Do you have any of these changes on your skin? Let's learn about Squamous Cell Carcinoma!

Have you ever been worried about a new bump, a sore that won't heal, or a red, scaly spot on your skin? You probably don't think much of it. But, these skin changes can sometimes be a sign of something more serious. Today we're going to talk about one such type of skin cancer. It's called squamous cell carcinoma, or SCC.

What is squamous cell carcinoma (SCC)? Let's understand it simply!

Okay, now let's see what squamous cell carcinoma is. Simply put, it's a type of skin cancer. It starts in the outermost layer of our skin, the epidermis, called squamous cells. To be precise, it's the second most common type of skin cancer. The first is basal cell carcinoma.

Most of the time, these squamous cell cancers develop in the areas of our bodies that are most exposed to the sun. Think of places like your head, arms, and legs. However, sometimes these cancers can also develop in areas of the body where there are mucous membranes. That is, in places like the inside of the mouth, lungs, and rectum.

What are the main types of this cancer?

There are several main types of squamous cell carcinoma, depending on where it is in the body and how far it has spread.

• Cutaneous: This type of cancer can be in situ (in the top layer of the skin) or it can spread beyond the top layer of the skin.
• Metastatic type: In this type, the cancer spreads beyond the skin to other parts of the body.

Who is at higher risk of developing squamous cell carcinoma?

Anyone can develop this cancer. However, some people are at a slightly higher risk. See if these facts apply to you:

• If your skin has been damaged by prolonged exposure to strong sunlight since childhood or due to sun damage.
• If you have very fair skin, blue or green eyes , and blonde or red hair.
• If you are 65 years of age or older.
• If you have a weakened immune system (for example, someone who has had an organ transplant).
• If you have been exposed to certain chemicals (e.g. cigarette smoke, arsenic).

Men are twice as likely to develop this cancer as women. Although it is most common among people over the age of 50, the incidence has recently been increasing among people under the age of 50.

It is reported that more than a million people in the United States alone develop squamous cell carcinoma each year. It is also said that the number of people suffering from this disease has increased by about 200% in the last 30 years. Therefore, it is very important to be aware of this.

What are the symptoms of squamous cell carcinoma? How do you recognize it?

If you notice any of these changes on your skin, be aware. These could be signs of squamous cell carcinoma:

• A rough, raised bump or growth on the skin. This may crust over and bleed .
• A lump that is raised above the surrounding skin and looks like a depression in the middle.
• A wound that does not heal or a wound that heals and reappears.
• A flat, scaly, red spot on the skin that can be an inch (about 2.5 centimeters) or larger .

What other signs can identify this?

There are some other signs that may indicate that it may be squamous cell cancer:

• A lump or growth on the skin. It may be dry, itchy , scaly, or a different color than the surrounding skin. This condition is also called ``Actinic Keratosis``.
• If you have a sore on your lower lip, the skin there is discolored, dry, and cracked . It may feel like a burn when you go out in the sun. This is also called `(Cheilitis)`.
• If you have white or discolored spots inside your mouth, on your tongue, gums, or cheeks , this condition is called ``Leukoplakia''.

Where in the body does this cancer most commonly occur?

Although squamous cell carcinoma can develop anywhere on the body, it is most commonly found in these areas:

• On the skin
• Mouth, tongue and throat (also called ``Oral Carcinoma'')
• Face, lips, nose, ears, eyelashes, and skull
• Esophageal Carcinoma (also called Esophageal Carcinoma or Epidermoid Carcinoma)
• Hands, legs
• The rectal area

Why does this squamous cell carcinoma develop? What is the cause?

The main cause of this cancer is a mutation in a gene called `(p53 gene)` in our cells. The main cause of this `(p53 gene)` mutation is exposure to ultraviolet rays (UV rays) from the sun and artificial methods such as `(tanning beds)` that expose the skin to UV rays.

Simply put, this `(p53 gene)` is what controls the division of our cells and the formation of new cells. This is like cancer.It's like a tumor suppressor. So, when this gene is mutated, cells start dividing too much without control. That's when things like cancerous tumors and tumors form.

Will this cancer spread throughout the body?

Cutaneous Squamous Cell Carcinoma is a rare type of skin cancer that rarely metastasizes to other parts of the body. Even if it does, it is slow. However, it can be life-threatening if left untreated. So if you notice any changes in your skin, it is best to see a doctor as soon as possible.

How is this cancer diagnosed? (Diagnosis)

Your doctor will first examine the area where your symptoms are located. This means the size, shape, and location of the lump or lesion. In addition, they will ask questions to learn more about your medical history and symptoms. For example:

• "When did you first notice this lump/wound?"
• "Did the size of this change after you first saw it?"
• "Is this painful? Is it itchy?"

What kind of tests confirm this?

After a medical examination, further tests may be performed to confirm the diagnosis:

• Skin biopsy: This involves taking a small piece of tissue from the affected area and examining it under a microscope.
• Imaging tests (e.g., CT scan or MRI): These are used to see the size of the cancer under the skin and whether it has spread to other parts of the body, especially the lymph nodes.

What are the stages of squamous cell carcinoma?

