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Squamous cell carcinoma is the second most common type of skin cancer, which appears in the most superficial layer of the skin, and which usually appears in the regions of the body most exposed to the sun, such as the face, neck, arms or legs.
This type of cancer can be difficult to identify, but it usually appears as a rough reddish or brown spot that can increase in size over time or cause the appearance of a wound that does not heal, for example.
The treatment options are diverse and depend on the size, location and depth of the tumor, the person's age and general health conditions. Thus, it is recommended to consult a dermatologist whenever a spot that did not exist on the skin is identified, that grows over time or that causes some type of symptom, such as pain or tingling.
Main signs and symptoms
Signs and symptoms that may indicate the presence of squamous cell carcinoma are:
- Firm and red nodule;
- Wound with scaly crust;
- Pain and roughness in an old scar or ulcer.
Squamous cell carcinoma most often occurs on skin exposed to the sun, such as the scalp, hands, ears or lips.
In addition, there may also be a rough, scaly stain on the lip that can develop into an open sore, a painful or rough red ulcer inside the mouth or the appearance of a wart-like sore on the anus or genitals.
Possible causes
The most frequent causes of squamous cell carcinoma of the skin are chronic exposure to sunlight, frequent use of tanning beds and skin wounds, as cancer can appear in burns, scars, ulcers, older wounds and in parts of the body previously exposed to X-rays or other chemicals.
In addition, it can also develop from chronic infections and inflammations on the skin or in people with HIV, autoimmune diseases or people who are undergoing or have had chemotherapy and certain medications that make the immune system weaker, decreasing resistance diseases and increasing the risk of developing skin cancer.
How the treatment is done
If it is identified early, the squamous cell carcinoma of the skin can be cured, otherwise these tumors can invade the tissues around the cancer and disfigure the skin, and may also create metastases and reach other organs.
Treatment must be adapted to the type, size, location and depth of the tumor, the person's age and general health conditions, and there are several therapies that can be used:
1. Mohs surgery
This technique consists of removing the visible part of the tumor, which is being examined under a microscope, and the procedure is repeated until the last tissue removed is free of tumor cells. After removal, the wound can heal normally or be reconstructed with plastic surgery.
2. Excisional surgery
With this procedure, all the cancerous tissue is removed, as well as a skin border around the lesion, as a safety margin. The wound is closed with stitches and the removed tissue is sent for analysis to verify that all cancer cells have been removed.
3. Curettage and electrodissection
In this procedure, the cancer is scraped with an instrument called a curette, and then an electro cauterizing needle is used that destroys malignant cells and controls bleeding. This procedure is usually repeated more often, to ensure that all cancer cells have been eliminated.
This procedure is not considered effective in more invasive and aggressive carcinomas or cancer in critical areas, such as the eyelids, genitals, lips and ears.
4. Cryosurgery
In cryosurgery, the tumor is destroyed by freezing the tissue with liquid nitrogen, without the need for cuts or anesthesia. The procedure may have to be repeated several times, so that all malignant cells are destroyed.
This method is not widely used to treat more invasive cancers, as it is not as effective in deeper regions of the tumor.
5. Radiotherapy
In this procedure, X-rays are applied directly to the lesion, and anesthesia or cutting is also unnecessary, however, it is necessary to perform a series of treatments, administered several times over a period of about one month.
Radiotherapy is indicated for tumors that are difficult to treat through surgery or for situations in which it is not recommended.
6. Photodynamic therapy
Photodynamic therapy is most commonly used in people whose cancer develops on the face or scalp. In this procedure, 5-aminolevulinic acid is used, which is applied to the lesions and the next day a strong light is used. This treatment destroys the carcinoma cells without causing damage to normal tissue.
7. Laser surgery
In this technique, a laser is used to remove the outer layer of the skin and varying amounts of deeper skin, without bleeding. The risks of scarring and pigment loss are slightly higher than in other techniques, and the recurrence rates are similar to those of photodynamic therapy.
Who is most at risk
Although it is thought that this type of cancer can be hereditary and appear spontaneously, the cases in which there is a greater tendency to develop squamous cell carcinoma are:
- Have light skin and hair or blue, green or gray eyes;
- Frequent exposure to the sun, especially in the hottest hours;
- Have a history of basal cell carcinoma;
- Having a disease called xeroderma pigmentosum. Learn more about this disease;
- Be over 50;
In addition, this disease is more common in men than women.
Created by: Tua Saúde Editorial Team
Bibliography>
- SKIN CANCER FOUNDATION. Squamous Cell Carcinoma. Available in: . Accessed on 17 Jun 2020
- BRITISH SKIN FOUNDATION. Squamous Cell Carcinoma. Available in: . Accessed on 17 Jun 2020
- AMERICAN CANCER SOCIETY. Treating Squamous Cell Carcinoma of the Skin. Available in: . Accessed on 17 Jun 2020