A Family Doctor's Tale - SQUAMOUS CELL CARCINOMA

DOC I HAVE SQUAMOUS CELL CARCINOMA


Squamous Cell Carcinoma is relatively rare in Singapore.
It is more common in Western countries and in Australia where the skin pigmentation is low and the sun is direct. The one patient that I have seen was treated with surgery with complete recovery.



Squamous Cell Carcinoma is a progressive neoplastic tumor of the epithelial cells of the skin which are found mainly in the late middle age and consists of a solitary skin lesion.

Squamous Cell Carcinoma is more common in :
1.People with fair skin than in those with darker skin.

2.People with skin condition called xeroderma pigmentosa

3.People with autoimmune disease such as systemic lupus erythematosus

4.People with family history of Squamous Cell Carcinoma
Familial causes are:
a.skin condition called xeroderma pigmentosa (autosomal recessive)
b.family history of Squamous Cell Carcinoma

5.People who spend time outdoors under the sun than those staying indoors.
Sun exposure:
Exposure to the sun is one of the most common causes of Squamous Cell Carcinoma.

Risk factors are:
1.intensity of the sun

2.duration of sun exposure,

3.age when sun exposure takes place

4.degree of skin pigmentation

Squamous Cell Carcinoma presents usually as:
1.single firm lesion

2.raised

3.red

4.indurated

5.scaling

6.ulceration may occur

7.rarely bleeding

8.found in sun exposed areas of body

9.regional lymph nodes may be enlarged

Biopsy show malignant epithelial cells with varying degrees of infiltration

Squamous Cell Carcinoma can spread to the organs and other parts of the body

Treatment is simple surgical removal of the skin lesion .

Sometimes the regional lymph nodes are also removed.

If the spread is further, chemotherpy and radiotherapy may be necessary.

The prognosis is good if detected early and there is complete removal of the cancer.

If there is spread to the organs, prognosis is variable depending on the degree of metastases.

Prevention is by:
1.Avoid the direct sun (long-sleeved shirts, long trousers, and broad-brimmed hats). Use sunscreens.

2.Good nutrition and healthy lifestyle boost the immune system and helps prevant malignancy.

3.Patients with family history of skin cancer should be reviewed yearly

4.Recently a melanocyte-stimulating hormone called melanotan has been found to provide photoprotection against squamous cell carcinoma of the skin.