Squamous cell carcinoma looks harmless at first. It attacks people with light skin

Squamous cell carcinoma, also known as squamous cell carcinoma, is one of the most common forms of skin cancer. It can develop on highly sunlit parts of the body, such as the head, neck, face, hands and arms. However, cancer can also form in areas of the body where there are mucous membranes that are the inner lining of organs and body cavities, such as the mouth, lungs, and anus. Squamous cell carcinoma is not as dangerous as melanoma, but it can spread to other parts of the body if left untreated.

Squamous cell carcinoma – characteristics

Squamous cell carcinoma is a cancer that grows in the squamous cells of the skin. Although not life threatening, this cancer can be dangerous if not treated in time. Otherwise, the skin lesions may enlarge and spread to other parts of the body, causing serious complications.

Squamous cell carcinoma in sick people causes scaly red patches, open wounds or papillary growths to form on the skin. These abnormal growths can grow anywhere, but are most often found in areas that are most exposed to ultraviolet (UV) light, from sunlight, or from tanning beds or lamps.

See also: Tanning beds can be dangerous to your eyesight

Squamous cell carcinoma – symptoms

Squamous cell carcinoma often occurs in areas of the skin that are exposed to UV light, such as the face, ears, and hands. However, it can also appear in the mouth, around the anus, and on the genitals. At first, skin changes seem harmless, which is why they are often underestimated.

Symptoms of squamous cell carcinoma can include:

1. red bumps on the skin;
2. wounds with peeling skin;
3. pain or bulge on an old scar or ulcer;
4. rough, flaky patches on the lip that can develop into open wounds;
5. red raised skin lesions or warty sores on or in the anus or genitals.

Squamous cell carcinoma and other types of skin cancer

Most skin cancers start in the top layer of skin called the epidermis. The epidermis, in turn, consists of three main types of cells:

1. squamous cells – located in the upper part of the epidermis. They are constantly exfoliated as new cells form. When these cells get out of hand, they can develop into squamous cell carcinoma of the skin (also called squamous cell carcinoma).
2. basal cells – located in the lower part of the epidermis. These cells continually divide to form new cells that replace the squamous cells that wear out on the skin’s surface. As these cells move up the epidermis, they become flatter, eventually becoming squamous cells. Skin tumors that start in the basal layer are called basal cell carcinomas of the skin.
3. melanocytes – which produce a brown pigment called melanin which gives the skin a light brown color. Melanin acts as a natural sunscreen, protecting the deeper layers of your skin from some of the harmful effects of the sun. Melanoma, or skin cancer, begins precisely in these cells.

The epidermis is separated from the deeper layers of the skin by the basal membrane. As skin cancer becomes more advanced, it generally crosses this barrier and reaches deeper layers.

Squamous cell carcinoma and basal cell carcinoma

Basal cell carcinoma (lat. basocellular carcinoma), the most common type of skin cancer. Cancer develops in areas that are exposed to the sun, especially the face, head and neck. It tends to grow slowly. Very rarely, basal cell carcinoma has spread to other parts of the body. However, it is important to know that, if not treated properly, basal cell carcinoma can spread to nearby areas and affect bone or other tissues under the skin.

If the basal cell carcinoma is not completely removed, it can recur in the same place on the skin. What’s more, people who have had basal cell skin cancer are also more likely to develop new cancers elsewhere.

Squamous cell carcinoma and melanoma

These tumors develop from melanocytes, pigment-producing cells found in the epidermis. Melanomas are much rarer than basal and squamous cell carcinomas, but if left untreated, they are more likely to grow and spread.

Also read: «Personal» melanoma vaccine. It can stop cancer from growing for years

Squamous cell carcinoma – stages

There are five stages of squamous cell carcinoma and the appropriate treatment is selected depending on the stage of cancer development:

1. Step 0: Cancer only occurs in the top layer of the skin (epidermis). This is also called In-situ Squamous Cell Carcinoma.
2. Stage I: Cancer occurs in the upper and middle layers of the skin (epidermis and dermis).
3. Stage II: Cancer is located in the upper and middle layers of the skin and moves towards the nerves or deeper layers of the skin (epidermis, dermis, and subcutaneous tissue).
4. Step XNUMX: The cancer has spread beyond the skin to the lymph nodes.
5. Stage IV: The cancer has spread to other parts of the body and organs, such as the liver, lungs, or brain.

What causes squamous cell carcinoma?

Squamous cell carcinoma is caused by mutations that occur in the DNA of squamous cells. These changes cause the abnormal cells to reproduce out of control.

