Squamous Cell Carcinoma: Symptoms, Causes, Treatment

What are the symptoms of squamous cell carcinoma?

Squamous cell carcinoma (SCC) can manifest with various symptoms depending on its location. Common symptoms include:

Skin Lesions: On the skin, SCC often appears as a persistent, scaly, or crusted lesion that might bleed or become painful. It can be red, firm, and often feels rough to the touch.
Wounds That Don’t Heal: A sore or wound that does not heal or keeps recurring.
Changes in Existing Lesions: Existing moles or spots may change in appearance, becoming larger, more irregular, or changing color.
Growths: Unusual growths or bumps that can appear on areas frequently exposed to the sun, such as the face, ears, neck, or hands.
Persistent Pain or Tenderness: Areas affected by SCC may be painful or tender.
Oral Symptoms: When SCC occurs in the mouth or lips, it can cause symptoms like persistent sores or ulcers, bleeding, or difficulty swallowing.
Lung Symptoms: In cases of SCC in the lungs, symptoms might include a persistent cough, coughing up blood, chest pain, and difficulty breathing.
Genital Symptoms: For SCC of the genital area, symptoms may include sores, warts, or bleeding.
Nasal Symptoms: If SCC affects the nasal cavity or sinuses, it may cause nasal congestion, bleeding, or a loss of smell.

These symptoms can vary based on the cancer’s location and stage. If you notice any unusual changes or persistent symptoms, it’s important to consult a healthcare professional for evaluation and possible biopsy to determine the cause.

What are the causes of squamous cell carcinoma?

Squamous cell carcinoma (SCC) is influenced by various risk factors and causes, which include:

Sun Exposure: Chronic exposure to ultraviolet (UV) radiation from the sun is a major risk factor, particularly for SCC of the skin. This includes both natural sunlight and artificial sources like tanning beds.
Tobacco Use: Smoking and the use of other tobacco products significantly increase the risk of SCC, especially in the mouth, throat, and lungs.
Alcohol Consumption: Excessive alcohol use, particularly in combination with tobacco, can elevate the risk of SCC in the oral cavity and throat.
Human Papillomavirus (HPV): Certain strains of HPV, particularly HPV-16 and HPV-18, are linked to SCC of the genital region, as well as the oropharynx (throat).
Chronic Irritation or Injury: Persistent irritation or injury to the skin, such as from poorly fitting dentures, can increase the risk of SCC. For example, long-term exposure to chemicals or physical trauma can contribute to the development of SCC.
Weakened Immune System: Individuals with a compromised immune system, such as those with HIV/AIDS or those on immunosuppressive medication, are at higher risk for developing SCC.
Previous Skin Cancer: Having had basal cell carcinoma or previous SCC increases the risk of developing new SCCs.
Genetic Factors: Genetic predispositions, such as a family history of skin cancer, can influence susceptibility to SCC.
Exposure to Carcinogens: Exposure to certain chemicals and substances, like arsenic and industrial chemicals, can increase the risk of SCC.
Genetic Mutations: Specific genetic mutations and conditions, such as xeroderma pigmentosum (a condition affecting DNA repair), can predispose individuals to SCC.

Addressing these risk factors, such as reducing sun exposure, quitting smoking, and avoiding excessive alcohol use, can help lower the risk of developing SCC. Regular skin checks and monitoring any unusual changes in the skin or mucous membranes can also aid in early detection and treatment.

What is the treatment for squamous cell carcinoma?

The treatment for squamous cell carcinoma (SCC) depends on factors such as the tumor’s size, location, stage, and the patient’s overall health. One common approach is surgical excision, where the tumor is removed along with some surrounding healthy tissue to ensure all cancer cells are eliminated. In sensitive areas, Mohs surgery may be used, which involves removing the tumor layer by layer and examining each layer under a microscope until no cancer cells remain. Curettage and electrodessication, a procedure where the tumor is scraped away and the area treated with an electric needle, can also be used.

Radiation therapy may be applied either as the primary treatment or after surgery to target any remaining cancer cells. It is often considered when surgery isn’t feasible or for cases that are difficult to remove surgically. In certain situations, cryotherapy can be employed, where the tumor is frozen with liquid nitrogen to destroy the cancerous tissue. Photodynamic therapy (PDT) is another option, which uses a photosensitizing agent and specific light exposure to destroy cancer cells, typically for superficial cases.

For early-stage or superficial SCCs, topical treatments, such as creams containing anti-cancer agents like 5-fluorouracil (5-FU) or imiquimod, may be prescribed. In more advanced cases where SCC has spread, chemotherapy could be used, either alone or in combination with other treatments. Targeted therapies, such as EGFR inhibitors, can be beneficial for specific cases of advanced SCC.

Immunotherapy is another option for advanced SCC that can’t be managed with surgery or radiation, involving drugs that help the immune system attack cancer cells. The specific treatment plan is tailored to the patient and may involve collaboration among specialists. Early detection and consistent follow-up care are essential to managing SCC effectively.

What is the survival rate for squamous cell carcinoma?

The survival rate for squamous cell carcinoma (SCC) depends on several factors, including the location of the cancer, its stage at diagnosis, and whether it has spread to other parts of the body. Here’s an overview of survival rates:

1. Skin Squamous Cell Carcinoma:

Early-Stage SCC: When detected early and treated promptly, the survival rate is very high. The 5-year survival rate for localized skin SCC is more than 95%.
Advanced-Stage SCC: If SCC has spread to nearby lymph nodes or other organs (metastatic SCC), the survival rate decreases. The 5-year survival rate for SCC that has spread is about 34%.

2. Squamous Cell Carcinoma in Other Organs (e.g., lung, throat, esophagus):

Lung SCC: The 5-year survival rate for lung SCC varies based on the stage:
Localized (early stage): About 60%.
Regional (spread to nearby structures): About 33%.
Distant (metastatic): Around 7%.
Esophageal SCC: The 5-year survival rate is approximately 47% for localized disease but drops to about 5-20% for metastatic cases.

Early detection and treatment significantly improve the prognosis for squamous cell carcinoma.