Squamous Cell Carcinoma - How Dangerous Is It?
Definition - What is Squamous Cell Carcinoma?
Squamous cell carcinoma is a malignant tumor or cancer. This comes from the skin or the mucous membrane. Squamous epithelium describes the upper layer of cells, which covers many outer and inner surfaces. Because of multiple mutations, changes in the squamous epithelium occur and cancer develops. Since squamous cell is found on many surfaces of the body, there is a wide variety of squamous cell carcinomas.
Squamous cell carcinoma can occur here
Squamous cell carcinoma can occur in many different places in the body because the skin, mucous membrane and many organ surfaces are covered by squamous epithelium. A common place of manifestation is the lungs. Squamous cell carcinomas are also common on the skin. The tongue, oral cavity or inside of the nose can also be affected. Squamous cell carcinoma also occurs in the esophagus. Squamous cell carcinoma can also develop on the penis. However, these are extremely rare. A risk factor for penile cancer is poor hygiene.
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Squamous cell carcinoma of the lungs
Lung cancer does not have to be squamous cell carcinoma, but squamous cell carcinomas of the lungs are quite common at 40%. The majority of lung cancer today is due to smoking. Most often, lung cancer develops after smoking for decades. Quitting smoking significantly lowers the risk of lung cancer even after years of smoking. In addition to smoking, there are other risk factors, such as polluted air or toxic substances. In a few cases, a genetic predisposition can also be the cause. Unfortunately, since lung cancer is often diagnosed late, the therapeutic options are often limited and many sufferers die as the disease progresses. Lung cancer is the number 1 killer of cancer among men. Men are significantly more likely to develop lung cancer than women.
Further information on this topic can be found at: Squamous cell carcinoma of the lungs
There are two types of carcinoma in the esophagus - squamous cell carcinoma on the one hand and adenocarcinoma on the other. Squamous cell carcinoma is a little rarer than adenocarcinoma in Europe today. But squamous cell carcinoma is more common in countries where very hot food or drinks are consumed. This includes e.g. Japan and china. Important risk factors for squamous cell carcinoma in the esophagus are smoking and high alcohol alcohol. Most tumors occur in the middle of the esophagus.
For more information, see: Esophageal cancer
Squamous cell carcinoma of the skin
Squamous cell carcinoma of the skin is called spinalioma. A spinalioma appears on the skin as an inconspicuous, gray-yellowish raised area. As the disease progresses, the spinaliomas grow, become more noticeable, and can bleed. They are characterized by rapid growth within a few months. Since the spinaliomas are mainly caused by UV light, they are located in places exposed to sunlight. 90% of spinaliomas are located on the face. In addition to UV radiation, various chemicals or non-healing skin lesions are also risk factors for spinalioma. Men are more often affected by spinaliomas than women. In diagnostics, a spinalioma must be differentiated from other types of skin cancer. Often, spinaliomas can simply be excised in the early stages.
Further information on this topic can be found at: Squamous cell carcinoma.
Squamous cell carcinoma of the nose
Squamous cell carcinoma can also develop inside the nose and the paranasal sinuses, mainly affecting the main nasal cavity. The tumor makes nasal breathing difficult on one side. There may also be other complaints such as nosebleeds and nerve failures in the face. Depending on the growth of the nasal cancer, discomfort to the teeth or eyes are possible.
Tongue cancer can come in different forms. As a rule, there are few or no symptoms at the onset of the disease. Tongue cancer often develops on the edge and base of the tongue. It spreads easily to the larynx. It is believed that regular consumption of tobacco and alcohol promote the formation of tongue squamous cell carcinoma. In addition to the tongue, other areas of the oral cavity can also be affected by squamous cell carcinoma. These must also be surgically removed.
For more information, see: Squamous cell carcinoma of the tongue
I recognize squamous cell carcinoma by these symptoms
Because squamous cell carcinoma occurs in different parts of the body, there are no general symptoms that are typical of squamous cell carcinoma. Depending on the organ affected, there are typical organ complaints. It does not have to be a squamous cell carcinoma in this organ; other types of cancer are also possible. Only in the course of further examinations can a distinction be made whether it is actually a squamous cell carcinoma or not. Squamous cell carcinoma does not cause any specific symptoms in the lungs at the beginning. Therefore, lung cancer is often recognized very late. They lead to general symptoms such as coughing, shortness of breath and chest pain. In the late stages, blood may also be expectorated from the lungs. The same problem exists with cancer of the esophagus. Uncharacteristic symptoms here are difficulty swallowing, weight loss and pain behind the sternum and back. Squamous cell carcinoma of the skin is primarily non-symptomatic. They are only noticeable by their appearance on the skin. If they are in places such as positioned around the lip, they can be very annoying and uncomfortable.
Treatment of squamous cell carcinoma
Therapy depends on the stage and location of the tumor. By default, the tumor must be surgically removed for healing. In lung cancer, the tumor must be surgically removed. In addition, lymph nodes in the vicinity of the tumor, which may therefore have been infiltrated by the tumor, are also removed. Furthermore, chemotherapy and radiation are carried out after the operation in order to prevent the tumor from recurring. Even if the lung cancer cannot be removed as part of an operation because the tumor has already progressed too far, chemotherapy and, in certain cases, radiation are given to extend the life span and alleviate possible symptoms. Squamous cell carcinoma of the esophagus also involves radical removal of the affected part of the esophagus. With squamous cell carcinoma of the skin, the spinalioma, a simple local removal is often sufficient. For larger tumors, however, more complex operations with reconstruction of removed skin areas are necessary. For carcinomas in the nose, the same therapy is used as for spinaliomas.
