Planar skin cancer. Squamous cell skin cancer: clinic, diagnosis, methods of treatment and prevention

The causes of this pathology have not been reliably elucidated. It has been established that neoplasia can form on intact skin or transform into a cancerous tumor from precancerous skin diseases, including xeroderma pigmentosa and Bowen's disease.

Sometimes squamous cell skin cancer is formed against the background of keratosis, keratoacanthoma, dermatitis focus, chronic inflammatory processes and ulcers of various origins (post-traumatic, radiation, caused by impaired local blood supply, etc.).

), chemical and sunburn.

Most often, the tumor develops against the background of precancerous diseases - Bowen's disease, when nodular rashes appear on the skin, covered with a crust, or xeroderma pigmentosa, which usually occurs in newborns in the form of a zone of hyperkeratosis. No less cases of diagnosing squamous cell carcinoma in people with chronic inflammatory processes: burns, ulcers and pyoderma. It is also impossible to pass by the cicatricial process, the result of which can also be the development of spinalioma. These are the following factors:

• Received chemical, thermal or chemical injuries;
• Skin diseases with a predisposition to cancer (furunculosis, carbuncles, lupus erythematosus);
• Features of the profession (obtaining repeated burns in the same place)

Less often, the appearance of tumors in people suffering from discoid lupus erythematosus and chronic radiation dermatitis is observed.

UV rays are the root cause of skin cancer

The main reason that increases a person's ability to get this disease is ultraviolet rays. In second place is the effect of radiation, which can provoke any oncological disease. People who are associated with the chemical industry are also at risk of getting cancer.

One of the causes of skin cancer is exposure to ultraviolet rays. Therefore, people who like to sunbathe in solariums or on the beach, during the hours when the sun is most active, are at risk of getting this dangerous disease.

In addition, Keyr's erythroplasia, Bowen's disease, Paget's disease, and xeroderma pigmentosa.

In fact, all of these diseases are forms of cancer that, if left untreated, transform into squamous cell skin cancer. Besides, chronic diseases skin of an inflammatory nature dermatologists rightfully refer to precancerous diseases.

These are dermatitis, ulcers, pyoderma. Various skin injuries, such as burns of various etymologies, radiation dermatitis.

• Squamous cell carcinoma skin (squamous cell carcinoma) - this type of disease is localized in the upper layers of the skin, it begins with the degeneration of flat cells.
• Basalioma is a form of squamous cell carcinoma in which there is an atypical degeneration of skin cells that are lower than squamous cells.
• Skin adenocarcinoma - this type of cancer is localized in the sweat and sebaceous glands.
• There is another type of squamous cell carcinoma in which malignant degeneration of pigment cells occurs.

Scientists came to the conclusion that the pathology often affects fair-skinned and red-haired people, and is inherited. Many factors can provoke the appearance of squamous cell carcinoma:

The main reason for the development of oncological diseases in the human body has not yet been precisely determined, but for squamous cell skin cancer, a photo of the manifestations of which can be viewed on the Internet resource, the main dangerous factor is considered to be excessive insolation, the negative effect of ultraviolet rays.

Failure of the cells (their mutation) is considered as a consequence of previous sunburns.

Can also provoke the development of pathology:

• genetic predisposition;
• body immunodeficiency;
• senile changes (thickening) of the stratum corneum;
• bruises and microtrauma;
• x-ray exposure;
• papillomavirus.

Accumulated during life ultraviolet radiation is the main leading cause of the development of squamous cell skin cancer. This is also evidenced by statistics in the form of the number of cases per year per hundred thousand of the population (morbidity).

Most neoplasms appear on open areas of the body of fair-skinned patients over the age of 60 years. Between 70% and 80% of tumors appear on the head and neck.

In particular, on the lower lip, ears, scalp. Slightly less common is the lesion of the dorsum of the hand, forearm, anterior surface of the lower leg and the dorsum of the foot.

Squamous cell skin cancer is much less common in areas inaccessible to sunlight. The human papillomavirus (HPV) also makes its contribution.

It can cause both precancerous lesions and skin cancer. Often in the foci of squamous cell skin cancer, HPV types 16, 18, 31, 33, 35, 39, 40, 51, 60 are found; 5, 8, 9 types of HPV were also found.

Of lesser importance is a decrease in immunity, constant trauma, inflammatory skin diseases, contact with harmful chemicals (especially arsenic compounds).

Kinds

Squamous cell carcinoma has several types, depending on which the symptoms and treatment approaches vary. The main types of such cancer include:

• Acanthotic. This histological type of cancer is most common in older people. It is characterized by a high frequency of metastasis as a result of the weakening of the immune function of the human genome due to age-related changes.
• Bowenoid. Bowenoid type of cancer is characterized by the absence of horn formations characteristic of other forms of the disease. Also, with this type, pronounced dyskeratosis is observed.
• Spindle cell. This type is similar to sarcoma and has the most active metastasis among squamous cell carcinomas both to neighboring and distant organs, as well as The lymph nodes. Tumor growth is pronounced.

There are quite a few types of squamous cell carcinoma and they are divided depending on the area of ​​tumor localization. Each is characterized by its own symptoms, which is the peculiarity of this type. oncological disease.

This type of tumor is the most common. In 90 percent of cases, it is keratinizing and develops, most often, in open areas. Perhaps the development of tumor or ulcerative-necrotic forms. Symptoms of this cancer include:

• Painful sensations.
• Swelling of tissues adjacent to the tumor.
• The appearance of burning and itching.
• Decreased sensitivity.
• Redness of tissues near the affected area.

Lips in the area of ​​the red border

Lip cancer is a common form of the disease. Most often, a neoplasm appears on the lower lip, however, in some cases, a malignant tumor forms on the upper lip.

This form is more aggressive and dangerous for the patient's health. Lip cancer is more common in men and is three times more common than in women.

The keratinizing form is most often observed, however, an infiltrative-ulcerative form is often present, which is more aggressive.

oral cavity

This type of disease is characterized by the presence of a malignant formation in the mucosal epithelium in the inner part of the lips, gums, cheeks or palate. Often, the disease is provoked, in addition to the reasons indicated in the article, by the frequent use of hot dishes or drinks.

A distinctive feature of this type of cancer is its aggressiveness, rapid growth of the tumor and its active germination in neighboring tissues.

Symptoms of this variety include:

• Pain at a late stage, which is caused by the pressure of the neoplasm on neighboring tissues.
• Increased salivation and feeling foreign body in the oral cavity.
• The presence of bad breath due to the destruction of cancer cells.
• Deterioration of speech and difficulty in performing chewing actions (present at a late stage of the disease).

Esophagus

In the esophagus, a tumor-like form of squamous cell carcinoma is more common, which is provoked by a number of factors, among which the main one is malnutrition.

In addition, an oncological tumor often develops against the background of reflux ophagitis due to the reflux of gastric juice into the inner part of the esophagus.

With development, a high growth rate of the tumor is observed, which can eventually block the esophageal opening. The symptoms of the disease include:

Squamous cell oncology is conditionally divided into the following types, depending on the ability of cells to undergo keratinization and the rate of their spread:

• Non-keratinizing highly differentiated - spreads relatively slowly, due to the fact that there are not a large number of pathological particles.
• Keratinized differentiated - develops rapidly, does not have a pronounced color, it is difficult to diagnose.
• Poorly differentiated non-trading - pathology spreads quickly due to the large number of pathological particles in the body.

