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The term “skin cancer” encompasses a series of injuries caused by the disorderly reproduction of cells that make up the different layers of what is the largest organ in the human body. Although all the pictures are relevant, some types of skin cancer bring greater risks to patients – this is the case of squamous cell carcinoma.
But, after all, is squamous cell carcinoma serious? Although it is not the most common type of skin cancer — in Brazil, it is behind non-melanoma basal cell tumors, for example — it is important to understand how it manifests itself and how it is possible to prevent it.
Furthermore, as with other tumors, patients with these carcinomas benefit from being diagnosed at an early stage, increasing the chance of successful treatment.
Learn more below!
What is squamous cell carcinoma?
According to estimates by the National Cancer Institute (INCA), it is expected that, by 2025, Brazil will diagnose up to 704,000 new cases of skin cancer per year. This makes this type of tumor the most common among the Brazilian population, ahead of breast, prostate and lung cancers, for example.
However, it is expected that a significant part of these diagnoses refer to the so-called “non-melanoma skin cancers”. In contrast, there are melanoma-type cancers, which form from melanocytes — cells responsible for producing melanin, which gives color to the skin. They tend to be rarer but far more aggressive.
Anyway, within the groups of non-melanoma tumors, there are those that form from the basal cells, which are in a lower layer of the skin.
There are also those that arise from spinocellular cells (also called squamous cells), which cover the surface layer of the skin. A tumor originating from these cells is called, precisely, squamous cell carcinoma.
Although more serious, squamous cell carcinomas are rarer. While non-melanoma basal cell tumors account for about 75% of diagnoses, only 20% have their origin in this group of skin cells. The remaining cases (less than 5%, on average) concern skin cancer of melanocytes (that is, they are melanomas).
What causes squamous cell carcinoma?
Frequent and unprotected exposure to sunlight is the main cause of skin tumors, including squamous cell carcinomas. Ultraviolet rays present in sunlight reach skin cells, damaging their genetic material. As these errors accumulate, they start to replicate in a disorderly way, generating tumors.
This process tends to be more intense in fair-skinned people. Furthermore, the damage caused by exposure to sunlight is cumulative: the longer the exposure, the greater the risk. Thus, it is common for squamous cell tumors to manifest in people over 40 years of age.
In addition, family history (that is, the presence of other cases in the family), some problems in the immune system and immunosuppression conditions can favor the development of this tumor.
The types of squamous cell carcinoma vary according to the aggressiveness of cell proliferation. Thus, it can be poorly differentiated (more aggressive), moderately differentiated (in the progression phase) or well differentiated (when cells are confused with healthy ones).
What are the symptoms of squamous cell carcinoma?
The most characteristic symptom of a squamous cell carcinoma is skin lesions. In general, they appear in areas most exposed to the sun, such as the face, neck and back of the hands.
This type of tumor can also be identified on the genitals and in other areas less exposed to solar radiation, from scars from old injuries or chronic wounds.
In most cases, the lesions are reddish or in the form of warts, which do not stop growing. The patches tend to have jagged edges and a scaly appearance. Also, they bleed easily.
In addition, injuries do not heal or take a long time to close. Also worthy of attention is the change in color and appearance of pre-existing spots and moles. In any case, only a dermatologist is able to conduct the proper evaluation to confirm the diagnosis.
How is the diagnosis made?
The diagnosis of a squamous cell carcinoma is made based on an evaluation of the patient’s history and on the clinical examination of the lesion, in which the doctor can use a kind of magnifying lens (dermoscope).
During the initial examination, the doctor may also assess the condition of the areas surrounding the injury. It is common, for example, for the spread of tumor cells to generate swelling in the lymph nodes (the so-called swells).
However, confirmation or not of the presence of a squamous cell carcinoma in the skin can only be confirmed by biopsy. In this type of examination, a small fragment of the lesion is removed and sent for laboratory analysis. With this, a pathologist can assess the nature of the cells that cause the identified alteration and determine whether or not they are cancerous.
What is the treatment for squamous cell carcinoma?
Once the diagnosis is confirmed, the physician can determine the best course of action for the treatment of squamous cell carcinoma.
At this point, having identified the problem at an early stage makes all the difference: when this happens, treatment tends to be done with local interventions, to remove the lesion before it grows and spreads to other parts of the body. For this, options such as surgery and radiotherapy sessions can be used.
In regions where surgical extraction may be difficult, there is the option of cryosurgery, which uses liquid nitrogen to freeze and destroy cancer cells.
In more advanced cases, it may be necessary to resort to treatments such as chemotherapy, targeted therapies and immunotherapy. For invasive conditions, resection of lymph nodes affected by tumor expansion may also be indicated.
How to prevent squamous cell carcinoma?
Although treatment against squamous cell carcinoma has a good chance of success when the diagnosis identifies its development at an early stage, this does not mean ignoring basic care to strengthen prevention.
In general, they are simple and can be adopted on a daily basis, without major changes in routine:
- protect yourself from ultraviolet radiation, not staying in the sun, unprotected, between 10:00 and 16:00;
- always use sunscreen with at least SPF 30;
- not using tanning beds;
- be aware of certain risk factors, such as a history of phototherapy treatment for psoriasis;
- be careful with chronic exposure to certain chemical compounds, especially in professional activities.
In addition, it is always worth monitoring the state of health of the skin and seeking medical help whenever any change in spots or moles draws attention. It doesn’t hurt to reinforce: the early diagnosis of a squamous cell carcinoma is one of the main allies in the effectiveness of the treatment.
Oncology at Hospital Israelita Albert Einstein has all the necessary structure to offer the best support to the patient. To learn more about the care offered, contact us.
Technical review: Alexandre R. Marra, researcher at the Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEP) and permanent professor at the Graduate Program in Health Sciences at the Faculdade Israelita de Ciências da Saúde Albert Einstein (FICSAE).