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Squamous Cell Carcinoma Treatment

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

Arising from the keratinizing epidermal cells, squamous cell carcinoma of the skin is an invasive tumor with metastatic potential. It occurs most of­ten in fair-skinned white men over age 60. Outdoor employment and residence in a sunny, warm climate (south western United States and Australia, for example) greatly increase the risk of developing squamous cell carcinoma.

Causes of Squamous Cell Carcinoma

Predisposing factors associated with squamous cell carcinoma include over­exposure to the sun's ultraviolet rays and the presence of premalignant lesions (such as actinic keratosis or Bowen's disease).

Other predisposing factors include 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). Rarely, squamous cell carcinoma may develop on the site of smallpox vaccination, psoriasis, or chronic discoid lupus erythematosus.

Signs and symptoms of Squamous Cell Carcinoma

Squamous cell carcinoma commonly develops on the skin of the face, the ears, the dorsa of the hands and fore­arms, and other sun-damaged areas. Lesions on sun-damaged skin tend to be less invasive and less likely to metastasize than lesions on unexposed skin.

Notable exceptions to this tendency are squamous cell lesions on the lower lip and the ears. These are almost invariably markedly invasive metastastic lesions with a generally poor prognosis.

Transformation from a premalignant lesion to squamous cell carcinoma may begin with induration and inflammation of the preexisting lesion. When squamous cell carcinoma arises from normal skin, the nodule grows slowly on a firm, indurated base.

Diagnosis

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

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.

Premalignant lesions respond well to treatment. A deeply invasive tumor may require a combination of techniques.

All the major treatment methods have excellent cure rates; the prognosis is usually better with a well-differentiated lesion than with a poorly differentiated one in an unusual location. The tumor may be reduced in size by radiation treatments.

Depending on the lesion, treatment may consist of:

• wide surgical excision
• electrodesiccation and curettage (which offer good cosmetic results for small lesions)
• radiation therapy (generally for elderly or debilitated patients)
• chemosurgery (reserved for resistant or recurrent lesions).

Special considerations and prevention

• Sun exposure and sunbathing produce gradual skin damage even if sunburn is avoided. Ten to forty years can pass between the time of sun exposure and the development of a squamous cell skin cancer.
• Tell the patient to use lip screens to protect the lips from sun damage
• Advise the patient to use sunscreen containing para-aminobenzoic acid, ben­zophenone, and zinc oxide. He should apply these agents 30 to 60 minutes before sun exposure.
• Keep the wound dry and clean.