Squamous Cell Cancer of the Skin

Incidence

Squamous cell cancer is the second most common type of skin cancer, being four times less common than basal cell cancer. In USA alone over 700,000 new cases of squamous cell carcinoma (SCC) are diagnosed every year.

Males are affected with SCC at a ratio of 2:1 in comparison to females

This form of skin cancer arises in the squamous cells that make up most of the skin’s upper layers (epidermis). Squamous cell carcinomas may occur on all areas of the body including the mucous membranes and genitals, but are most common in areas frequently exposed to the sun, such as the rim of the ear, lower lip, face, bald scalp, neck, hands, arms and legs. Often the skin in these areas reveals telltale signs of sun damage, such as wrinkling, changes in pigmentation, and loss of elasticity

Origin

It arises from outermost layer of the skin (epidermis) from the squamous cells. It also may arise from the outermost layer of the inner body lining. This means it can originate in many organs besides the skin. The organs and tissues besides the skin that can develop this cancer includes - lips, mouth, esophagus, urinary bladder, prostate, lung, vagina, and cervix. The cells first get mutated and may appear as a rough patch and if this occurs due to excess sun exposure it is called solar keratosis or actinic keratosis. Any such rough patch on the skin that recurs or persists despite treatment should be biopsied for cancer.

Risk Factors

Squamous cell cancer usually affects elderly individuals and more commonly, men. White-skinned individuals living at the tropics and exposed to excessive sunlight are at a particular risk for developing the cancer, though the cancer could occur in dark-skinned individuals as well. It is also commonly seen in patients undergoing organ transplantation, who have low levels of immunity. It also may grow on skin damaged by inflammation, radiation and chemicals like arsenicals and tar. Tobacco increases the risk for developing squamous cell cancer.

Symptoms & Signs

A squamous cell cancer may appear as a small swelling that ulcerates in the center and shows everted edges. The ulcer does not heal in spite of local treatment. The base of the ulcer appears hard on touch.

Diagnosis:

Squamous cell cancer is diagnosed based on a biopsy of the lesion.

Treatment

It is treated with surgical excision. Radiotherapy and cryotherapy may be used in select cases. A cancer that is large in size, has spread to other tissues or occurs in people with low immunity has a poor prognosis or outcome.

Prevention

Squamous cell cancer can be prevented by using adequate protection and limiting exposure to the afternoon sun. People should be aware of skin changes that could indicate cancer, such as, sudden increase in the size of a lesion, change in color and / or shape and sudden bleeding and/or itching. Regular skin examination with a dermatologist should be commenced after the age of 40 years for early detection and treatment of solar keratosis.