According to the direction and nature of growth, 2 types of squamous cell formation of the skin are distinguished:

• Exophytic - the neoplasm grows on the surface.
• Infiltrating - the tumor grows deep into the subcutaneous layers. Capable of breaking down quickly bone tissue, vessels. Leads to complications in the form of bleeding.

The success of the treatment depends on how deep the oncoformation has grown inside the tissues.

By appearance, squamous cell oncology is divided into 3 forms. They use different methods of treatment:

• Plaque - on the red-colored area there are small tubercles that are clearly visible even to the naked eye. They have a rough surface and may bleed.
• Nodular - multiple nodules are observed on the skin different sizes, because of this, the formation resembles a cauliflower. It has a thick texture Brown color. It often develops at the sites of old injuries and scars.
• Ulcerative - a crater-like ulcer is visible on the skin. It is slightly elevated above the skin, its edges are ridge-like. The deepening of the defect smoothly descends. The ulcer grows rapidly in breadth and depth. When pressing on the pathology, a bloody fluid is released from it.

Basalioma is the most common form of skin cancer, and the least aggressive. It is often located on the face and head, less often on the trunk and limbs.

The probability of the formation of this type of tumor in men is 33%, in women - 23%. Basalioma does not have clear stages of development, it very rarely gives metastases (in 0.5%), but at the same time it aggressively affects the surrounding tissues, causing their destruction, and relapses in 50%.

Survival forecasts for this type of neoplasm are almost 100%.
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In 20% of cases, patients develop squamous cell skin cancer. It often forms on exposed areas of the body exposed to solar radiation. It goes through 5 stages of development:

Stage 0: tumor cells are located in the superficial layers of the epithelium.

Stage 1: the lesion is up to 2 cm in diameter and slowly grows deep into the tissues.

Stage 2: The tumor is 2-4 cm in diameter and has damaged the deep layers of the skin.

At all these stages, the prognosis of skin cancer treatment is favorable, the procedures consist in removing the tumor, the five-year survival rate is more than 90%.

Stage 3: metastases in regional tissues.

Stage 4: metastases in distant tissues.

These stages involve an operation to remove the primary focus and metastases, as well as chemotherapy. The prognosis for survival over 5 years is 25-45%.

The probability of recurrence after tumor removal is 40%, in 20% of cases it is formed in the area of ​​the primary focus.

Melanoma is the most malignant of all types of skin cancer. It is characterized by rapid progression, involvement of deep layers and early metastases.

It looks like an asymmetric mole, rising above the level of surrounding tissues, erosion of its surface, itching and soreness is possible. It goes through 5 stages of development:
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Stage 0: pathological melanocytes are located within the surface layer of the epithelium. Therapeutic measures consist in the removal of the lesion, the five-year survival rate of this stage is 97%.

Stage 1: this period means an increase in the tumor, but its thickness is not more than 1 mm and there are no metastases. Treatment involves surgery, it is also recommended to biopsy the lymph nodes for the presence of metastases. The five-year survival rate is 75-95%. Tumor ulceration at this stage reduces prognosis by up to 60%.

Stage 2: the thickness of the neoplasm increases to 4 mm or more, but there are no metastases. With adequate treatment, the prognosis for skin cancer reaches 65%.

Stage 3: The tumor metastasizes to nearby tissues in 67% of cases. If metastases are small in size and are determined only after histological examination, the 5-year survival rate is 30-60%. If the lymph nodes are significantly damaged, then the forecasts are reduced to 20-40%. Therefore, at stages 2 and 3, it is desirable to remove not only the neoplasm, but also regional lymph nodes in order to prevent the development of relapses.

Stage 4: melanoma metastasizes to distant organs (liver, kidneys, lungs, and others). At this stage, surgical intervention is rarely performed, most often chemotherapy drugs or palliative operations are used to remove the most dangerous metastases. The prognosis of five-year survival is 10%.

Relapses after medical measures observed in 3-5% of patients. Therefore, it is important to monitor the state of your health and skin for a long time after the manipulations in order to detect a recurrent tumor early.

stages

To date, there are several classifications of spinocellular cancer at once - according to the international TNM system and the domestic one. We will dwell on the domestic one in more detail.

I stage

The primary node does not exceed 2 cm in size, affects only the epidermis and dermis. Adjacent tissues are usually not infiltrated. The tumor is mobile and has no metastases (both distant and regional).

The primary nodule is more than 2 cm in diameter, usually affecting all layers of the skin, but does not extend to adjacent underlying tissues. Sometimes there is a single regional metastasis

The tumor reaches a significant size, strongly compacted, grows deep into the skin and underlying tissues, without affecting the cartilage and bones. One distant metastasis.

The tumor is large and growing soft tissues, cartilage and bones. Also, stage 4 includes tumors of any size with distant metastases or multiple regional mobile metastases.

The tumor can look different: in the form of a plaque, a spot, a crater, or a nodule and be located anywhere on the surface of the skin. Most often, these are open places that are more prone to sunburn (hands, upper lip, nose, head, neck), but, nevertheless, there are also cases of damage to the external genital organs, as well as the perianal region.

A person who notices a small weeping wound or a rough spot that does not go away within a month and even more so tends to grow should contact a specialist as soon as possible to conduct the necessary diagnosis.

Squamous cell carcinoma has two forms of development:

• Exophytic. In this case, the neoplasm has a dense texture and may look like a rough wart covered with keratinized cells and rising above the general level of the skin.
• Endophytic. With this form of development, external and internal tumor growth is observed, which manifests itself as a wet wound on the surface of the skin with rapid ulceration of healthy tissues around it.

Squamous cell skin cancer, like any cancer, has four stages of development:

Squamous cell skin cancer has been divided into 4 stages. Information about tumor cells, the degree of their atypicality, the depth of germination was taken as a basis:

• Stage 1 - a neoplasm no more than 20 mm, amenable to displacement, only the epidermis is affected.
• Stage 2 - the formation exceeds 20 mm, the dermis has sprouted without affecting neighboring tissues. Possible metastases in nearby lymph nodes.
• Stage 3 - oncoformation has reached a significant size, has grown into neighboring tissues without touching the bones. There may be one distant secondary focus.
• Stage 4 - a large neoplasm, sprouted into all the lower layers, spread metastases.

Squamous cell formations of the skin are often distinguished by size. The larger it is, the worse the prognosis.

Squamous cell skin cancer develops in the middle layers of the epidermis due to cell mutation and the onset of their abnormal, random division.

Depending on the type of neoplasms, this type of oncology is divided into forms:

• endophytic, or ulcerative. With it, a nodule appears, which deepens into the skin. Then the so-called "daughter" elements may appear around it, which subsequently (as a result of their decay) increase the ulcer. With this form, the attachment of infections is frequent. The growth of such a tumor can occur both along the periphery and in depth. Deepening is accompanied by damage to bone tissue;
• exophytic. With this form, the neoplasm protrudes above the surface, it is very dense, inactive, has a thick base covered with crusts (dry flat papules). For this appearance, squamous cell skin cancer is called "mushroom" (look at the photo);
• verrucous. With it, a primary seal appears, which is then covered with warty growths. It is characterized by slow growth and rare metastasis.

For information! A separate form of such oncology is commonly called Bowen's disease, in which neoplasms that have appeared are only on the surface of the epidermis and do not yet touch the dermis.

