Carcinoma, Squamous Cell

Carcinoma, Squamous Cell

National Organization for Rare Disorders, Inc.

Important

It is possible that the main title of the report Carcinoma, Squamous Cell is not the name you expected. Please check the synonyms listing to find the alternate name(s) and disorder subdivision(s) covered by this report.

Synonyms

  • Carcinoma, Epirmoid Intradermal
  • Skin Cancer, Squamous Cell Type

Disorder Subdivisions

  • Bowen's Disease

General Discussion

Squamous cell carcinoma (SCC) is the second most common skin cancer with between 200,000 and 250,000 cases reported each year. It is a malignant cancer that usually develops from the epidermis and/or the mucous lining of the body cavities (epithelium), but may occur anywhere on the body. SCC most often affects individuals who are exposed to large amounts of sunlight. Susceptibility is related to the amount of melanin pigment in the skin, and light-skinned persons are most vulnerable. With appropriate treatment, it is usually curable.

Symptoms

Squamous cell carcinoma may develop anywhere on the skin or mucous membranes. It is characterized by a red papule or plaque with a scaly or crusted surface. Most cases appear on sun-exposed areas of the body, but some occur in other areas such as the mouth. In some cases, the bulk of the lesion may lie below the skin, eventually ulcerating and invading the underlying tissue. It is estimated that in about two-thirds of the cases of lesions on the tongue or mucous membranes of the body, the disorder has not spread before it was diagnosed.



SCC is suspected whenever a small, firm reddish-colored skin lesion or growth or bump appears on the skin. It may also be a flat growth with a curly and crusted surface. Most often these growths are located on the face, ears, neck, hands and/or arms, but such SCC growths may occur on the lips, mouth, tongue, genitalia or other area.



Clinicians have concluded that extensive sun damage to the skin may cause "precancerous conditions". Some of these include actinic keratosis, leukoplakia and Bowen's disease. Actinic (sometimes called solar) keratoses consist of rough, scaly growths that range in color from brown to red. These growths may grow as large as one-inch in diameter and are more frequently found in older people. When actinic keratosis affects the lips (usually the lower lip), it is known as actinic cheilitis. Leukoplakia arises most often as white patches on the tongue or in the mucous membrane of the mouth. It is usually caused by smoking or by the persistent irritation of the gums because of ill-fitting dentures.



For more on Bowen's disease, see Related Disorders, below.

Causes

The most common causes of squamous cell carcinoma are radiation from the sun and arsenic exposure. Skin that has been damaged by exposure to certain chemicals (carcinogens), heat, radiation, chronic skin ulcers or chronic draining sinuses is also susceptible to SCC. It may develop on normal tissue or it may develop on preexisting patches of precancerous tissue (leukoplakia).

Affected Populations

Squamous cell carcinoma is a common form of skin cancer that affects men and women equally. Individuals who are chronically exposed to sunlight or arsenic are at higher risk of being affected. The Bowen's disease form of this disorder affects both males and females. However, women are more apt to be affected when the disease is found in the genital area.

Standard Therapies

Diagnosis

A biopsy is essential for the diagnosis of SCC.



Treatment

Treatment of squamous cell carcinoma depends upon the size, site and potential aggressiveness of the lesion. Methods of treatment include:



Curettage and desiccation is an in-office procedure that uses a special spoon-like instrument (curette) to scoop out the cancerous cells and tissue. This is followed by the application of an electric current to kill the remaining cells (desiccation). Surgical excision is a method of cutting out of the tumor and stitching up of the remaining tissue. Radiation therapy is used if the skin cancer is located in an area difficult to treat surgically. Microscopically controlled excision (Mohs surgery) involves the repeated cutting out of small pieces of tissue that is then examined microscopically. Repeated application of this technique minimizes the removal of healthy tissue and is cosmetically more satisfying, especially if carried out with a plastic surgeon as part of the medical team. The outlook for small squamous cell lesions that are removed early and completely is excellent.

Investigational Therapies

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government website.



For information about clinical trials being conducted at the National Institutes of Health (NIH) in Bethesda, MD, contact the NIH Patient Recruitment Office:



Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov



nformation on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.



For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:



Tollfree: (800) 411-1222

TTY: (866) 411-1010

Email: prpl@cc.nih.gov



For information about clinical trials sponsored by private sources, contact:

www.centerwatch.com



There is a tremendous amount of clinical trial activity on squamous cell carcinoma, with more than 100 studies listed (2005) on www.clinicaltrials.gov. Many of the investigational treatments involve chemotherapies, combinations of drugs, and drug comparisons to treat squamous cell carcinoma in its various stages and locations on the human body.



Two drugs have earned orphan status for treating squamous cell carcinoma. Intradose was designated an orphan drug in 2000 and is produced by Matrix Pharmaceuticals. Proxinium was designated an orphan drug in 2005 and is produced by a Canadian pharmaceutical company, Viventia Biotech, Inc.

