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» Home » CAD » Oncology » Malignancy of the Skin » Squamous Cell Carcinoma
Background
In the United States, squamous cell carcinoma of the skin, also known as cutaneous squamous cell carcinoma, is the second most prevalent form of skin cancer, behind basal cell carcinoma.
Actinic Keratosis appears as a precursor lesion before SCC development, and it demonstrates tumor growth, and has the ability to spread inside the body.
Ultraviolet (UV) sun radiation is the key risk factor for the development of cutaneous squamous cell carcinoma, and cumulative lifetime exposure plays a significant role in the progression of this malignancy.
Mohs micrographic surgery is the best method for treating cutaneous squamous cell carcinoma which presents on the neck, head, and other high-risk areas. SCCs which have particularly dangerous characteristics are also treated with MMS. Only patients who cannot sustain surgery are suggested radiotherapy. This is generally the case with the elderly.
Very high tumors are typically treated with adjuvant radiation following surgical intervention. Lifetime squamous cell carcinoma risk is considerably increased by immunosuppression.
Metastasis is uncommon in squamous cell carcinomas that arise in areas of persistent sun exposure, although it can occur, and the risk is elevated in immunocompromised people.
Individuals with cutaneous SCC should be evaluated routinely and reminded to use UV protection measures.
Epidemiology
Following Basal Cell Carcinoma, SCC is the skin cancer which most people in the US are afflicted with. Previously BCC would affect 3 times more individuals than Squamous Cell Carcinoma, but now the number of individuals affected are almost the same.
They’re both responsible for around 1 million cases each annually.
It has been observed that the ratio tends toward the occurrence of squamous cell carcinoma as age increases. White-skinned individuals with light eyes, and significant exposure to UV rays are extremely susceptible to SCC, especially after turning 50.
Those having a history of extensive UV exposure, whether because of a history of sun exposure or medical treatment, are at a higher risk.
Immunosuppressed patients also have a high incidence of squamous cell carcinoma, which can progress into aggressive subtypes.
Anatomy
Pathophysiology
UV exposure is recognized as the primary risk factor for cutaneous squamous cell cancer.
The most prevalent genetic anomalies in actinic keratosis, squamous cell carcinoma in situ, and invasive squamous cell carcinoma are mutations in the p53 gene.
Some of the common risk factors for Squamous Cell Carcinoma development are:
This process most likely happens through the p53 pathway. The p53 protein prevents the replication of cells with mutant or damaged DNA.
If the p53 gene becomes altered in any of the aforementioned ways, the p53 protein becomes inactive, and cells with damaged DNA, such as those present in squamous cell carcinoma, are able to proliferate.
Etiology
The leading cause of SCC is solar UV radiation. Squamous cell carcinoma can also be caused by extended periods of exposure to substances which increase cancer risk, such as the tar in cigarettes.
Other probable reasons include a severe burn scar, a long-standing ulcer or sore, and some forms of HPV, particularly in the vaginal area.
Genetics
Researchers do not yet understand all of the DNA alterations that lead to Squamous Cell Carcinoma, or Basal Cell Carcinoma — nevertheless, they have discovered that in many skin malignancies, tumor suppressor genes are altered.
The TP53 tumor suppressor gene is most frequently mutated in squamous cell malignancies. Typically, this gene causes DNA-damaged cells to perish.
When the TP53 gene mutates, aberrant cells may survive for longer, and eventually develop into malignant cells.
Prognostic Factors
Clinical History
Physical Examination
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
by Stage
by Modality
Chemotherapy
Radiation Therapy
Surgical Interventions
Hormone Therapy
Immunotherapy
Hyperthermia
Photodynamic Therapy
Stem Cell Transplant
Targeted Therapy
Palliative Care
Medication
350 mg given IV over 30 minutes every three weeks
continue the drug until disease progression, or unacceptable toxicity occurs
Dose Adjustments
Renal impairment:
No adjustment is recommended.
Liver impairment:
No adjustment is recommended.