There are four stages of oncology, in which:

1. the emerging focus of tumor localization does not exceed 2 cm, the lesion affects only the lower layers of the epidermis and reaches the dermis, the spread of metastases has not begun;
2. the tumor increases, does not exceed 5 cm in size, the lesion has affected all layers of the epidermis and dermis, a single metastasis may appear;
3. tumor of considerable size, metastases affected nearby tissues;
4. a tumor of considerable size, cell metastasis went to other organs, bone tissues and cartilage are affected.

There is a division according to histological principle on squamous cell keratinizing skin cancer and non-keratinizing. The first type is characterized by the growth of epithelial strands, the appearance of the so-called "horn pearls".

It is quite difficult to suspect a cancerous lesion. Formations on the skin do not differ in obvious specificity.

In the early stages, nodal formations can arouse interest. Usually they rise above the upper layer of the epithelium and are distinguished by a wide base.

When palpated, the formation is dense and inactive. This is due to the presence of several layers.

As it progresses, sores may appear on the body.

Squamous cell skin cancer is divided into stages, depending on the characteristics of the tumor. To determine the stage, it is first fitted with suitable values ​​in the TNM system.

Where T characterizes the size of the tumor, N refers to regional lymph nodes, and M encodes the absence or presence of distant metastases.

TNM scores for staging squamous cell skin cancer.

Skin cancer staging based on TNM signs.

• There are four stages of the disease. To accurately determine the stage, there is a TNM system. The combination of signs in this system gives reason to attribute squamous cell skin cancer to any stage. The most initial stage is the zero or first stage. The tumor may not pass through the zero stage. The prognosis for the effectiveness of treatment and survival depends on the definition of the stage.
• The initial (first and zero) stage is treated quite easily and effectively. However, the location of the focus may be difficult to access. In areas such as in the auricle, a person himself may not notice the disease in time, which will lead to rapid growth into the cartilage and the transition to the third stage. In the eye area, squamous cell skin cancer can quickly grow into the orbit, which makes treatment extremely difficult and leads to loss of vision. There are also problems associated with long waiting times. medical care, passing many additional examinations and queues.
• Until the second stage, people grow the tumor themselves, or under the supervision of doctors. In the latter case, doctors treat inflammatory skin diseases, radiation dermatitis, trophic ulcers, and perform “scar plastic surgery”. In conditions of hard-to-reach qualified medical care in Russia, savings on everything in the CHI system, this is not uncommon.
• The third stage can be established when squamous cell skin cancer grows into cartilage or bone, affects a regional lymph node, or grows to a size greater than 5 cm. Germination in cartilage most often occurs in the ears and nose. Above 5 cm, people like to grow tumors on their backs and stomachs.
• In the fourth stage, squamous cell skin cancer passes in the case of metastasis during internal organs distant lymph nodes. However, most often - due to the refusal of surgical treatment due to the severe general condition of the person (contraindication to anesthesia). In order to prevent the transition to the fourth stage, it is most rational to be treated with cryodestruction. It can be performed on patients in any condition, it does not require anesthesia.

In the photo, squamous cell skin cancer of the third stage with the destruction of the lower lip, keratinizing.

Squamous cell skin cancer in the photo, appeared near the ear, led to the fourth stage. There is germination in the bone and damage to the lymph nodes.

Squamous cell skin cancer, its signs.

Many cancers have four stages of development. Squamous cell skin cancer, the prognosis of which can be positive only if it is detected on initial stage.

As a rule, with timely treatment, it is possible to cope with it. Therefore, it is extremely important to see a doctor at the first sign.

The manifestation of squamous cell carcinoma of the skin begins with the formation of a red spot, nodule or small ulcer (you can see in the photo), which does not go away on its own and does not decrease when treated with conventional dermatitis remedies, but only increases in size and is accompanied by infection.

In the case of the formation of a nodular form, squamous cell skin cancer shows the following symptoms: the resulting seal grows, becomes covered with a scaly surface or crust, often looks like a wart, gradually rises more above the surface.

After a while, it can take the form of a “cauliflower” or become covered with erosion.

If we are talking about the development of ulcerative cancer, then such squamous cell skin cancer in the photo looks like a round wound, prone to bleeding with raised edges, has a loose bottom, with a drying liquid. Also, the affected area emits an unpleasant odor.

It happens that the neoplasm appears in the form of bleeding plaques, with a bumpy surface, red in color.

At the initial stage, squamous cell skin cancer (the photo confirms this) is often mistaken for the manifestation of other ailments: psoriasis, dermatitis, the spread of a fungal infection.

The growth of a squamous cell tumor of the skin leads to external deformities (can be seen in the photo), deterioration of the body, weakness, exhaustion.

Signs of squamous cell skin cancer and its danger depend largely on the degree of differentiation. Highly differentiated means that cancer cells look similar enough to normal cells under the microscope that they are the least dangerous.

Poorly differentiated is the most dangerous, its cells under the microscope are very different from normal ones. Moderately differentiated occupies an intermediate position.

A sign of squamous cell skin cancer can be considered the appearance of a plaque or a node with a weeping bleeding surface or with dense yellowish crusts.

The density of formation varies considerably in each case. Symptoms of low-grade cancer are the softness of the node to the touch and the absence of horny crusts.

Usually, that skin cancer is highly differentiated, on the surface of which there are yellow horny masses, and, dense to the touch. Cancer should be suspected in any case if there is a suspicious mass that does not go away within a month.

Rapidly growing squamous cell carcinoma can grow within a few weeks, its symptoms are soreness, softness of the node. Squamous cell skin cancer is most similar to non-pigmented melanoma, inflammatory ulcer, pyogenic granuloma, basoscamous or ulcerative basalioma.

If there is any doubt about the diagnosis, a biopsy of the tumor is indicated, followed by a histological examination. The pronounced nature of the compaction of the skin surrounding squamous cell carcinoma also helps in the diagnosis.

If the tumor is up to 2 cm in diameter, and is highly differentiated, it is enough only to examine the regional lymph nodes with the doctor's fingers (palpation).

Compaction of the lymph node and an increase of more than 1.5 cm is a common sign of metastasis in it. It is possible to conduct a biopsy from the node using a needle from a syringe and an ultrasound machine.

If the tumor is more than 2 cm in diameter and / or is poorly differentiated, it is advisable to do an ultrasound of the regional lymph nodes, even if everything is fine on palpation.

And, sometimes, conduct a deeper examination.

Highly differentiated skin cancer of the upper eyelid. Dew for a relatively long time, has horny masses on the surface.

Symptoms

The tumor in this disease is a small nodule. Its surface is characterized by unevenness, sometimes it is covered with a somewhat keratinized epithelium of a rough appearance. The disease can manifest itself in areas such as:

• oral mucosa;
• language;
• lips;
• nostrils (rare);
• eyes;
• senile keratomas;
• papillomas, etc.

As a rule, a person pays attention to it only when it begins to ulcerate, deepen and expand.

On early stages squamous epithelioma is very often confused with basalioma, therefore, a mandatory cytological examination is carried out. The main difference between spinocellular carcinoma and basalioma is that the tumors of the former develop and increase in size much faster.

In appearance, the nodules can be flesh-colored (rarely with a reddish tint), dense to the touch, covered with crusts and horny plates. To date, two types of squamous cell carcinoma are distinguished clinically: tumor and ulcerative.

tumor type

This type is characterized by the appearance on the body of a small papule, which in a short time increases in size, turning into a dense nodule of a reddish-brown hue with a diameter of 2 cm.

The surface of the nodule may be covered with scales or warty growths that bleed at the slightest touch. The manifestation of the tumor can be observed at 3-4 months of its existence.

