Risk factors of Squamous Cell Carcinoma
Symptoms of early detection
Now that we have covered some of the possible risk factors of squamous cell carcinoma, it is important to know how to detect early signs of the condition especially if you have identified with some of the risk factors mentioned above.
Therefore, it is recommended that you check your skin on a regular basis, observing for any warning signs. The first thing you can look out for is the presence of actinic keratoses. These are scaly, rough, crusty lesions which can be of different colours, typically found on sun-exposed areas of skin. If left untreated, there is a risk of these precancer lesions progressing towards squamous cell carcinoma. As they are more easily felt than seen, you can check for actinic keratoses by feeling for any rough, scaly lesions on sun-exposed areas of skin. Another thing to look out for is Bowen disease which is a non-invasive early form of squamous cell carcinoma. It can be identified by red, scaly patches which tend to be larger than actinic keratoses and affect sun exposed areas of skin or skin of the anal and genital areas. If left untreated, it may progress to invasive squamous cell carcinoma where the cancer cells now invade past the outermost layer into the deeper layers of the skin.
Other general things to look out for when checking your skin are:
- Atypical moles which tend to be asymmetrical, have irregular borders, have varying uneven colour, are larger than 6mm and show change over time such as enlargement.
- A spot or sore that itches, hurts, scabs, crusts, erodes or bleeds
- Persistent open sores that do not heal within 3 weeks
- Any skin growths that increase in size
How is Squamous Cell Carcinoma diagnosed?
When consulting a doctor, the doctor will ask some questions about your health and examine your skin to check for any skin changes which raise suspicion. However, to confirm a diagnosis of squamous cell carcinoma, a sample of the skin lesion needs to be removed and sent to the laboratory for testing.
What are the treatment options available for Squamous Cell Carcinoma?
There are currently many treatment options available to treat squamous cell carcinoma.
- Mohs micrographic surgery. This is done by removing the tumour in stages – excising a thin layer of the tissue and immediately examining it under a microscope to look for cancer cells. If cancer cells are still present, the surgeon will remove another layer at the precise location where the cancer cells are, and the process is repeated until all the cancer cells are removed. This allows for a more targeted and complete removal of the cancer cells, maximizing the sparing of normal tissue and lowering the risk of recurrence of the cancer. Therefore, this is recommended for squamous cell carcinomas that have recurred or have a high risk of recurrence or those with ill-defined borders which makes complete excision of the tumour difficult. Furthermore, as this procedure leaves minimal scarring, it is recommended for squamous cell carcinomas on the face and other cosmetically sensitive areas.
- Excisional surgery. An alternative to Mohs surgery which involves excising the tumour along with a safety margin of surrounding normal skin and is often the treatment of choice for lower risk squamous cell carcinomas.
- Curettage and electrodesiccation. Where the lesion is scraped off and the tumour site is burned to kill any additional cancer cells. This can be used to treat low risk squamous cell carcinomas that are small and superficial but is not recommended for those that are aggressive and have a high risk of recurrence. This procedure also causes scarring and hence is not recommended to be done on cosmetically sensitive areas.
- Cryosurgery. This is done for superficial squamous cell carcinomas and involves freezing the tumour with liquid nitrogen. It is easy to administer with no cutting, bleeding or anaesthesia and hence may be suitable for patients with bleeding disorders or intolerance to anaesthesia. However, it is not suitable for invasive squamous cell carcinomas as cryosurgery may fail to remove the deeper cancer cells and lead to cancer recurrence.
- Radiation therapy. It is meant for patients who are not able to undergo surgery or have inoperable tumours. Therefore, the choice of treatment really depends on the severity and location of the cancer as well as many other patient factors. At times, a combination of treatments may be required for more advanced cases of squamous cell carcinoma. Hence, it is important to discuss with your doctor on a treatment plan that is catered to you and your condition.
In conclusion, most squamous cell carcinomas are easily treatable with good outcomes, but prevention is better than cure. You can start reducing exposure to UV radiation by regularly applying a broad-spectrum sunscreen, avoid tanning, seeking shade and wearing protective clothing against the sun. It is also important to examine your skin every month to look out for any skin changes which may raise suspicion. Such habits need to be cultivated and it is only by doing so can we win the fight against skin cancer.