Most often, squamous cell carcinoma is attributed to exposure to UV radiation from sunlight or tanning devices such as tanning lamps and beds. Other potential causes include:

Factors that may increase the risk of squamous cell carcinoma of the skin include, but are not limited to, the following aspects.

1. Light skin. Although anyone can get squamous cell carcinoma regardless of skin color, less pigment in the skin provides less protection against harmful UV radiation, and this translates into a greater risk of skin cancer. People with blonde or red hair, who easily get sunburn and freckles, are at risk.
2. Overexposure to the sun. UV radiation from the sun increases the risk of squamous cell carcinoma. The risk increases the longer we stay in the sun, especially if we do not cover our skin with clothing or protect it with sunscreen.
3. Use of tanning beds. People using the solarium are also at risk.
4. A personal history of sunburn. The more times we have been burned by the sun in the past, the greater our chances of developing squamous cell carcinoma in the future (current sunburn also matters).
5. A personal history of precancerous skin lesions. Pre-cancerous skin lesions, such as actinic keratosis or Bowen’s disease, increase the risk of squamous cell carcinoma.
6. A personal and family history of skin cancer. If you have had squamous cell carcinoma once, the chance of it coming back increases. A 2015 study published in Dermatologic Surgery found that people with a family history of squamous cell carcinoma are approximately four times more likely to develop the disease.
7. Weakened immune system. People with a weakened immune system have an increased risk of skin cancer. This includes people with leukemia or lymphoma, and people taking medications that suppress the immune system, for example after organ transplants.
8. A rare genetic disorder. People suffering from parchment skin, which makes them extremely sensitive to sunlight, have a significantly increased risk of developing squamous cell carcinoma.
9. Smoking. Smoking is believed to increase the chances of developing squamous cell carcinoma, especially in the mouth. Furthermore, smoking is a major risk factor for the development of squamous cell carcinoma of the lung and other non-small cell lung cancers.
10. Chemical substances. Exposure to certain chemicals, such as coal tar, paraffin, certain petroleum products, and arsenic can contribute to the development of squamous cell carcinoma.
11. Radiotherapy. Having radiation therapy slightly increases your risk of developing skin cancer in the part of your body that receives treatment.
12. Organ transplant. It is assumed that after an organ transplant, such as a kidney, heart, or lung, you have a significantly increased risk of developing squamous cell carcinoma.
13. HPV infection. Squamous cell carcinoma can develop under the fingernail, on the genitals, or in the anus. Scientists have found that in these areas, the cancer is often accompanied by infection with HPV (human papillomavirus).
14. Immunosuppression. Immunosuppression contributes to the development of squamous cell carcinoma. Organ transplant recipients are thought to have a 65 to 250 times higher risk of developing squamous cell carcinoma than people in the general population.
15. HIV. According to Danish researchers, people infected with HIV have a higher risk of developing the most common types of squamous cell carcinoma. In a 2018 study published in the Journal of the American Academy of Dermatology, the risk of developing squamous cell carcinoma was 5,4 percent. higher in HIV positive people than in uninfected people.
16. Severe burn scars and wounds. Squamous cell carcinoma can develop from severe scars from burns or ulcerations that have been present on the body for many years.

See also: Common skin diseases

Squamous cell carcinoma risk factors

Risk factors for squamous cell carcinoma include:

1. having a fair complexion;
2. having light hair and blue, green or gray eyes;
3. being exposed to prolonged exposure to UV radiation;
4. living in sunny regions or at high altitudes;
5. having a history of multiple severe sunburns, especially if they occurred early in life;
6. having been exposed in the past to chemicals such as arsenic;
7. having severe burn scars, ulcers, or ulcers.

Also check: Seven diseases that can be seen on the hands

Squamous cell carcinoma – diagnosis

In the diagnosis of squamous cell carcinoma, a physical examination is initially performed and any abnormal areas are assessed for tumor development. The medical history of the patient is also important. If a specialist suspects you have squamous cell carcinoma, they will order a biopsy to confirm the diagnosis.

A biopsy is the removal of a very small portion of the affected skin. The skin sample is then sent to a laboratory for testing. Occasionally, most or all of the skin lesion is removed for testing.

It is very important that the patient shows up for all follow-up visits after treatment. Squamous cell carcinoma may come back, so it’s important to check your skin at least once a month for signs of cancer or a precancerous condition.

Squamous cell carcinoma – treatment

Treatment of squamous cell carcinoma depends on many factors, including:

1. the patient’s age;
2. general health of the patient;
3. the extent and severity of the cancer;
4. the location of the cancer.