Very often, the tumor form is compared with "cauliflower" or "tomato", which outwardly are very similar to nodules of squamous cell carcinoma.

Ulcerative type

Symptomatic manifestations of squamous cell carcinoma are very different and directly depend on the type of disease. As a rule, localization of squamous cells malignant neoplasms observed in the region of the lower lip of the patient, on the external genital organs and in the perianal region.

In most cases, patients complain of a tumor or the presence of ulcerative inflammation on the skin, which is rapidly increasing in size. In the case of aggressive tumor development, pain is often observed.

Initially, squamous cell carcinoma is a nodule, plaque, or ulcer. The tumor has raised edges that surround it along the perimeter in the form of a kind of roller, and the ulcer itself has the appearance of a crater with an uneven bottom, falling below the main level of the skin.

There is a release of serous-bloody exudate from the tumor, and the formation is actively growing in size. There is also a type of cancer that manifests itself in the form of a nodular skin formation with external erosion or ulcers.

A plaque-like tumor has, as a rule, a finely tuberous surface and is red in color, rapidly growing and bleeding.

During the development of the disease and the onset of metastasis, there is an increase in lymph nodes located in the immediate vicinity of the malignant neoplasm.

Initially, the nodes have a dense and mobile texture, and later they lose their mobility and are destroyed under the influence of tumor metastases.

Skin cancer is characterized by a malignant course, it develops rapidly and metastasizes to the inner layers of the skin and to nearby tissues.

Spreading into muscles, bones and cartilage, the process provokes inflammation, which causes pain in the patient. Externally, cancer manifests itself in the form of ulcers, plaques or nodes:

Symptoms of the disease are primary tumors in the form of a node, ulcer or plaque. Over time, they grow in breadth and depth, leading to inflammation and pain.

Other symptoms of cancer are mobile bumps that form near the lymph nodes. At first, these bumps move freely under the skin and do not cause discomfort.

Over time, they become soldered to the skin, lose their mobility and cause pain.

It is necessary to distinguish 3 types of malignant tumors:

All these symptoms indicate that the disease is progressing.

Symptoms depend on the form of the disease. The following skin problems should alert:

• A wound is a non-healing wound that appeared without apparent reason, may look like erosion, nodule, plaque, red area. Instead of healing, the formation begins to grow.
• Scabs - erosion is often covered with crusts that differ from healthy skin in density.
• Smell - with an ulcerative form, the patient may feel a fetid odor from the affected area. It's hard not to notice him.
• Excretion of blood - fluid mixed with blood may be released from an ulcer or plaque. This happens if you intentionally remove the pathology or accidentally touch it.
• Pain - at the initial stage of development, the neoplasm is mobile and does not hurt. In the process of deepening under the skin, it begins to create discomfort.
• Cachexia - manifested by fatigue, fatigue, loss of strength, a sharp decrease in weight. The body is exhausted in the fight against the disease.

Most malignant skin growths grow within a few months, so it is important not to delay visiting a doctor.

Squamous cell carcinoma is classified into two main types. Oncology can be:

1. Exophytic.
2. Infiltrating.

In the first case, a massive knot is visible on the skin, which is distinguished by a wide base. Often, oncology is characterized by a "cabbage" appearance and an impressive size. As they grow, dense crusts appear, which often bleed.

The infiltrating form is characterized by the presence of ulcers. They differ in irregular outlines with dense edges. The tumor is prone to rapid germination in the tissue. During the diagnosis of the disease, the presence of metastases is noted, which indicates a neglected course.

Diagnostics

The diagnosis must certainly be confirmed by a histological examination or the results of a cytological examination of a special scraping taken from the surface of the neoplasm, in which atypical cells are quite simply and quickly determined.

During the diagnosis, it is important for an oncologist to differentiate the squamous cell form of cancer from basal cell cancer, Bowen's disease, and other diseases that have similar symptoms.

The main difference of the disease is its constant progression. To establish an accurate diagnosis, tumor markers are used and histological examination tumors.

These techniques are often combined with additional research methods designed to determine the degree of damage to other organs, neighboring tissues and the presence of metastases.

For this purpose, magnetic resonance imaging is used, with the help of which adjacent tissues and lymph nodes are examined.

Diagnosis of patients with suspected skin cancer is carried out by a dermato-oncologist. During the consultation, the doctor examines neoplasms and skin areas.

In this case, palpation of the lymph nodes and dermoscopy are performed. Based on the results of the examination, a conclusion is made about the degree of tissue damage by the oncological process.

In addition, an ultrasound is prescribed in order to find out how deeply the tumor has spread. If these are pigmented formations, then an additional examination is carried out using siascopy.

If there is a suspicion of skin oncology, then additional studies of histology and cytology are carried out. A cytological examination is carried out under a microscope, smears are examined, which are taken from the surface of ulcers or erosion.

Histological examination is carried out on the material that is obtained after surgery to remove the tumor or biopsy.

In the event that there is a suspicion of skin cancer, but the surface of the skin is not broken, then in this case the material for biopsy is taken by puncture.

Based on indications for suspicion of squamous cell skin cancer, a biopsy of the lymph nodes is performed. During histological examination, cells of atypical origin are detected.

In case of suspicion of squamous cell skin cancer, a cytological analysis will be carried out, the purpose of which is to establish the type of oncological disease and distinguish it from possible manifestations of other diseases similar in outward signs.

A scraping is also taken from the affected area for tissue examination in the laboratory. Additional diagnostic ultrasound or MRI may be prescribed to search for metastases.

In the treatment of this disease, the surgical method is most often used, since it is better to cut out the tumor until metastases have gone from it to the deeper layers of the skin.

This also includes the Mosch method, which in 95% of cases allows you to save the maximum amount of healthy tissue in the excised tumor focus. In addition to surgery, different types of therapies are used - for example, chemotherapy, laser, radiation, general and local.

The diagnosis is made on the basis of a number of studies:

• Histological examination of excised tumor tissues;
• Cytological examination of biological material from the surface of the tumor;
• Biopsies of enlarged lymph nodes;
• Ultrasound of nearby lymph nodes, liver, lungs.

Usually, several research methods are used, since cancer must not only be found, but also differentiated from other similar diseases. If, as a result of the studies, the presence of atypical cells in the tissues was established, the diagnosis is confirmed.

The diagnosis is made only after a thorough examination, which begins with a consultation with a specialist.

Instrumental and laboratory methods diagnostics:

• Dermoscopy is a painless method in which a specialist makes a visual assessment of skin lesions. Various magnifications of the optical device allow you to study the structure of the neoplasm in detail.
• Confocal scanning microscopy - the method allows you to get an intravital image at the cell level and demonstrate it in four dimensions. Due to the inability to fix the objective lens in any area, the method is inferior to histological examination.
• Differential diagnosis - the essence of the method is to distinguish squamous cell oncology from such forms as solar keratosis, Bowen's disease, cutaneous horn and others. To do this, conduct tests for tumor markers.
• Histological examination - for examination under a microscope, a scraping from the affected area is carried out.

The final diagnosis is most influenced by the results of histological examination.

Diagnosis cannot be made by visual examination alone. The specialist can put forward an assumption, but to confirm it, you must undergo a complete examination.

The standard procedure is histological examination. It is based on the study of a piece of tissue taken from the site of the lesion. Often, specialists remove scrapings. When metastasizing, enlarged, dense, immobile lymph nodes are observed.

Oncology is necessarily differentiated from other diseases of the skin. After the laboratory tests, the treatment tactics are determined.

