A concise note on Carcinoma

1. SQUAMOUS CELL
SQUAMOUS CELL
CARCINOMA
CARCINOMA
BY DR. ASHFAQ AFRIDI
BY DR. ASHFAQ AFRIDI

2. Whatisit?
Whatisit?
 Squamous cell carcinoma is
Squamous cell carcinoma is
an extremely common form
an extremely common form
of skin cancer which is
of skin cancer which is
usually noncancerous,
usually noncancerous,
especially if caught early. In
especially if caught early. In
almost 97% of cases, the
almost 97% of cases, the
cancer can be
cancer can be excised
excised
and the patient will fully
and the patient will fully
recover. In other instances,
recover. In other instances,
squamous cell carcinoma has
squamous cell carcinoma has
the potential to
the potential tometastasize
metastasize, spreading
, spreading
to other portions of the body
to other portions of the body
and creating serious health
and creating serious health
problems.
problems.

4. Conti…..
Conti…..
It is the second most
It is the second most
frequent malignant skin
frequent malignant skin
tumor after basal cell
tumor after basal cell
carcinoma.
carcinoma.Most common type of
Most common type of
cancer in the Caucasian
cancer in the Caucasian
population
populationSkin cancers have about
Skin cancers have about
600,000 cases per year.
600,000 cases per year.
Of these, 100,000 to
Of these, 100,000 to
150,000 are squamous
150,000 are squamous
cell carcinomas.
cell carcinomas.

6. Mostlikelytoget
Mostlikelytoget
it:it:
 Fair skin white men, usually
Fair skin white men, usually
over age 60.
over age 60. Blonde or red hair; blue or
Blonde or red hair; blue or
green eyes.
green eyes. History of indoor
History of indoor
tanning
tanning
 Diagnosed with
Diagnosed with actinic
actinic
keratoses
keratoses (AKs).
(AKs).
 Family history of skin cancer.
Family history of skin cancer.
 Weakened immune system
Weakened immune system
((immunosuppression
immunosuppression).).
 Received radiation therapy.
Received radiation therapy.
 History of exposure to coal tar
History of exposure to coal tar
products or arsenic.
products or arsenic.

8. Howyougetit:
Howyougetit:
 The incidence of skin cancers is
The incidence of skin cancers is
rising every year, likely due to
rising every year, likely due to
increased sun exposure. Most
increased sun exposure. Most
squamous cell carcinomas
squamous cell carcinomas
result from prolonged exposure
result from prolonged exposure
toto ultraviolet (UV)
ultraviolet (UV)
radiation
radiation, either from
, either from
sunlight or from tanning beds
sunlight or from tanning beds
or lamps. Avoiding UV light as
or lamps. Avoiding UV light as
much as possible is the best
much as possible is the best
protection. Sunscreen is an
protection. Sunscreen is an
important part of a sun-safety
important part of a sun-safety
program, but by itself doesn't
program, but by itself doesn't
completely prevent squamous
completely prevent squamous
cell carcinoma or other types of
cell carcinoma or other types of
skin cancer.
skin cancer.

10. Symptoms
Symptoms
 Skin cancer first appears
Skin cancer first appears
as a growth and it
as a growth and it
sometimes takes the form
sometimes takes the form
of a sore or pimple that
of a sore or pimple that
does not heal.The sore
does not heal.The sore
may bleed or ooze fluid,
may bleed or ooze fluid,
crust or scab over, and
crust or scab over, and
then ooze or bleed again.
then ooze or bleed again.
Cancer can occur on
Cancer can occur on
almost any area of the skin,
almost any area of the skin,
but is most common on
but is most common on
areas often exposed to the
areas often exposed to the
sun. Skin cancer usually is
sun. Skin cancer usually is
painless.
painless.

11. Symptoms
Symptoms
The most common
The most common
symptoms are:
symptoms are:
1. A new growth on the
1. A new growth on the
skin.
skin.
2. A change in an
2. A change in an
existing skin growth.
existing skin growth.
3. A sore that does not
3. A sore that does not
heal.
heal.

13. Diagnosis
Diagnosis
 In addition to taking a
In addition to taking a
complete medical history
complete medical history
and checking the affected
and checking the affected
area of skin, your doctor
area of skin, your doctor
may remove a small skin
may remove a small skin
sample (biopsy) for
sample (biopsy) for
examination under a
examination under a
microscope. Often, the
microscope. Often, the
biopsy is sent to a
biopsy is sent to a
pathologist who has
pathologist who has
special expertise in
special expertise in
diagnosing skin samples.
diagnosing skin samples.

