from Bowen’s disease. Like actinic keratosis, this is manifested by increased cornification of the epidermis associated with flat, reddish and crusty bumps.

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Unlike keratosis, Bowen’s disease mainly occurs in areas with little or no sun exposure; It occurs on the face, fingers, body and lower legs. In every twenty affected individuals, Bowen’s disease develops as squamous cell carcinoma.

Who is at risk?

Factors that can increase your risk of squamous cell carcinoma include:

  • Fair skin: Anyone can get this type of carcinoma, regardless of skin color. However, having less pigment (melanin) in your skin provides less protection against harmful UV radiation.
  • Excessive sun exposure: Exposure to UV light from the sun increases your risk. Spending too much time in the sun (especially if you don’t cover your skin with clothing or sunscreen) further increases the risk of squamous cell carcinoma of the skin.
  • Use of tanning beds: People who use closed tanning beds have an increased risk of developing cancer of the skin.
  • History of sunburn: Having one or more blistering sunburns in childhood or youth increases your risk as an adult. Sunburn in adulthood is also a risk factor.
  • Personal history of precancerous skin lesions: Having a precancerous skin lesion such as actinic keratosis or Bowen’s disease increases the risk of developing carcinoma of the skin.
  • A personal history of skin cancer: If you have any previous history of skin cancer, you are more likely to develop it again.
  • Weak immune system: People with weakened immune systems have an increased risk of skin cancer. This includes people who have leukemia or lymphoma, and people who take immunosuppressant drugs, such as those who have had an organ transplant.
  • Rare genetic disorder: People with certain genetic disorders (such as albinism) that cause hypersensitivity to sunlight have a greatly increased risk of developing skin cancer.

What are the symptoms of squamous cell carcinoma?

Squamous cell carcinoma of the skin usually occurs on sun-exposed skin, such as the scalp, the tops of your hands, ears, or lips. But it can appear anywhere on your body, including the inside of your mouth, the soles of your feet, and your genitals.

Signs and symptoms of squamous cell carcinoma of the skin include:

  • A hard, red nodule
  • A scaly, crusty, and flat sore
  • A new wound or raised area over an old wound and ulcer
  • A rough, scaly patch on the lip that can turn into an open sore
  • A red sore or rough patch in your mouth
  • A red, raised patch or wart-like sore on your anus or genitals
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When should you see a doctor?

If there is a wound or scar that does not heal in about two months, or a flat scaly skin patch that does not go away, it is useful to see a doctor immediately.

How is squamous cell carcinoma diagnosed?

Tests and procedures used to diagnose squamous cell carcinoma of the skin include:

  • Physical exam: Your doctor will ask questions about your health history and will examine your skin to look for signs of skin carcinoma.
  • Biopsy: To confirm squamous cell carcinoma, your doctor will use a tool to excise some or all of the suspected skin lesion. What type of skin biopsy you do depends on your situation. The tissue is sent to a laboratory for examination.

How is squamous cell carcinoma treated?

Most scumous cell carcinomas of the skin can be completely removed with relatively minor surgery or sometimes with a medication applied to the skin. Which treatments are best for you depend on the size, location and aggressiveness of the tumor and your own preferences.

Treatments for minor skin cancers

If your skin cancer is very small and has a low risk of spreading, you may consider invasive treatments including:

  • Curettage and electrodication: This treatment involves removing the surface of the skin cancer with a scraping instrument (curette), and then rupturing the base of the cancer with an electric needle. This method is generally used for small or very superficial squamous cell carcinomas of the skin.
  • Laser therapy: An intense beam of light usually vaporizes the growth with little damage to the surrounding tissue and reducing the risk of bleeding, swelling, and scarring. Laser therapy may be an option for very superficial skin lesions.
  • Freezing: This treatment involves freezing the cancer cells with liquid nitrogen ( cryosurgery ). It may be an option for the treatment of superficial skin lesions. Freezing can be done after using a scraping tool (curette) to remove the surface of the skin cancer.
  • Photodynamic therapy: Photodynamic therapy combines photosensitive drugs and light to treat superficial skin cancers. During photodynamic therapy, a liquid drug that sensitizes cancer cells to light is applied to the skin. Then a light shines on the area, which destroys the skin cancer cells.

Treatments for major skin cancers

If the larger squamous cell carcinoma extends deeper into the skin, the following treatments may be recommended.

  • Simple excision: In this procedure, your doctor cuts out the cancerous tissue and the surrounding healthy skin margin. In some cases, your doctor may recommend removing the normal skin around the tumor.
  • Mohs surgery: During Mohs surgery, your doctor separates the cancer into layers by examining each layer under a microscope until no abnormal cells remain. This allows the surgeon to ensure that all growth is removed and to avoid excessive removal of the surrounding healthy skin.
  • Radiation therapy: Radiation therapy uses high-energy rays such as X-rays and protons to kill cancer cells. Radiation therapy is sometimes used after surgery when the risk of the cancer returning is increased. It may also be an option for people who cannot have surgery.
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Skin cancer treatments that have spread beyond the skin

When squamous cell carcinoma has spread to other parts of the body, drug treatments may be recommended, including:

  • Chemotherapy: Chemotherapy uses powerful drugs to kill cancer cells. If the carcinoma has spread to the lymph nodes or other parts of the body, chemotherapy may be used alone or in combination with other treatments such as targeted drug therapy and radiation therapy.
  • Targeted drug therapy: Targeted drug therapies focus on specific weaknesses found in cancer cells. By blocking these weaknesses, targeted drug treatments can cause cancer cells to die. Targeted drug therapy is often combined with chemotherapy.
  • Immunotherapy: Immunotherapy is a drug therapy that helps your immune system fight cancer. Your body’s disease-fighting immune system may not attack cancer because cancer cells produce proteins that blind immune system cells. Immunotherapy works by interfering with this process. For squamous cell carcinoma of the skin, immunotherapy may be considered when the cancer has progressed.

Can squamous cell carcinoma be prevented?

You can do the following to protect yourself from this type of cancer:

  • Avoid midday sun: Stay out of the sun, especially during the hours when the sun is intense and strong. Plan outdoor activities during the less sunny hours of the day, even during the winter months or when the skies are cloudy.
  • Use sunscreen year-round: Protect yourself by using broad-spectrum sunscreen. Reapply the cream when you sweat.
  • Wear protective clothing: Wear dark, tightly woven clothing that covers your skin, arms and legs, and wear a wide-brimmed hat that gives you more protection.
  • Avoid tanning beds: Tanning beds emit UV rays and can increase your risk of skin cancer.
  • Check your skin regularly and report changes to your doctor: Examine your skin frequently for new skin growths or changes in existing moles, freckles, bumps, and birthmarks. Check your face, neck, ears and scalp with the help of mirrors.

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