Can squamous cell carcinoma spread to lymph nodes?
Unlike other types of carcinoma, squamous cell carcinoma can spread from its original site to the lymph nodes, e.g. in the neck or around the collarbone.
Squamous cells are thin, flat cells found in tissues that form the surface of the skin and the lining of body cavities, such as the mouth, nose and throat. Squamous cell carcinoma is a fairly slow-growing carcinoma. The doctor will try to find the original site from where the tumor metastasized (spread). When physicians cannot locate a primary tumor, it is called an occult (hidden) primary tumor. The chance of recovery depends on the number of lymph nodes containing cancer, the location of cancer in the neck and the patient’s general health.
What causes squamous cell carcinoma?
Squamous cell carcinoma of the skin occurs when the flat, thin squamous cell in the middle and outer layers of the skin develop mutations in their DNA. The mutations trigger the squamous cell to grow out of control. Ultraviolet (UV) radiations found in sunlight may prompt the cells to mutate.
Other factors that can increase the risk of squamous cell carcinoma include
- Fair skin: Having less pigment (melanin) in the skin provides less protection from the damaging UV rays.
- Excessive sun exposure: Exposure to UV rays from sunlight may increase the risk of squamous cell carcinoma.
- History of sunburns: History of blistering sunburns as a child or teenager increases the risk of developing squamous cell carcinoma.
- Rare genetic disorder: People with a genetic disorder (albinism, xeroderma pigmentosum) that causes extreme sensitivity to sunlight are more prone to squamous cell carcinoma.
- Weakened immune system: People with conditions that lead to a weak immune system are highly prone to squamous cell carcinoma.
- A previous history of squamous cell carcinoma will most probably be the causative factor.
- A previous history of precancerous skin lesions, such as actinic keratosis or Bowen disease, can increase the chance of squamous cell carcinoma.
What are the signs and symptoms of squamous cell carcinoma?
Squamous cell carcinoma commonly occurs on the sun-exposed areas of the skin, such as the scalp, the back of the hands, ears or lips. Symptoms of squamous cell carcinoma of the skin include
- A firm, red nodule
- A red sore or rough patch inside the mouth
- A flat sore with a scaly crust
- A red, raised patch or war-tlike sore on the genitals
- A new sore or raised area on an old scar or ulcer
- A rough, scaly patch on the lip that may evolve into an open sore
- A sore that does not heal despite treatment
How is squamous cell carcinoma treated?
The treatment options depend on the stage and type of skin cancer. For localized cancers, the following treatment may be used
- Curettage and electrodessication (C and E): Scraping the cancerous ulcer with a curette and then searing the base of the cancer with an electric needle is one treatment method.
- Laser therapy: Laser treatment may be an option for very superficial skin lesions. It is used to burn down cancer cells.
- Freezing: Liquid nitrogen is used to freeze and kill the cancer cells. Freezing might be done after using a scraping instrument (curette) to remove the surface of the skin cancer.
- Photodynamic therapy: The cancer cells are sensitized to light with chemicals and then exposed to light.
The most common treatment in large cancers include
- Excision: The removal of the tumor.
- Moh surgery: The removal of the tumor layer by layer and examination of each layer under a microscope until no cancer cells are seen.
- Surgery to remove cancerous lymph nodes as well as healthy lymph nodes in more invasive cancers. Complications of surgery include bleeding, infection or pneumonia.
- Radiation therapy: Radiation of high frequency destroys the cancerous cells.
- Chemotherapy: Chemotherapy uses medications to kill cancerous cells.
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