Squamous cell skin cancer - photo:

To make the correct diagnosis, the specialist prescribes a histological examination. It may also be necessary to scrape the ulcer itself, and subject the contents of the scraping to cytological examination.

If it is really a squamous cell skin cancer, cancer cells will be found in the scraping.

According to statistics, skin cancer is most often detected at stages 3 or 4. The main reason for the spread of the tumor in the last stages is the untimely appeal for help.

Based on the research, experts found that at the time of the initial visit to the doctor, 50% of patients had the disease for more than 3 years, and 12% for more than 10 years.

Prior to seeking qualified help, such patients were treated on their own at home with ointments and herbal infusions, some went to healers.
.

But it is worth noting that if skin cancer is detected at stage 1 or 2, then more than 90% will be completely cured of the pathology, while 90% of these patients will not experience relapses. In addition, the removal of tumors up to 5 cm in diameter does not cause cosmetic defects.

Thus, educational lectures on cancer should be held in order to improve survival rates and reduce the incidence of skin cancer. It is also important to improve the qualifications of general practitioners in order to increase the activity of detecting tumors and replenish certain knowledge and skills. Indeed, in 15% of the examined patients, an incorrect primary diagnosis was made, which led to further growth and development of the tumor. Therefore, when obtaining negative histological analyzes with a single tissue sampling, one should not resort to expectant tactics if a malignant tumor is suspected.

Treatment

Oncologists and dermato-oncologists choose the tactics of treating squamous cell skin cancer depending on the location of the neoplasm, the prevalence of the oncological process, the presence or absence of secondary foci, the age and condition of the patient's body.

For small tumors, radiation therapy is used. In older patients, initial radiotherapy is usually performed for squamous cell skin cancer of any size (including large tumors).

The goal of radiation treatment is the complete disappearance of neoplasia or its reduction to a size that allows for radical surgery.

Squamous cell skin cancer can be represented by two types, namely: non-aggressive or impetuous. Treatment for the patient is determined solely by the oncologist, who analyzes the type of disease and the stage of its development.

Treatment of the disease, as a rule, consists in the complete removal of the tumor. Surgical excision can be performed in addition to radiotherapy. The treatment may also include cryodestruction, general and external chemotherapy, laser therapy, photodynamic therapy.

Purpose of procedures and operations

As you know, electrocoagulation, cryodestruction, curettage are used more often for multiple, but small tumors.

With chemosurgical treatment according to the Moch method, a very high level of getting rid of the disease (up to 99%) is now noted, it is possible to save the normal tissues around the focus to the maximum. This method is usually used for tumors with indistinct borders.

As for X-ray therapy, it is carried out more often when skin cancer is localized in the nose, eyelids, lips, as well as in old people who, due to general health, are not able to undergo surgery.

Chemosurgical treatment, special aromatic retinoids and professional X-ray therapy are indicated, as a rule, for relapses.

Treatment for relapses is accompanied by surgical excision of the recurrent tumor. This is followed by plastic surgery of the resulting tissue defects.

Treatment in the presence of metastases involves treating the primary tumor. Of course, surgical excision of all metastases is the fundamental method.

Usually, doctors resort to surgical intervention when excessively enlarged nodes (lymph nodes) are detected, as well as when metastatic formations are suspected.

With limited mobility of serious metastases, combined treatment is carried out by specialists. Initially, preoperative irradiation is prescribed, and then complete surgical removal is performed.

Any treatment for squamous cell skin cancer begins with a diagnosis based on clinical picture. Can be dispensed with in the early stages cytological examination(scrapings from the surface of the nodule).

In more complex cases, they may resort to a radioisotope method or a biopsy of the tumor. When diagnosing, it is necessary to exclude benign tumors skin (papillomas, fibromas), malignant melanomas, sarcoma and a number of chronic inflammatory processes (syphilis, skin tuberculosis).

How to treat squamous cell carcinoma will be decided by the oncologist and surgeon, who, depending on the stage of the tumor, select effective methodology- X-ray therapy, surgical removal of the nodule, chemotherapy, electrocoagulation, cryosurgery or radiation therapy. The choice of method strictly depends on the following factors:

• The stage of the tumor;
• Localizations;
• The presence of metastases;
• Histological picture;
• age;
• The general condition of the patient.

The most common method is surgical removal of the tumor within healthy tissue. In cases of localization of lesions in the nose, lips or eyelids, X-ray therapy may be prescribed.

The prognosis for successful treatment will largely depend on timely diagnosis. Prevention of squamous epithelium consists of timely prevention and treatment of precancerous diseases.

Treatment of squamous cell carcinoma is directly dependent on the size of the tumor, localization, age characteristics of the patient and the stage of development of the malignant formation.

Most often, a surgical technique for the complete removal of the tumor is used for treatment, after which the patient undergoes X-ray therapy in order to completely remove the metastases.

X-ray therapy is also carried out in case of localization of the tumor on the lips, in the oral cavity and other areas in which a surgical operation cannot be performed.

It is often prescribed to elderly patients for whom surgical intervention is contraindicated due to their state of health. It is also allowed to use photodynamic therapy and cryodestruction - point cooling of the tumor using liquid nitrogen to destroy its cells.

This video shows the actual operation:

The treatment plan for squamous cell cancer is not made by one specialist, but by an oncoconsilium. The group of doctors includes an oncologist, a surgeon, a chemotherapist, an immunologist, a radiologist.

Therapy methods:

• Electrocoagulation - the method is used for pathology, the size of which does not exceed 10 mm, located on the face, lips, neck. Its advantage is in minor trauma. The neoplasm is removed with the help of current.
• The Mohs method is the most reliable and painless method. It consists in layer-by-layer removal of pathology. Each layer is frozen and sent for histology. As a result, the layers are combined into a tumor, which is subsequently studied.
• Chemotherapy - one or more drugs are injected into the body, which disperse throughout the body with the bloodstream and destroy cancerous particles.
• Radiation therapy - the method is used independently for small oncoformation. In the last stages, X-ray radiation is used in combination with surgery.

For large neoplasms, additional procedures are required to restore the operated area. This may take a month.

Therapeutic measures completely depend on the location of the tumor and the results of histology. Modern medicine distinguishes several basic techniques, the fundamental of which are surgical removal and radiation therapy.

In the early stages, alternative methods are used. In this case, it is necessary to take into account the condition of the person, the presence of contraindications and operational risk.

The most popular treatments for squamous cell skin cancer today are:

• surgical removal;
• radiation therapy;
• chemotherapy;
• cryogenic impact;
• photodynamic therapy;
• medicinal effect.

Surgical removal is the most effective and high-quality way to eliminate the tumor. The technique allows you to completely get rid of the primary focus, which prevents the further spread of oncology.

Radiation therapy is used both in combination with surgery and on its own. Monotherapy is used only if there are contraindications to surgical excision. Differs in high efficiency.

Chemotherapy is used for large tumors. The technique reduces the size of education, stops the process of progression.

Cryogenic exposure consists in freezing the affected area. This is an additional method of treatment, characterized by moderate effectiveness. Photodynamic therapy has a similar effect.

The medicinal effect is based on the use of several courses of cytostatics. The procedure is appropriate in the presence of superficial formations.

Each method is effective in its own way, much depends on the location of the formation and its prevalence.

In general, the success of the treatment of stage 1 squamous cell carcinoma (up to 2 cm in diameter) is quite good. The effectiveness of treatment is assessed by the absence of relapses and metastases within 5 years.