Chemotherapy is a standard treatment for squamous cell carcinoma in the lungs. There are 4-6 cycles of chemotherapy with two drugs three weeks apart. If the squamous cell carcinoma is no longer curable, the chemotherapy is adapted individually. Chemotherapy is also used by default for cancer of the esophagus. Chemotherapy can also be used prior to surgical removal of the tumor to shrink the tumor and make surgery easier. For skin cancer and nasal cancer, chemotherapy is only given if there are metastases or the cancer is inoperable.
For more information on how chemotherapy is performed and the side effects, see: chemotherapy
Radiation is also standard for lung cancer. Here the chest cavity is irradiated. The aim is to hit the places where the tumor may have spread. For esophageal cancer, skin cancer and tongue cancer, radiation can be used as a complementary therapy or as an alternative to chemotherapy.
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- Treatment with radiation therapy
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Prognosis and life expectancy of squamous cell carcinoma
In general, no statement can be made about the individual prognosis or life expectancy. The prognosis of squamous cell carcinoma primarily depends on how advanced it is and where it is located. Lung cancer usually has a relatively poor prognosis. The situation is similar with squamous cell carcinoma of the esophagus, since here too the tumor is recognized late. In contrast, the life expectancy with spinaliomas is very good, as they can be easily removed in most cases.
In terms of survival rates, too, the individual locations and stages of squamous cell carcinoma must again be considered.With lung cancer, 15% of people who were newly diagnosed with lung cancer are still alive after 5 years. However, the survival rate is highly dependent on how early the cancer was diagnosed. In the early stages, 5-year survival rates are between 25 and 50%. Often, however, lung cancer is only recognized when it can no longer be operated on. With esophageal carcinoma, less than 10% of patients are alive after 5 years, since most patients already have cancer in an advanced stage at the time of diagnosis. However, if surgery is successful and the tumor is completely removed, about 35% are still alive. Spinaliomas that are less than one centimeter in size, on the other hand, have a very good chance of recovery and can usually be easily removed.
Course of disease
The course of the disease varies greatly from person to person. Since it depends on many other factors in addition to the actual cancer type, cancer stage and location. This includes, for example, the response to therapy as an important criterion. It is also very important whether the planned therapy is well tolerated. In some cases, for example, chemotherapy is so poorly tolerated that it has to be stopped. Age and physical condition also play a role.
The likelihood of metastases depends on the location of the squamous cell carcinoma. Lung carcinomas often metastasize, which is why therapy is usually difficult here. Typical organs to which lung cancer metastasizes are the liver, the brain, the adrenal glands and the skeleton. Metastases are also common in esophageal cancer. In addition, tongue carcinomas metastasize early via the lymph to the lymph nodes of the neck and lower jaw and from there to other organs. In contrast, squamous cell carcinomas metastasize to the skin rather rarely and late.
At this point we also recommend the following article: What are metastases?
Diagnosis of squamous cell carcinoma
In general, squamous cell carcinoma is suspected based on typical symptoms and location. Depending on the location, various examinations are carried out to establish the diagnosis. The reliable diagnosis of squamous cell carcinoma is made using a biopsy. During a biopsy, some tissue is removed with a small punch, which is then examined under the microscope. Squamous cell carcinoma can then be clearly identified here. However, a biopsy is not always necessary or possible. Skin changes can also be removed without a biopsy and only examined microscopically afterwards. In the case of squamous cell carcinoma in the lungs, the diagnosis is always an X-ray of the lungs and a CT scan to identify the tumor and its spread. CT is also done if you have squamous cell carcinoma in the esophagus. In addition, an endosonography is performed. Here, the mucous membrane of the esophagus is examined with an ultrasound device. This allows the extent of the tumor to be assessed. Imaging examinations such as CT or MRI are also necessary for squamous cell carcinomas in the nose and oral cavity
Are there suitable tumor markers for squamous cell carcinoma?
Tumor markers are proteins or other body substances that are increased in the blood in the event of a tumor. However, these can also be increased by other diseases. With a few exceptions, a tumor is never diagnosed on the basis of tumor markers. They rather serve as progress parameters in order to assess the tumor occurrence and the response to therapy. In lung cancer, however, tumor markers do not play a role. For esophageal squamous cell carcinoma there is the SCC.
Causes of the emergence
In general, carcinomas result from mutations, i.e. changes in the DNA. The causes for this are very different and also often influenced by the individual genetic predisposition. The DNA mutations can be triggered by many different influences, so-called risk factors. These are very different depending on the organ. A major risk factor for squamous cell carcinoma of the lungs is smoking. In addition to hard alcohol, smoking is also a widespread cause of cancer of the esophagus. UV light is very damaging to DNA. This is the main cause of the development of squamous cell carcinoma of the skin. Furthermore, the risk of developing cancer generally increases with age.