Squamous Cell Carcinoma

Squamous cell carcinoma or Epithelioma is a slowly evolving and asymptomatic malignancy. Albino people and elderly are more prone to develop squamous cell carcinoma than others.

It is the commonest cancer affecting the cheek, lip, oral cavity tongue, ear auricle, lungs, oesophagus, cervix, vulva, penis etc. The lesions are commonly found in sun-exposed areas including cheeks, lips (lower lip more common than upper), ears, scalp and dorsum of hands. Other regions that are commonly involved are gall bladder, stomach, bronchus, urinary bladder and kidney.

The exact cause behind the development of squamous cell carcinoma is not known. Exposure to sunlight and chronic irritation of the skin are important risk factors. Sometimes old scars also change into such cancerous cauliflower like growth. Other risk factors include leukoplakia, paget’s disease of nipple, papilloma, ionizing radiation, industrial carcinogens etc.

There are no signs of regression. Slight pain or bleeding may be present occasionally. There is often a history of weight loss. Joint movements are often restricted due to pain caused by infiltration into the joint.

It starts from the prickle cell layer of the skin. The lesion starts as a crack or fissure, which grows to form a cauliflower like growth. Usually there is a single mass with raised and everted (rolled out) edge. Surrounding region is also involved. Nearby lymph nodes become palpable, hard and fixed.

The cancer spreads to the surrounding tissues through infiltration and lymphatic spread. There may be muscle, tendon or even bone involvement. The spread may also occur in blood (though rarely) in the later stages.

The diagnosis is confirmed by biopsy. Treatment of squamous cell malignancy is done through surgery, radiotherapy, chemotherapy and topical medications.

Squamous cell carcinoma is readily treated and 5-year survival rate is seen in almost 75% of cases. The disease becomes incurable once lung metastasis occurs. Only preventive measure is avoiding unnecessary prolonged sun-exposure.