Often, this efficiency is higher than for basalioma. Perhaps this is due to a more wary attitude of doctors and a clearer contour of the tumor.

The end result of treating squamous cell skin cancer in any way depends on the skill and experience of the doctor more than on the tools used. In the right hands, the treatment is more than 90% effective, regardless of the method chosen.

Surgical treatment of skin cancer.

Treatment for squamous cell skin cancer is divided into several main options. It can be: surgical treatment (including the Mohs method), radiation therapy, cryodestruction and photodynamic therapy.

Surgical treatment and the Mohs method.

Surgical treatment is used most often. It makes it possible to get rid of not only the focus of squamous cell skin cancer, but also its metastases to regional lymph nodes.

Surgical treatment is carried out, most often, under local anesthesia. When squamous cell skin cancer is at its initial stage, and in order to close the wound, it is enough to stretch its edges.

Larger surgeries require general anesthesia. When, through additional incisions, skin flaps are moved.

Or, when it is necessary to cut out regional lymph nodes. The recurrence rate after surgical treatment of the first (initial stage) is 8%.

For the second stage, the recurrence rate is twice as high, for the third - three times. Option surgical treatment is the Mohs method.

Already during the operation, a histological examination is carried out, determining whether there are cells of squamous cell skin cancer in the edges of the excised piece of skin. If there is, the operation is continued in the direction of the remaining tumor.

Radiation treatment.

Radiation therapy for squamous cell carcinoma is indispensable for elderly, debilitated patients. For them, anesthesia is dangerous.

It allows you to get rid of enough bulky tumors. But, it has a much higher risk of recurrence compared to surgical treatment.

At the initial - the first stage, the recurrence rate after radiation treatment is 10%. The second and third stages give 2-3 times more relapses.

Often there are distant side effects in the form of the development of chronic dermatitis in the area of ​​the radiation scar and in the form of the appearance of new foci of squamous and basal cell skin cancer from apparently healthy skin around, from damage to its DNA during irradiation.

The appearance of a radiation scar deteriorates over time. Radiation treatment should not be performed on relatively young patients under 70 years of age due to the risk of developing new skin cancer, already from the radiation itself.

Cryodestruction with liquid nitrogen.

Cryodestruction (freezing, cryotherapy, treatment liquid nitrogen) squamous cell skin cancer is rare. Its effectiveness depends on the equipment used and the skill of the doctor.

In the most primitive version - using a cotton swab moistened with liquid nitrogen, it is not effective for the treatment of squamous cell skin cancer. In the case of using modern reliable equipment, its effectiveness is comparable to surgical treatment.

The recurrence rate is about 4% for the initial stage. In addition, cryodestruction scars look much better than radiation scars over time.

Photodynamic therapy is treatment with laser light.

The choice of treatment method is determined separately for each patient and depends on such factors as:

• Patient's age.
• The stage of the disease.
• Tumor localization.
• The presence of metastases.

It is also used when it comes to the treatment of elderly patients who will not be able to undergo surgery.

What complications are observed in squamous cell carcinoma of the face?

If the treatment was not carried out in time, it is possible for metastases to spread not only over the surface of the skin, but also to the internal organs and nearby lymph nodes. In this case, it will be much more difficult to cure the disease.

An overgrown tumor in the photo looks like this:

Cured squamous cell carcinoma often recurs. In this case, X-ray therapy, chemosurgical treatment and aromatic retinoids (etretinate, neotigazon) are used.

Prevention of skin cancer.

Preventive measures aimed at skin cancer are primarily active treatment and timely cure of precancerous dermatoses.

As you know, even after an absolutely successful cure for a disease, a neoplasm can develop in a different place, so regular check-ups with a doctor are very important.

Prevention of squamous cell carcinoma is to eliminate the risk factors that lead to the development of the disease. Preventive measures:

• Timely treatment of precancerous diseases;
• Protection of the skin from the harmful effects of sunlight;
• The use of nourishing creams to prevent drying of the skin;
• Protection of scars from repeated mechanical damage;
• Compliance with precautions when working with chemicals containing carcinogens.

• All patients who are found to have skin cancer or precancerous lesions should avoid sun exposure. Especially during hot periods from 10 am to 4 pm.
• Use a sunscreen with an SPF of at least 15.
• Regular monitoring by an oncologist and treatment of precancerous diseases using cryodestruction, or other methods, will help to avoid unnecessary surgical interventions.

Squamous cell skin cancer is a group of oncological diseases (ICD-10 code C44). As a native focus, releasing metastases to the surrounding tissues, the middle, spiny layer and the keratinocyte forming the tissue act. Other names for cancer are squamous cell epithelioma, papillary cancer, and spinalioma. The malignant process covers defenseless areas of the skin that are strongly influenced by UV rays. In most cases, the neoplasm affects the lower lip.

Squamous cell carcinoma of the skin is characterized by aggressive development, accelerated infiltration of the lower layers of the epithelium and progressive metastasis. The risk group includes people with fair skin. Pathology occurs more often among people of the age category from 60 to 65 years. IN rare cases the disease affects children.

The squamous form of the oncological course is divided into subspecies - intercellular, small cell, multicellular and unicellular type. The types differ in external factors and treatment regimens used to combat the affected cells. The following classification according to TNM of the indicated type of tumor is presented.

plaque

This type of epidermal atypicality in external characteristics resembles a sharply painted part of the skin. On the skin, the manifestation of medium-sized tubercles is noticeably expressed. According to tactile sensations, the affected area is rough. The skin acquires a noticeable density compared to other areas. At the same time, the intensity of the spread of cancer cells is very fast.

Over time, with the progression of the plaque type of the tumor, the spread and deepening of the affected tissues into nearby materials is noted. Bleeding and severe pain may occur.

nodal

According to external data, this type of cancer is similar to a large group of nodules of various sizes. A large accumulation on the outer region of the covered part of the epidermis resembles a cauliflower inflorescence. The neoplasm feels solid. The affected epidermis is colored brown, and the top layer is bumpy.

In most cases, the nodular type of squamous cell carcinoma is formed at the site of the location of the scars and at the sites of previous injuries. Initially, cracks form on the skin. They are accompanied by pain. Over time, small-sized nodules appear.

The node in the early stages does not cause pain and has noticeable mobility. During the malignant process, the nodule increases in size, characteristic mobility is lost, and painful discomfort may occur. This form of pathology expresses a rapid process of spread. There is a deepening of the oncological neoplasm in the lower layers of the epidermis.

ulcerative

This type of atypical course of the upper part of the skin occurs on the surface with crater-like ulcers. Ulcers slightly above the surface of the body. The edge of the covered area is in the form of a roller, and the hearth deepens, gently descending lower.

Ulcers can grow rapidly. The development of ulcerative areas occurs in width, as well as in deeper epidermal layers. A characteristic feature of this type of squamous cancer is represented by the manifestation of a specific smell. Such signs are cause for concern and subsequent full medical examination of the surface of the body. Pressing on a crater ulcer can cause a discharge with blood clots.

The above types of squamous cell carcinoma are similar in specific characteristics. There is a high rate of spread of cells with metastases. Therefore, a timely medical and hardware examination plays a serious role. Prompt and successful treatment depends on detecting even the slightest suspicion of an atypical skin condition. Conventionally, squamous cell carcinoma is divided into a non-keratinizing differentiated type, which is formed from tissues that are not subject to keratinization, and keratinizing cancer.

