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SQUAMOUS CELL CARCINOMA

What is Squamous Cell Carcinoma ?

Squamous cell tumours are malignant growths which can develop in any part of the skin. They have the ability to spread to other parts of the body. Tumours often arise where the skin has been damaged by sun exposure, radiation therapy, or mechanical or thermal injury. They can also result from one of the skin diseases which leave scars in the skin, such as discoid lupus erythematosus and sites of infection by tuberculosis. The commonest areas affected are the face, the ears, and the backs of the hands. The tumours start as small hard white or skin-coloured lumps in the skin which grow at a variable rate. They eventually ulcerate to give non-healing ulcers.

How does Squamous Cell Carcinoma occur ?

The commonest cause of squamous cell tumours is excessive sunlight exposure. Sunlight contains ultraviolet radiation which is responsible for sun- tanning and sunburn. It is also the major cause of skin cancer in man. Ultraviolet light exposure often produces changes in the skin which are not malignant to begin with. These early changes are called solar keratoses. However, they can become squamous cell tumours if not treated. On the other hand, squamous cell tumours can arise in previously normal skin. Squamous cell tumours are commonest in older patients in their 60s and 70s, but the popularity of sunny holidays and recreational use of sunbeds means that we are seeing them in younger age groups. Other factors can influence the development of squamous cell tumours. People who are treated with steroids and other drugs which inhibit the immune system become much more sensitive to the effects of ultraviolet light. Not only do such patients develop more tumours, but also they occur at an earlier age. Squamous cell tumours can arise in areas of the skin which have been treated with x-ray therapy, scarred by burns or other skin disease, or injured in some way. They are also more common in people who work with tar and pitch.

Why does Squamous Cell Carcinoma occur ?

Skin pigment is the body's major protection against the effects of ultraviolet light. In patients with pale complexions, and particularly those of Celtic origin, sun damage is much greater. Consequently, there is a much higher occurrence of squamous cell tumours. Some people inherit a rare gene which makes their skin much more sensitive to ultraviolet light. In such people, skin tumours of all sorts are much commoner and occur at an earlier age.

Treatment involved for Squamous Cell Carcinoma

The diagnosis must be confirmed by examining part of your tumour under the microscope. If tumours are small, the removal of the tissue for diagnosis will also act as a cure. Depending on the size and site of the tumour, these can be treated by surgery or radiotherapy (x-ray treatment). Small tumours are best removed surgically . The tumour is completely removed under a local anaesthetic, and the edges of normal skin are stitched together, leaving a small scar. For large tumours and those in awkward places, radiotherapy is extremely effective. This will cure the majority of tumours. A special mask is made to protect normal skin. The tumour is then treated with x-rays through a hole in the mask. Several treatments are given over about a week. This area may become sore and red, but the tumour eventually develops a scab and falls off, leaving a small, depressed scar. Squamous cell tumours have the ability to spread to other parts of the body. One of the first site of spread is to lymph glands (glands which fight infection) that drain the area the tumour is situated in. If you are found to have glands involved, these will be surgically removed.

During treatment for Squamous Cell Carcinoma

Squamous cell tumours are easily treated, particularly when they are identified at an early stage. Surgery and radiotherapy are effective and cause little discomfort.

After Treatment

Following treatment of the tumour by surgery or radiotherapy, the tumour may recur at the same site. Squamous cell tumours also have the capacity to spread to lymph glands. In large tumours, the tumour may have had time to spread to other organs of the body. Once spreading occurs anywhere outside the skin, radiotherapy and anti-cancer drugs can be given. However, such spreading is quite difficult to cure.

If Squamous Cell Carcinoma is left untreated

Squamous cell tumours have the capacity to spread to other organs of the body. If left untreated, the tumour ulcerates, damaging nearby structures such as the eye, mouth and ear. It could eventually spread to organs such as the lung and brain, which would be very serious indeed.

Effects on the family of Squamous Cell Carcinoma

Sensitivity of the skin to sun tends to be an inherited trait. Protection from sun exposure from an early age will help to prevent the development of sun-related skin cancers. It is important that children are not allowed to sunburn their skin. Sunlight exposure is dangerous to the skin at all ages. Never allow the skin to burn in the sun. Always use an adequate sunblock.