Your doctor will give you a stage of the disease to determine how far the cancer has spread in your body. This stage will determine the best treatment for you. There are five main stages of squamous cell carcinoma:

• Stage 0: The cancer is only in the top layer of the skin (epidermis). This is also called Squamous cell carcinoma in situ.
• Stage I (1): The cancer is in the upper and middle layers of the skin (Epidermis and Dermis).
• Stage II (2): The cancer is in the upper and middle layers of the skin and has spread to the nerves or the deepest layers of the skin (Epidermis, Dermis and Subcutis).
• Stage III (3): The cancer has spread beyond the skin to the lymph nodes.
• Stage IV (4): The cancer has spread to other parts of the body and organs such as the liver, lungs, and brain.

How is squamous cell carcinoma treated?

The main goal of treatment is to remove the cancer from the body. The type of treatment you receive will depend on factors such as the size, shape, and location of the cancer. Here are some of the most commonly used treatments:

• Cryosurgery: Freezing and destroying cancer cells.
• Photodynamic Therapy (PDT):Cancer is removed from the skin using light-sensitive materials and blue light.
• Curettage and Electrodesiccation: The cancerous lump is scraped away with a spoon-like instrument called a curette and then burned with an electric current.
• Excision: Surgery is performed to cut out the cancer from the skin and then sew the skin back together.
• Mohs surgery: This involves removing layers of skin affected by cancer. This is most often done for cancers that occur on the face.
• Systemic Chemotherapy: Powerful drugs are given to destroy cancer cells in the body.

What are the types of drugs given for this cancer?

Sometimes, if the cancer has spread a little, or if surgery to remove the cancer is not a good option for you, your doctor may prescribe medication.

• Skin creams containing ``Imiquimod`` or ``5-Fluorouracil`` are used for squamous cell carcinoma in the upper layer of the skin (epidermis).
• Immunotherapy called ``Cemiplimab-rwlc (Libtayo®)`` is given to advanced squamous cell carcinomas.
• Immunotherapy (Pembrolizumab (Keytruda®)) is given to patients with squamous cell carcinoma that cannot be treated with surgery.

Are there any side effects to these treatments?

The most common side effect is changes in the appearance of the skin after cancer removal, such as scarring.

If you are taking immunotherapy, talk to your doctor about the side effects of those medications.

How quickly will I recover after treatment?

The time it takes for your body to heal after treatment varies from person to person. It depends on factors such as the size, shape, and location of the cancer. In general, most people recover within two to four weeks of treatment to remove the cancer. A few weeks after treatment, your doctor will check you again to make sure your body is healing properly and that the treatment is working.

How does this protect against squamous cell cancer?

While it's not possible to completely protect yourself from all types of squamous cell cancer, there are things you can do to reduce your risk:

• Avoid excessive sun exposure.
• Avoid using tanning beds.
• Always wear sunglasses, hats, and clothing with UPF protection when outdoors. Also, use sunscreen.
• Quit smoking.
• Avoid exposure to chemicals without protective equipment.

The most important thing is that if you notice any new changes to your skin, a lump, or a wound that doesn't heal, or if you have any doubts about it, see a doctor or dermatologist immediately.

What happens if I have squamous cell carcinoma?

Most often, squamous cell carcinomaIf detected early, there is a good prognosis and a very high chance of survival. Early detection and treatment can prevent the cancer from growing larger and damaging other parts of the body.

Even if your doctor removes your cancer, there is a small chance that it will come back in the future. So keep in touch with your doctor to make sure you are completely cancer-free. It is also important to protect your skin from UV rays when you go outside.

When should I see a doctor?

In such a case, you should definitely see a doctor:

• If you notice something on your skin, such as a new lump, birthmark, wound that won't heal, or a change in a spot that has been there for a long time .
• If you want to have your annual skin check done by a dermatologist.
• If there are side effects or complications such as pain, bleeding, or itching related to treatment for squamous cell cancer.

What questions should I ask my doctor?

• "What stage of squamous cell carcinoma do I have?"
• "Do I need surgery to remove the cancer from my body?"
• "Should I see a dermatologist?"
• "Are there any side effects of the treatment?"

What is the difference between squamous cell carcinoma (SCC) and basal cell carcinoma (BCC)?

Squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) are both types of skin cancer. Both are caused by excessive exposure to sunlight (ultraviolet rays). Both conditions are caused by the overproduction of squamous cells or basal cells. Squamous cell carcinoma, like basal cell carcinoma, can develop in the epidermis of the skin. However, SCC is unique in that it can also develop in areas where there are mucous membranes, such as inside the mouth, throat, lungs, and genitals.

What is 'squamous cell carcinoma in situ'?

Squamous cell carcinoma in situ is also called Bowen disease . The word "in situ" means that the cancer cells are only in the top layer of the skin (epidermis). Bowen disease is most often found on sun-exposed skin. However, it can sometimes develop in the skin around the anus and genitals, for example, on the labia or vulva (also called vulvar cancer).

Finally, things to remember (Take-Home Message)

It's normal to feel scared when you see a new lump on your skin and find out it's cancer. However, treatment for squamous cell carcinoma can successfully remove the cancer from your body. The most important thing is to take steps to protect yourself from the sun's UV rays. If you notice any new lumps or changes on your skin, don't waste time and see a doctor, get them checked out, and get treatment as soon as possible if necessary. Your health is in your hands!

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