• The non-keratinized form can be represented as highly differentiated, spreading at a low rate, since the body produces a small amount of atypical tissues.
• Poorly differentiated nonkeratinized skin cancer progresses rapidly. The number of affected cells of an aggressive nature in the body is large.
• A differentiated type of skin tumor with keratinization is more difficult to diagnose. Cancer formation does not have a pronounced color, and the rate of development is high.

Causes of oncology

The main reason for the formation of a malignant pathology of the epidermis may be hereditary factor. A dangerous disease is divided into congenital and acquired. The reasons for the development of oncological course are as follows:

• Violation of the DNA of the cell as a result of exposure to certain factors, which causes the mutation of the TP53 gene - the p53 protein. The function of a protein is to regulate life cycle cells, which effectively prevents pathogenic tissue degeneration. The TP53 gene is included in the group of key genes involved in blocking the possible formation of a malignant neoplasm.
• Violation of the functioning of the immune system and the protective function, aimed at combating tumor growths - anti-cancer immunity. The human body periodically undergoes a series of cellular mutations. It is determined and destroyed by immune components - macrophages, T- and B-lymphocytes, natural destroyers. The production and performance of these cells is assigned to certain genes, where the mutation process reduces the effectiveness of anti-cancer immunity and is able to pass genetically to generations.
• Disturbed carcinogenic metabolism - the problem involves the mutation of genes that control the severity of the functioning of certain structures and processes aimed at clogging, destruction and accelerated removal of harmful microelements from the body.

The following factors contribute to the development of squamous cell skin cancer:

• Age - the disease rarely affects children and the younger generation of people. The rate increases sharply among patients 40 years of age and older. And after 60-65 years, this atypical condition is observed quite often.
• Skin type - according to statistical indicators, dangerous disease in the majority is determined by representatives of bright eyes, hair and white skin, resistant to tanning.
• In men, squamous typology of growth is observed 2 times more often than in women.
• Skin atypical manifestations - a malignant oncological process can progress on a completely healthy epidermis. However, for the most part, the development of atypicality is affected by freckles, telangiectasia and genital warts, a precancerous condition - Bowen and Paget's disease, xeroderma pigmentosa - scar areas formed as a result of burns and radiation therapy. After these factors, the tumor can form even after 30 years or more. Also, the risk of creating a pathogenic site is affected by post-traumatic scars, trophic transformations of the skin (varicose veins), gaps in fistulous passages in bone osteomyelitis (metastasis is characterized by a 20% probability), psoriasis, lichen planus, pathologies in tuberculous and systemic lupus erythematosus.
• Prolonged deterioration of immunity and a decrease in the protective functions of the body.

The following mechanisms are distinguished that provoke the atypicality of normal cells:

• Ultraviolet radiation under conditions of prolonged and frequent exposure - sunbathing, PUVA therapy with psoralen performed to combat psoriasis, and desensitization if present allergic reaction to solar radiation. Ultraviolet rays provoke the mutation of the TP53 gene and lower the anti-cancer immune defense of the human body.
• Ionizing and electromagnetic radiation.
• Long term exposure high temperatures indicators, burns, systematic long-term injury and irritation of the epidermis, a precancerous disease of a dermatological nature.
• Local action over a long time period of carcinogenic trace elements and harmful substances associated with the specifics of working conditions - aromatic hydrocarbons, soot, coal tar, paraffin, insecticides and mineral oils.
• Treatment with glucocorticoid drugs and immunosuppressants, topical use of products containing arsenic, mercury and chloromethyl.
• HIV and papillomavirus bacterium - 16, 18, 31, 33, 35 and 45 species.
• Improper and unhealthy diet, serious poisoning with nicotine products and alcohol-containing products.

If a person refuses treatment or postpones therapy, the prognosis of life is extremely negative. The probability of occurrence of metastases reaches, according to averaged data, 15%. 85% of probable metastasis occurs in regional lymph nodes. In 15% of diagnosed cases, metastases expand into the bone structure and into internal structures and organs, especially in the lung. As a result, death is predicted.

A serious danger is represented by the possibility of developing a head tumor and damage to the facial covering, which is diagnosed in 70% of cases. In particular, planar cancer of the epidermis of the back of the nose is often recorded. Tumor formations are often located on the forehead, in the nasolabial folds, periorbital areas, in the part of the external auditory canal, on the border of the lips, especially on the upper one. The auricle and the area behind the shell are affected. Increased aggressiveness regarding the process of metastasis is noted in pathogenic growths formed in a closed area of ​​​​the body, especially in the area of ​​\u200b\u200bthe external genitalia.

Stages of development of skin pathology

There are 4 stages of progression of a squamous cell tumor of the skin:

• Stage 1 - in the early stages of the disease, a medium-sized seal appears on the skin of the body. Symptoms are not expressed, characteristic soreness is absent. The tumor body appears mobile. The size of the lesion does not exceed 20 mm in diameter. Metastases are absent. The neoplasm acquires a yellowish or light brown hue. Diagnosis rarely reveals atypical cells in the initial stages.
• Stage 2 - the stage is accompanied by the formation of the first metastatic cells, often formed in the lymph nodes. The cancer cell spreads through the bloodstream to organs throughout the body. The magnitude of the lesion crosses the border of 2 cm. The seal is pronounced. The color of the skin becomes saturated. When squeezing the area, pain does not appear. However, the patient notes uncomfortable sensations when pressed.
• Stage 3 - the development of the disease is characterized by an increase in the affected area and progressive metastasis. Nearby lymph nodes and materials from normal neighboring organs are covered. Painful sensations become more pronounced when squeezed. Probably the allocation of atypical contents from ulcerative areas on the cover of the tumor body. The boundaries of the affected area are accompanied by rollers from the skin seal. The surface of the epidermis is covered with ulcers.
• Stage 4 - the last stage in the development of oncology involves the overgrown metastasis of cancer cells to the lymph nodes and tissues. Painful sensations are strongly expressed. The pain becomes permanent. Fluid is often exuded from the ulcers. Metastases penetrate into cartilaginous structures and bone tissues. As a result, nearby joints lose their mobility.

Diagnostics

The treatment regimen for patients with squamous cell skin cancer is compiled depending on the stage, location of the affected focus, the prevalence of the coverage area, the age category of the patient and the presence of concomitant pathologies. The choice of therapeutic measures is based on a comprehensive hardware examination. Diagnostics includes procedures:

• Medical examination (oncologist and dermato-oncologist) - during the examination, the doctor determines the presence of oncological formation, the consistency of the growth, the color of the affected skin area, the condition of the circumferential epidermis, the presence of neoplasms in other parts of the body. Palpatory examination of the lymph nodes and collection of anamnesis are carried out.
• Instrumental examination - is carried out for clarifying purposes regarding the presence of ongoing malignant pathology, the intensity of deepening of the affected tissue into the deep layers of the epithelium, the presence of transformations with metastases in nearby lymph nodes and the presence of distant metastases.

Among the instrumental methods, the following stand out: confocal scanning microscopy fully assesses the state of all epidermal layers, ultrasound of the OBP determines the presence of metastatic changes. MRI detects a tumor, determines the shape, structure and metastasis to nearby materials and structures of the body, X-ray and endoscopic examination reflect the oncological process located in another area and indicate distant metastases. More modern method when an external examination of the affected part of the body in medical practice is considered dermatoscopy (surface microscopy of the epidermis).