References

TEXTBOOKS

Beers MH, Berkow R., eds. The Merck Manual, 17th ed. Whitehouse Station, NJ: Merck Research Laboratories; 1999:321-24; 691-93; 758; 843.



Berkow R., ed. The Merck Manual-Home Edition.2nd ed. Whitehouse Station, NJ: Merck Research Laboratories; 2003:672; 764-65; 1238-39.



Larson DE. ed. Mayo Clinic Family Health Book. New York, NY: William Morrow and Company, Inc; 1996:1004-06.



Kasper, DL, Fauci AS, Longo DL, et al. Eds. Harrison's Principles of Internal Medicine.

16th ed. McGraw-Hill Companies. New York, NY; 2005:497-98.



REVIEW ARTICLES

Veness MJ. Treatment recommendations in patients diagnosed with high-risk cutaneous squamous cell carcinoma. Australas Radiol. 2005;49:365-79.



Lane JE, Kent DE. Surgical margins in the treatment of nonmelanoma skin cancer and mohs micrographic surgery. Curr Surg. 2005;62:518-26.



Dixon AJ, Hall RS. Managing skin cancer -- 23 golden rules. Aust Fam Physician. 2005;34:669-71.



Maier T. Korting HC. Sunscreens -- which and what for? 2005;18:253-62.



Tran KT, Lamb P, Deng JS. Matrikines and matricryptins: Implications for cutaneous cancers and skin repair. J Dermatol Sci. 2005;40:462-67.



Boukamp P. UV-induced skin cancer: similarities -- variations. J Dtsch Dermatol Ges. 2005;3:493-503.



Boukamp P. Non-melanoma skin cancer: what drives tumor development and progression? Carcinogenesis. 2005;26:1057-67.



FROM THE INTERNET

Grund S. Squamous cell cancer. Medical Encylopedia. MedLine Plus. Update Date: 8/16/2004. 3pp.

www.nlm.nih.gov/medlineplus/ency/article/000829.htm



Skin Cancer (PDQ): Treatment Health Professional Version. National Cancer Institute. Last Modified: 04/01/2005. 11pp.

www.nci.nih.gov/cancertopics/pdq/treatment/skin/healthprofessional/allpages/print



Skin Cancer (PDQ): Screening Health Professional Version. National Cancer Institute. Last Modified: 12/16/2005. 6pp.

www.nci.nih.gov/cancertopics/pdq/screening/skin/healthprofessional/allpages/print.

Resources

Skin Cancer Foundation

149 Madison Avenue

Suite 901

New York, NY 10016

Tel: (212)725-5176

Fax: (212)725-5751

Tel: (800)754-6490

Email: info@skincancer.org

Internet: http://www.skincancer.org



American Cancer Society, Inc.

250 Williams NW St

Ste 6000

Atlanta, GA 30303

USA

Tel: (404)320-3333

Tel: (800)227-2345

TDD: (866)228-4327

Internet: http://www.cancer.org



National Cancer Institute

6116 Executive Blvd Suite 300

Bethesda, MD 20892-8322

USA

Tel: (301)435-3848

Tel: (800)422-6237

TDD: (800)332-8615

Email: cancergovstaff@mail.nih.gov

Internet: http://www.cancer.gov



OncoLink: The University of Pennsylvania Cancer Center Resource

3400 Spruce Street

2 Donner

Philadelphia, PA 19104-4283

USA

Tel: (215)349-8895

Fax: (215)349-5445

Email: hampshire@uphs.upenn.edu

Internet: http://www.oncolink.upenn.edu



Rare Cancer Alliance

1649 North Pacana Way

Green Valley, AZ 85614

USA

Internet: http://www.rare-cancer.org



Genetic and Rare Diseases (GARD) Information Center

PO Box 8126

Gaithersburg, MD 20898-8126

Tel: (301)251-4925

Fax: (301)251-4911

Tel: (888)205-2311

TDD: (888)205-3223

Internet: http://rarediseases.info.nih.gov/GARD/



Esophageal Cancer Awareness Association, Inc.

P.O. Box 55071 #15530

Boston, MA 02205-5071

Tel: (607)257-1141

Fax: (607)255-0349

Tel: (800)601-0613

Email: aschoener@ecaware.org

Internet: http://www.ecaware.org/



Friends of Cancer Research

1800 M Street NW

Suite 1050 South

Washington, DC 22202

Tel: (202)944-6700

Email: info@focr.org

Internet: http://www.focr.org



Cancer Support Community

1050 17th St NW Suite 500

Washington, DC 20036

Tel: (202)659-9709

Fax: (202)974-7999

Tel: (888)793-9355

Internet: http://www.cancersupportcommunity.org/



Lance Armstrong Foundation

2201 E. Sixth Street

Austin, TX 78702

Tel: (512)236-8820

Fax: (512)236-8482

Tel: (877)236-8820

Email: media@livestrong.org

Internet: http://www.livestrong.org



For a Complete Report

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