Monotherapy:
200
mg
Intravenous (IV)
every 3 weeks
OR 400 mg Intravenous (IV) every 6 weeks
300
mg
Intravenous (IV)
over 30 minutes
3
weeks
continue the drug until disease progression, or unacceptable toxicity occurs
Dose Adjustments
Renal impairment:
No adjustment is recommended.
Liver impairment:
No adjustment is recommended.
0.25 - 0.5
unit/kg
Intravenous (IV)/IM/SC
1-2 times a week
Future Trends
References
https://www.ncbi.nlm.nih.gov/books/NBK441939/
https://www.cancer.org/content/dam/CRC/PDF/Public/8819.00.pdf
ADVERTISEMENT
» Home » CAD » Oncology » Malignancy of the Skin » Squamous Cell Carcinoma
In the United States, squamous cell carcinoma of the skin, also known as cutaneous squamous cell carcinoma, is the second most prevalent form of skin cancer, behind basal cell carcinoma.
Actinic Keratosis appears as a precursor lesion before SCC development, and it demonstrates tumor growth, and has the ability to spread inside the body.
Ultraviolet (UV) sun radiation is the key risk factor for the development of cutaneous squamous cell carcinoma, and cumulative lifetime exposure plays a significant role in the progression of this malignancy.
Mohs micrographic surgery is the best method for treating cutaneous squamous cell carcinoma which presents on the neck, head, and other high-risk areas. SCCs which have particularly dangerous characteristics are also treated with MMS. Only patients who cannot sustain surgery are suggested radiotherapy. This is generally the case with the elderly.
Very high tumors are typically treated with adjuvant radiation following surgical intervention. Lifetime squamous cell carcinoma risk is considerably increased by immunosuppression.
Metastasis is uncommon in squamous cell carcinomas that arise in areas of persistent sun exposure, although it can occur, and the risk is elevated in immunocompromised people.
Individuals with cutaneous SCC should be evaluated routinely and reminded to use UV protection measures.
Following Basal Cell Carcinoma, SCC is the skin cancer which most people in the US are afflicted with. Previously BCC would affect 3 times more individuals than Squamous Cell Carcinoma, but now the number of individuals affected are almost the same.
They’re both responsible for around 1 million cases each annually.
It has been observed that the ratio tends toward the occurrence of squamous cell carcinoma as age increases. White-skinned individuals with light eyes, and significant exposure to UV rays are extremely susceptible to SCC, especially after turning 50.
Those having a history of extensive UV exposure, whether because of a history of sun exposure or medical treatment, are at a higher risk.
Immunosuppressed patients also have a high incidence of squamous cell carcinoma, which can progress into aggressive subtypes.
UV exposure is recognized as the primary risk factor for cutaneous squamous cell cancer.
The most prevalent genetic anomalies in actinic keratosis, squamous cell carcinoma in situ, and invasive squamous cell carcinoma are mutations in the p53 gene.
Some of the common risk factors for Squamous Cell Carcinoma development are:
This process most likely happens through the p53 pathway. The p53 protein prevents the replication of cells with mutant or damaged DNA.
If the p53 gene becomes altered in any of the aforementioned ways, the p53 protein becomes inactive, and cells with damaged DNA, such as those present in squamous cell carcinoma, are able to proliferate.
The leading cause of SCC is solar UV radiation. Squamous cell carcinoma can also be caused by extended periods of exposure to substances which increase cancer risk, such as the tar in cigarettes.
Other probable reasons include a severe burn scar, a long-standing ulcer or sore, and some forms of HPV, particularly in the vaginal area.
Researchers do not yet understand all of the DNA alterations that lead to Squamous Cell Carcinoma, or Basal Cell Carcinoma — nevertheless, they have discovered that in many skin malignancies, tumor suppressor genes are altered.
The TP53 tumor suppressor gene is most frequently mutated in squamous cell malignancies. Typically, this gene causes DNA-damaged cells to perish.
When the TP53 gene mutates, aberrant cells may survive for longer, and eventually develop into malignant cells.
350 mg given IV over 30 minutes every three weeks
continue the drug until disease progression, or unacceptable toxicity occurs
Dose Adjustments
Renal impairment:
No adjustment is recommended.