When detected early enough, squamous cell carcinoma can usually be successfully treated. Unfortunately, once the cancer has spread, it will become much more difficult.

Several basic methods are listed among the procedures performed in the case of squamous cell carcinoma.

1. Mohs micrographic surgery – the procedure involves the use of a scalpel to remove skin abnormalities along with the surrounding tissue. The cut sample is then examined under a microscope to look for cancerous cells. The process is repeated until no cancer cells are found.
2. Electrosurgery (electrocoagulation) – scraping off the cancer and burning the skin to kill the cancer cells. This process is usually done more than once to ensure thorough treatment and complete tumor removal.
3. Cryosurgery – the procedure uses liquid nitrogen to freeze and destroy cancerous tissue. Like electrosurgery, this procedure is repeated multiple times to ensure that all cancerous tissue is eliminated.
4. Radiotherapy – it uses ionizing radiation to kill cancer cells. This treatment is administered externally by a machine that directs the rays to the affected area. Radiotherapy is often done several times a week for several weeks.
5. Fotochemioterapia (PTD; Photodynamic therapy) – it consists in applying a photosensitizing substance to neoplastic areas. After 1 to 3 hours or more, the treated areas are exposed to strong light for several minutes. This activates the applied drug and kills the abnormal cells.
6. Laser therapy. An intense beam of light evaporates the skin lesions, usually with little damage to the surrounding tissue and with a reduced risk of bleeding, swelling and scarring. Laser therapy is used in the case of very superficial skin lesions.

Drug treatment may be recommended if squamous cell carcinoma has spread to other parts of the body.

1. Chemotherapy. It involves the use of powerful drugs to kill cancer cells. When squamous cell carcinoma has spread to the lymph nodes or other parts of the body, chemotherapy can be used alone or in combination with other treatments such as targeted drug therapy and radiation therapy.
2. Targeted drug therapy. This method focuses on the weaknesses present in the cancer cells, causing them to die. This therapy is often combined with chemotherapy treatments.
3. Immunotherapy. It aims to support the immune system in the fight against cancer. This is because the body’s disease-fighting immune system may not attack cancer, because cancer cells produce proteins that blind the cells of the immune system. Immunotherapy works by interfering with this process. For squamous cell carcinoma of the skin, immunotherapy may be considered when the cancer is advanced and other treatments are not possible.

Squamous cell carcinoma – complications

If left untreated, squamous cell carcinoma can damage nearby healthy tissue, spread to lymph nodes or other organs, and can be fatal, although this is rare.

The risk of aggressive squamous cell carcinoma may be increased when the cancer:

1. it is particularly large or deep;
2. includes mucous membranes such as the mouth;
3. occurs in a person with a weakened immune system, such as someone who is taking anti-rejection medications after an organ transplant or someone with chronic leukemia.

Squamous cell carcinoma – prophylaxis

To reduce the risk of squamous cell carcinoma, follow these recommendations.

Limit your exposure to the sun. Especially during the hottest time of the day, which is between 10:00 and 16:00. It is also recommended to schedule outdoor activities for other times of the day (if possible).

Wear sunscreen with an SPF of 30 minimum when going out in the sun. The cream should be applied generously and again every two hours or more often if we are swimming or especially sweating.

Wear a hat and cover your skin when working outdoors. Cover your skin with dark, tight clothing that covers your arms and legs, and a wide-brimmed hat that offers better protection than a baseball cap. Of course, it is also important to wear sunglasses (they should protect against UVA and UVB rays).

Avoid the use of tanning beds and lamps. Such devices emit UV rays and may increase the risk of skin cancer.

Protect your skin also in winter, as winter UV rays can be particularly dangerous.

Check your skin regularly and report changes to your doctor. You should frequently check your skin for new skin changes or changes to existing moles, freckles or tumors. A mirror may be a useful tool, thanks to which you can see not only your face, but also your neck, ears and scalp. It is important to also check the chest, torso, and upper and lower arms and hands. Attention should also be paid to the front and back of the legs and feet, including the soles and spaces between the toes. Let’s also check the genital area and between the buttocks. We should visit a dermatologist once a year.

Organ transplant recipients may need medications to help reduce the risk of squamous cell carcinoma developing. Patients are sometimes given acitretin, which can help reduce the number of skin cancer cases.

Sometimes you hear that taking vitamin A, selenium, or any other supplement can reduce your risk of developing another skin cancer. But researchers believe that these substances do not reduce the incidence of skin cancer at all. What’s more, side effects of taking them are observed in people taking them. Vitamin A taken in high doses can cause the skin to turn yellow, and selenium can cause stomach upset.

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