WHAT IS SQUAMOUS CELL CANCER?
Squamous Cell Carcinoma is the second most common type of skin cancer in the world today. In 2008, over 250,000 cases of squamous cell carcinoma are estimated to occur annually in the United States. Thankfully, this form of skin cancer is readily curable in most instances. Squamous cell carcinoma can arise as a result of chronic sun exposure, tobacco use or a predisposed genetic susceptibility. Those patients with blue eyes and freckles, who burn easily, or who have a history of blistering sunburns are more likely to develop this type of skin cancer. In some instances, squamous cell cancer arises without symptoms. For these reasons, complete skin checks should be performed by your dermatologist annually. Once a diagnosis of squamous cell carcinoma is made, there is up to a 50% chance of your developing a second similar cancer within 5 years.
Fig. 1 Squamous Cell Cancer – scaling non healing lesion on the foot
HOW DO I RECOGNIZE SQUAMOUS CELL CANCER?
Squamous cell carcinoma can present itself in a multitude of ways. Often a non-healing lesion is the earliest sign. Bleeding, pain, tingling, ulceration and itching can also be early symptoms. Squamous cell carcinoma can appear as a red bump or a scaly patch. Typically, this form of cancer occurs on sun exposed sites such as the rim of the ear, or nose. Unlike basal cell carcinoma, the most common form of skin cancer, Squamous cell carcinoma can metastasize internally. When a tumor is noted on the lip or mucous membrane region, the risk for internal spread is greater. If a non-healing sore occurs as described above, it is advisable to have us assess the lesion as soon as possible.
HOW DO I KNOW IF THIS FORM OF CANCER HAS SPREAD INTERNALLY?
Fig. 2 SCC near the ear … a high risk area
Many times when cancer has spread internally or “metastasized”, the patient may develop swelling of lymph node glands around the primary cancer site. Symptoms such as cough, persistent headaches or shortness of breath can also suggest that the cancer may have spread internally. It is important to refrain from smoking or chewing tobacco as these habits can potentate Squamous cell carcinoma formation. If you develop the symptoms described above, please let our ADAS providers know immediately so that a thorough examination can be arranged to assess the nature of your symptoms.
RISK FACTORS FOR DEVELOPING SQUAMOUS CELL CARCINOMA
- Personal and family history of Skin Cancer
- History of Blistering sunburns
- Fair skin
- History of Blue or Green eyes
- History of Freckles
- History of chronic sun damage
- Exposure to hydrocarbons (soot, pipe-smoking)
- Old age
HOW CAN I PREVENT SQUAMOUS CELL CANCER FROM AFFECTING ME OR MY CHILDREN?
Education is the key to prevention. Over 80% of one’s sun exposure occurs before the age of 20. Therefore, it is important to learn some smart skin habits early in life. These include such things as:
- Avoiding excessive sun exposure between the hours of 10 AM and 4 PM (a good rule of thumb is to avoid the sun when your shadow is shorter than your actual height).
- Applying sunscreens with a SPF of at least 15 that are waterproof and sweat-proof (especially if you are exercising or working outdoors).
- Reapplying sunscreens every 3 to 4 hours.
- Wearing densely woven protective clothing, (e.g. denim/ Solumbra®).
- Performing self examinations every 3 months.
- Having annual comprehensive skin examinations performed by one of our ADAS providers.
- Familiarizing yourself with the early signs of Squamous Cell Cancer as described previously.
Fig. 3 Squamous Cell Cancer early stage
WHAT ARE SOME OF THE OPTIONS FOR TREATMENT OF SQUAMOUS CELL CANCER?
The mainstay therapy for Squamous Cell Cancer involves surgical removal. Cold liquid nitrogen spray can also yield high cure rates in certain instances. Many of these procedures are performed under local anesthesia and recovery time is rapid. In cases where cancer is impinging on a vital area such as on the nose or eye, a technique called Mohs Surgery may be employed.
Mohs surgery involves the evaluation of multiple frozen specimens to make sure that these “danger areas” are free from residual tumor. Other options for treatment include a “Slow Mohs” procedure in which the cancer is initially removed, the defect left bandaged and the area repaired 48 hours later. This option has an advantage over standard Mohs Surgery in that permanent sections are utilized to assess tumor margins. The added 24 to 48 hour period of healing can often make the surgical repair process much easier. When internal spread has occurred, treatment with intravenous chemotherapy is begun and a cancer specialist is consulted.
NEW TREATMENTS FOR SQUAMOUS CELL CANCER
For early and limited Squamous Cell Cancer, Aldara™ cream can be used to eliminate the cancer. This saves patients from surgery and leads to an excellent cosmetic result.