Squamous Cell Carcinoma Stages And Treating

Squamous Cell Carcinoma Stages And Treating
SCC is the second most common form of skin cancer and is mainly seen in individuals with chronic exposure to the sun. It is important to be able to recognize this form of skin cancer because it has the potential to spread to other parts of the body and can be locally destructive. It is commonly seen in fair skinned and elderly individuals with long term sun exposure. Other risk factors for the development of SCC include: male sex, exposure to chemical carcinogens (such as arsenic and tar), immunosuppression, ionizing radiation, scarred skin, infection with specific HPV subtypes and history of other skin cancers.
 squamous cell cancer
Squamous Cell Cancer (SCC)
SCC is generally a slow growing tumor that tends to grow without physical symptoms. However, some forms of this cancer may be fast growing and painful, especially when the lesions are large. They may become irritated and bleed. Typically, lesions are flesh colored to pink raised spots that may have overlying scale and crust. Some may look like warts especially ones close to the fingers and some may look like they have an overlying horn. The majority occur on the head and neck, but also occur on the upper extremities and other sun exposed areas. SCC occurring on the lips may appear as a new red bump or redness and crust in an existing dry spot. High risk areas for cancer that will spread include the lips, ears and nose.

Read the others :
Some Squamous Cell Skin Cancers Are Deadly
squamous cell cancer
Squamous-cell carcinoma
Cutaneous squamous cell carcinoma is usually easily treated with surgery; however, a subsection of patients with specific disease risk factors are more likely to develop metastases and die from the disease, according to the results of a study published in JAMA Dermatology.

Squamous cell carcinoma accounts for roughly 20% of all cases of non-melanoma skin cancer. Squamous cell carcinoma commonly involves the head or neck. The tumor may appear as a red bump or as a rough or scaly area on the skin. Squamous cell carcinoma is more likely than basal cell carcinoma to spread to lymph nodes or distant parts of the body, though this happens infrequently. Treatment of squamous cell carcinoma often involves surgery to remove the cancer.

The prognosis for cutaneous squamous cell carcinoma (CSCC) is usually good, but some patients have poor outcomes. To identify factors associated with poor outcomes, researchers conducted a 10-year retrospective cohort study that included 985 patients and 1,832 tumors. The majority of patients (73.3%) had one tumor, 21.2 percent of patients had two to four tumors, and a small percentage of patients had more than four tumors. Most (69.5%) were treated with standard excision and 20.2 percent were treated with Mohs surgery.

The data revealed that 4.6 percent of patients experienced local recurrence, 3.7 percent developed metastases, and 2.1 percent died from the disease. Upon analysis, one consistent predictor of poor outcome was tumor size of 2 cm or more. Multivariate risk analysis revealed that several specific disease factors were associated with metastasis and disease-specific death:

Risk Factors Associated with Metastasis
Risk Factors Predictive of Disease-Specific Death
Tumor diameter greater than 2 cm
Tumor diameter greater than 2 cm
Poor differentiation
Poor differentiation
Invasion beyond the subcutaneous fat
Invasion beyond the subcutaneous fat
Tumor location on the temple or ear
Perineural invasion

Tumor location on the temple or ear

Anogenital location of tumor

The researchers hope that identifying these risk factors will help with treatment decision-making. Prognosis worsens once local or distant metastasis occurs, so identifying patients who are at high risk would allow more aggressive treatment from the outset.
Squamous cell carcinoma stages
There are certain features that are considered to make the cancer at higher risk for spreading or recurrence, and these may also be used to stage squamous cell carcinomas. These include:
  • Greater than 2 mm in thickness
  • Invasion into the lower dermis or subcutis layers of the skin
  • Invasion into the tiny nerves in the skin
  • Location on the ear or on a hair-bearing lip

After the TNM components and risk factors have been established, the cancer is assigned to one of the five squamous cell carcinoma stages, which are labeled 0 to 4. The characteristics and stages of squamous cell cancer are:
  • Stage 0 squamous cell carcinoma: Also called carcinoma in situ, cancer discovered in this stage is only present in the epidermis (upper layer of the skin) and has not spread deeper to the dermis.
  • Stage I squamous cell carcinoma: The cancer is less than 2 centimeters, about 4/5 of an inch across, has not spread to nearby lymph nodes or organs, and has one or fewer high-risk features.
  • Stage II squamous cell carcinoma: The cancer is larger than 2 centimeters across, and has not spread to nearby organs or lymph nodes, or a tumor of any size with 2 or more high risk features.
  • Stage III squamous cell carcinoma: The cancer has spread into facial bones or 1 nearby lymph node, but not to other organs.
  • Stage IV squamous cell carcinoma: The cancer can be any size and has spread (metastasized) to 1 or more lymph nodes which are larger than 3 cm and may have spread to bones or other organs in the body.
Treating Squamous Cell Carcinoma of the Skin

1. Surgery

Different types of surgery can be used to treat squamous cell skin cancers.
  • Excision: Cutting out the tumor, along with a small margin of normal skin, is often used to treat squamous cell cancers.
  • Curettage and electrodesiccation: This approach is sometimes useful in treating small (less than 1 cm across), thin squamous cell cancers, but it’s not recommended for larger tumors.
  • Mohs surgery: Mohs surgery has the highest cure rate. It’s especially useful for squamous cell cancers larger than 2 cm (about 4/5 inch) across or with poorly defined edges, for cancers that have come back after other treatments, for cancers that are spreading along nerves under the skin, and for cancers on certain areas of the face or genital area. This approach is typically more complex and time-consuming than other types of surgery.

2. Radiation therapy

Radiation therapy is often a good option for patients with large cancers, especially in areas where surgery would be hard to do (such as the eyelids, ears, or nose), or for patients who can’t have surgery. It’s not used as much as the first treatment in younger patients because of the possible risk of long-term problems.

3. Cryotherapy

Cryotherapy (cryosurgery) is used for some early squamous cell cancers, especially in people who can’t have surgery, but is not recommended for larger invasive tumors or those on certain parts of the nose, ears, eyelids, scalp, or legs.

Reference:
A Health teacher and Midwife..

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