Liver impairment:
No adjustment is recommended.
Monotherapy:
200
mg
Intravenous (IV)
every 3 weeks
OR 400 mg Intravenous (IV) every 6 weeks
300
mg
Intravenous (IV)
over 30 minutes
3
weeks
continue the drug until disease progression, or unacceptable toxicity occurs
Dose Adjustments
Renal impairment:
No adjustment is recommended.
Liver impairment:
No adjustment is recommended.
0.25 - 0.5
unit/kg
Intravenous (IV)/IM/SC
1-2 times a week
https://www.ncbi.nlm.nih.gov/books/NBK441939/
https://www.cancer.org/content/dam/CRC/PDF/Public/8819.00.pdf
In the United States, squamous cell carcinoma of the skin, also known as cutaneous squamous cell carcinoma, is the second most prevalent form of skin cancer, behind basal cell carcinoma.
Actinic Keratosis appears as a precursor lesion before SCC development, and it demonstrates tumor growth, and has the ability to spread inside the body.
Ultraviolet (UV) sun radiation is the key risk factor for the development of cutaneous squamous cell carcinoma, and cumulative lifetime exposure plays a significant role in the progression of this malignancy.
Mohs micrographic surgery is the best method for treating cutaneous squamous cell carcinoma which presents on the neck, head, and other high-risk areas. SCCs which have particularly dangerous characteristics are also treated with MMS. Only patients who cannot sustain surgery are suggested radiotherapy. This is generally the case with the elderly.
Very high tumors are typically treated with adjuvant radiation following surgical intervention. Lifetime squamous cell carcinoma risk is considerably increased by immunosuppression.
Metastasis is uncommon in squamous cell carcinomas that arise in areas of persistent sun exposure, although it can occur, and the risk is elevated in immunocompromised people.
Individuals with cutaneous SCC should be evaluated routinely and reminded to use UV protection measures.
Following Basal Cell Carcinoma, SCC is the skin cancer which most people in the US are afflicted with. Previously BCC would affect 3 times more individuals than Squamous Cell Carcinoma, but now the number of individuals affected are almost the same.
They’re both responsible for around 1 million cases each annually.
It has been observed that the ratio tends toward the occurrence of squamous cell carcinoma as age increases. White-skinned individuals with light eyes, and significant exposure to UV rays are extremely susceptible to SCC, especially after turning 50.
Those having a history of extensive UV exposure, whether because of a history of sun exposure or medical treatment, are at a higher risk.
Immunosuppressed patients also have a high incidence of squamous cell carcinoma, which can progress into aggressive subtypes.
UV exposure is recognized as the primary risk factor for cutaneous squamous cell cancer.
The most prevalent genetic anomalies in actinic keratosis, squamous cell carcinoma in situ, and invasive squamous cell carcinoma are mutations in the p53 gene.
Some of the common risk factors for Squamous Cell Carcinoma development are:
This process most likely happens through the p53 pathway. The p53 protein prevents the replication of cells with mutant or damaged DNA.
If the p53 gene becomes altered in any of the aforementioned ways, the p53 protein becomes inactive, and cells with damaged DNA, such as those present in squamous cell carcinoma, are able to proliferate.
The leading cause of SCC is solar UV radiation. Squamous cell carcinoma can also be caused by extended periods of exposure to substances which increase cancer risk, such as the tar in cigarettes.
Other probable reasons include a severe burn scar, a long-standing ulcer or sore, and some forms of HPV, particularly in the vaginal area.
Researchers do not yet understand all of the DNA alterations that lead to Squamous Cell Carcinoma, or Basal Cell Carcinoma — nevertheless, they have discovered that in many skin malignancies, tumor suppressor genes are altered.
The TP53 tumor suppressor gene is most frequently mutated in squamous cell malignancies. Typically, this gene causes DNA-damaged cells to perish.
When the TP53 gene mutates, aberrant cells may survive for longer, and eventually develop into malignant cells.
https://www.ncbi.nlm.nih.gov/books/NBK441939/
https://www.cancer.org/content/dam/CRC/PDF/Public/8819.00.pdf
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