15. Diagnosis
Diagnosis
A suspected squamous
A suspected squamous
cell carcinoma is often
cell carcinoma is often
biopsied by shaving off
biopsied by shaving off
the top layers of skin
the top layers of skin
with a surgical blade.
with a surgical blade.
Tumors that have spread
Tumors that have spread
deeper into the skin may
deeper into the skin may
be partially or
be partially orcompletely removed
completely removed
(incisional or excisional
(incisional or excisional
biopsy).
biopsy).

17. Treatments
Treatments
 Freezing:
Freezing: This involves
This involves
removing cancerous
removing cancerous
cells by freezing them
cells by freezing them
with liquid nitrogen.
with liquid nitrogen. Simple excision:
Simple excision: In this
In this
procedure, your doctor
procedure, your doctor
cuts out the cancerous
cuts out the cancerous
tissue and a surrounding
tissue and a surrounding
margin of healthy skin.
margin of healthy skin.

18. Treatments
Treatments
Laser therapy:
Laser therapy: AnAn
intense beam of light
intense beam of light
vaporizes growths,
vaporizes growths,
usually with little
usually with little
damage to surrounding
damage to surrounding
tissue and with a
tissue and with a
reduced risk of
reduced risk of
bleeding, swelling and
bleeding, swelling and
scarring. Lasers are often
scarring. Lasers are often
used to treat superficial
used to treat superficial
carcinomas on the lips.
carcinomas on the lips.

19. Treatments
Treatments
 Mohs surgery:
Mohs surgery: This is
This is
often considered the most
often considered the most
effective treatment for
effective treatment for
squamous cell carcinomas.
squamous cell carcinomas.
During the procedure,
During the procedure,
your doctor removes the
your doctor removes the
tumor layer by layer.This
tumor layer by layer.This
allows the entire growth to
allows the entire growth to
be removed without taking
be removed without taking
an excessive amount of
an excessive amount of
surrounding healthy skin.
surrounding healthy skin.

21. Treatments
Treatments
Radiation therapy:
Radiation therapy: ThisThis
may be an option for
may be an option for
treating large cancers on
treating large cancers on
the eyelids, lips and ears
the eyelids, lips and ears
— areas that are difficult
— areas that are difficult
to treat surgically — or
to treat surgically — or
for tumors too deep to
for tumors too deep to
cut out.
cut out.

22. Treatments
Treatments
 Chemotherapy:
Chemotherapy: For very
For very
superficial cancers,
superficial cancers,
creams or lotions
creams or lotions
containing anti-cancer
containing anti-cancer
agents may be applied
agents may be applied
directly to your skin. Some
directly to your skin. Some
of these medications can
of these medications can
cause severe inflammation
cause severe inflammation
and scarring.This can also
and scarring.This can also
come in the form of an IV
come in the form of an IV
which is inserted into the
which is inserted into the
body.
body.

24. Medications
Medications
 Fluorouracil
Fluorouracil::Indications: IV- treatment
Indications: IV- treatment
of colon cancer, breast
of colon cancer, breast
cancer, gastric cancer,
cancer, gastric cancer,
pancreatic carcinoma.
pancreatic carcinoma.
Topical- management of
Topical- management of
carcinoma cancer
carcinoma cancerActions:Theraputic
Actions:Theraputic
Effects- death of rapidly
Effects- death of rapidly
replicating cells, particularly
replicating cells, particularly
malignant ones.
malignant ones.

26. Prognosis
Prognosis
 Although an original
Although an original
squamous cell carcinoma
squamous cell carcinoma
diagnosis comes with a
diagnosis comes with a
95% cure rate, the disease
95% cure rate, the disease
is typically recurring if the
is typically recurring if the
tumors spread to other
tumors spread to other
locations on the body, the
locations on the body, the
prognosis is less
prognosis is less
promising if the cancer
promising if the cancer
spreads t the lymph nodes
spreads t the lymph nodes
or organs in the body.
or organs in the body.

27. Prognosis
Prognosis
The prognosis for if the
The prognosis for if the
cancer spreads to the
cancer spreads to the
lymph nodes can be as
lymph nodes can be as
high as 73% with proper
high as 73% with proper
treatment.When in the
treatment.When in the
lungs, it is not cureable.
lungs, it is not cureable.
Prompt treatment of
Prompt treatment of
suspicious skin lesions
suspicious skin lesions
help to ensure early
help to ensure early
diagnosis and affords the
diagnosis and affords the
best possible prognosis.
best possible prognosis.

28. Video
Video
http://www.5min.com/Vi
http://www.5min.com/Vi
deo/Understanding-
deo/Understanding-
Squamous-Cell-
Squamous-Cell-
Carcinoma-29158691
Carcinoma-29158691