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Squamous Cell Carcinoma (SCC)

Squamous cell carcinoma (SCC) is a common type of skin cancer that typically arises from the squamous cells in the outer layer of the skin, often because of prolonged exposure to ultraviolet (UV) radiation from the sun. Recognising the signs and symptoms of SCC is essential for early detection and effective treatment. Here’s what you need to know:

Symptoms and Signs of Squamous Cell Carcinoma:

Various skin abnormalities that warrant attention for prompt evaluation by a skin specialist characterise squamous cell carcinoma (SCC):

Skin Lesions: SCC commonly presents as firm, red nodules or flat, scaly patches on sun-exposed areas of the skin, such as the face, ears, lips, and back of the hands. These lesions may have an irregular border and can grow rapidly.

Warty Growth: Some SCCs may appear as rough wart-like growths that may crust, bleed, or ulcerate. These growths often have a raised, uneven surface and can vary in size and colour.

Persistent Sores: SCCs may manifest as non-healing sores or ulcers that cannot resolve despite conventional wound care measures. These sores may be tender to the touch and may continue to increase in size.

SCC

Causes and Risk Factors of Squamous Cell Carcinoma:

Understanding the underlying causes and risk factors associated with squamous cell carcinoma can help patients adopt preventive measures to reduce their risk:

UV Exposure: Prolonged and unprotected exposure to UV radiation from the sun or artificial sources, such as tanning beds, is a primary risk factor for SCC development. UV radiation damages the DNA in skin cells, leading to genetic mutations that promote the development of cancerous growths.

Fair Skin: Individuals with fair skin, light-coloured eyes, and blond or red hair are at an increased risk of developing SCC, as they have less melanin, which provides natural protection against UV radiation.

Age: The risk of SCC increases with age, with most cases diagnosed in individuals over the age of 50. However, SCC can occur in younger individuals, particularly those with a history of intense sun exposure or indoor tanning.

Immunosuppression: Immunosuppressed individuals, such as organ transplant recipients or those with conditions like multiple sclerosis, rheumatoid arthritis, have a higher risk of developing SCC due to compromised immune function, which impairs the body’s ability to detect and eliminate cancerous cells.

Treatment Options for Squamous Cell Carcinoma:

Squamous cell carcinoma treatment options encompass various approaches tailored to the size, location, and aggressiveness of the tumour:

Surgical excision: The process of surgical excision entails the complete removal of the SCC, including a margin of healthy surrounding tissue for thorough eradication. Most times, surgeons choose to perform this procedure using local anesthesia, which has proven to be highly effective in curing localised SCCs.

Mohs Micrographic Surgery: Mohs surgery is a specialised surgical technique that allows for the precise removal of SCC while sparing healthy tissue. During Mohs surgery, the surgeon removes the tumour layer by layer and examines it under a microscope until no cancer cells are detected, ensuring maximal tissue preservation and minimal scarring.

Radiation Therapy: Radiation therapy utilises high-energy radiation beams to target and destroy cancerous cells in the skin. Doctors may recommend radiation therapy for SCCs that are challenging to surgically remove or for individuals who cannot undergo surgery.

Topical Treatments: For superficial SCCs or lesions in cosmetically sensitive areas, topical treatments such as imiquimod cream or 5-fluorouracil (5-FU) may be prescribed to stimulate the immune system or induce cell death in cancerous cells.

Cryotherapy: Cryotherapy involves the application of liquid nitrogen to freeze and destroy cancerous cells. Cryotherapy is a common treatment for small, superficial SCCs or as an additional therapy after surgical excision.

Prognosis and Outlook for Squamous Cell Carcinoma:

The prognosis for squamous cell carcinoma is favourable, especially when diagnosed and treated at an early stage. However, the risk of recurrence and metastasis varies depending on factors such as tumour size, depth of invasion, and presence of high-risk features.

Recurrence Risk: SCC has a moderate risk of recurrence, particularly for larger, more aggressive tumors or those with incomplete surgical excision. Regular skin examinations and follow-up appointments are essential for monitoring for signs of recurrence and detecting new SCCs early.

Metastasis Likelihood: While SCC has a lower risk of metastasis compared to melanoma, metastatic spread can occur, particularly in cases of advanced or neglected tumours. SCCs with high-risk features, such as deep invasion, perineural involvement, or lymphovascular invasion, are more likely to metastasize.

Long-Term Prognosis: With treatment, most individuals with squamous cell carcinoma can expect favourable long-term outcomes and a low risk of complications. However, ongoing sun protection practices, regular skin examinations, and adherence to recommended follow-up care are essential for minimizing the risk of recurrence and preserving skin health.

In conclusion, squamous cell carcinoma is a common type of skin cancer that requires early detection and treatment for optimal outcomes. By recognizing the signs and symptoms, understanding the underlying causes and risk factors, exploring treatment options, and maintaining vigilant surveillance, individuals can effectively manage SCC and reduce the risk of complications. Regular consultation with a dermatologist or skin cancer specialist is essential for personalised evaluation, treatment planning, and long-term skin health management.

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