This non-invasive method helps to study the morphological and subepidermal composition of the dermis. For the procedure, an optical device with a lens equipped with a backlight is used - a dermatoscope and immersion oil. The micropreparation allows you to explore a deep layer from 0.2 microns. Today, a digital dermatoscope is used. The device provides the ability to save the resulting visualized image of the layers of the epithelium in a computer archive, and analytical programs to decipher the information received. The results of the performed dermatoscopy are similar to the morphological diagnosis by 90%.

Laboratory diagnostic procedures - standardized general analyzes, analysis for the presence of tumor markers, the cytological picture is aimed at determining the size, structure, shape and composition of tumor tissues. A biopsy provides an opportunity to fully explore the typology of the ongoing oncological process, the cellular composition and the degree of progression of malignant pathology. The biopsy procedure is the "gold standard" for diagnosing cancer. Based on the information received, the doctor develops further therapeutic treatment.

Treatment methods for squamous cell cancer

There are a number of treatments that can help treat squamous cell skin cancer. The choice of a suitable pathology treatment method is based on the following factors:

• histology of the structure of the tumor body;
• the location of the affected area;
• stages of development of the malignant process, taking into account metastasis and the prevalence of metastatic cells.

Surgery

If the tumor has a small size and develops without metastases, removal occurs surgical method within the boundaries of intact, healthy materials with an indent of 1-2 cm from the edge of the designated focus. If the operation is performed in accordance with the existing rules and regulations, the average five-year survival rate reaches 98%. In particular, a positive result is noted after the operation to remove a cancerous neoplasm, performed in one block with a deep layer of fiber and fascia.

Radiation therapy

The small size of the tumor at T1 and T2 stages allows the use of close-focus X-ray radiation as a separate, independent therapeutic technique. At T3-T4 degrees, radiation therapy is used for preoperative preparatory measures and postoperative treatment. The greatest effectiveness of therapy is observed in the treatment of tumor neoplasms of the skin deeply located in the layers of the epidermis.

Also, a radiation procedure is performed to prevent possible metastasis after the surgical removal of the main tumor body and as a palliative method for the inoperable nature of the cancer growth in order to slow down the development and reproduction of the affected cells. The large size of the tumor formation with no metastases is an indication for the use of remote gamma therapy. In case of metastasis, combined treatment is performed with a number of hardware procedures - X-ray, gamma irradiation, radical excision of one's own tumor body with removal of regional lymph nodes.

Cryodestruction and electrocoagulation

It is possible to cure a small area of ​​well-differentiated squamous cell carcinoma with a superficial location on the patient's torso using cryodestruction. However, a prerequisite in the procedure is prior confirmation of the characteristics of a malignant neoplasm by performing a previous biopsy. Elimination of an oncological focus on the skin of a similar nature with a diameter of less than 1 cm in the area of ​​the face, lips and cervical can be carried out through the technique of electrocoagulation. The advantage of therapy is represented by a lesser likelihood of causing dangerous injuries.

Chemotherapy

Chemotherapy for squamous cell skin cancer is prescribed in most cases before surgery to remove cancerous tissue. Chemotherapy is designed to shrink the size of the tumor. Also, therapy is carried out in conjunction with the method of radiation treatment for inoperable cancer. In such situations, medicinal drugs are used - Fluorouracil, Bleomycin, Cisplastin, Interferon-alpha and 13-cis-retinoic acid.

Traditional medicine is not highly recommended for the fight against cancer. Non-traditional methods can reduce the patient's precious time and provoke the active production of metastases. It is possible to resort to folk remedies as complementary and auxiliary options to the main therapeutic regimen only after consulting with the attending physician to cure radiation dermatitis.

It is important to strictly follow the instructions prescribed by the doctor. clinical guidelines in order to avoid the development of complications and undesirable consequences.

Alternative Treatment Options

In modern medical practice, among the physical treatment of oncological diseases, there are similar methods of photodynamic therapy using a pre-selected specific sensitizing dye (PDT) and laser-induced light-oxygen therapy (LISCT). These methods are prescribed in most cases for the treatment of elderly patients in the presence of aggravating comorbidities, with the location of cancer cells above the cartilage and on the surface of the face, especially in the periorbital region, since they do not adversely affect the eyes, normal soft tissues and cartilage.

It is important to determine in time the causes and mechanisms that provoke the developing malignant oncological process. A person should quickly begin treatment and, if possible, eliminate or reduce the negative impact of external and internal factors. These actions are important in preventive measures and prevention of recurrent manifestations of squamous cell carcinoma, which, according to averaged data, occurs in 30% of diagnosed cases after radical therapy.

Forecast and prevention

The prognosis is made by the attending doctor. The subsequent prognostic conclusion is carried out on the basis of the data obtained regarding the oncological disease of the patient. In compiling possible results, calculating risks and probable consequences, the stage of progression of the pathology, the age category of the victim, the state of health and well-being at the time of diagnosing a squamous cell tumor in the patient, the treatment being carried out and the condition at the end of the prescribed therapeutic course are taken into account.

Stages 3 and 4 of the development of the malignant process provide a prognosis and a five-year survival rate equal to 60%. Successfully and correctly carried out therapy and the initial stage of the disease of this type of cancer increases the likelihood of recovery over 90%. Many factors are based on the degree of damage to the tissues of the human body by the oncological course of this variety and the therapeutic method. Prevention includes serious actions to prevent the development of a squamous cell tumor:

• Regularly undergo a medical preventive examination - a systematic examination of the body helps to quickly identify existing violations in the condition of the skin of the body and start the necessary medical procedures in time.
• Know the symptoms, nature and features of the manifestation of the squamous form of the oncological process at an early stage of progression.
• Carefully examine your own body, notice even the smallest atypical deviations from the normal state of the body.
• Quickly start therapeutic measures when confirming suspicions of cancer and identifying an area of ​​the body affected by oncology.
• Refuse self-medication and non-traditional methods of treatment - unqualified treatment can provoke the development of an advanced stage of the malignant course.
• Lead a healthy lifestyle, adhere to the right diet - actively engage in sports, exercise, regularly walk in the fresh air, eat a healthy, balanced and portioned diet, set your own mind on a positive wave. Avoid prolonged exposure to stressful situations in order to avoid overstrain and filling the mind with negative energy.

When a person is attentive to his own health and the state of the body, the safety, immunity and protection of organs from a large list of possible dangerous diseases, including oncological lesions of the epidermis at the level of the superficial and deep layers of the epithelium, increase.

Sometimes even a specialist is not able to recognize it at this stage, and even more so the patient. A person comes to the doctor when he already has pain.

Squamous cell carcinoma is an oncological disease that has a rapid development and rapid course with penetration into the lymph nodes. This type of disease occurs in people of different age categories, but most often it affects the elderly (after 65 years), it is more developed in men. Fair-skinned and red-haired people suffer from this disease, which is very typical, these are residents of the southern regions of the country. Ultimately, without appropriate treatment, multiple organ failure rapidly develops, leading to death.

Causes of tumor development

Microflora of squamous cell carcinoma

To date, the exact causes of the disease have not been established. But the alleged causes of squamous cell carcinoma can be quite different. People who sunbathe for a long time under the sun or under artificial ultraviolet rays (go to the solarium) fall into the risk zone of this disease.

Squamous cell carcinoma causes can be caused after thermal or chemical burns and, in some cases, after exposure to radiation. Most people with this type of disease are those who are employed in hazardous industries and have frequent contact with chemicals. Thus, the skin is exposed to contamination with resins and arsenic. Sometimes the cause of the development of oncology are the so-called precancerous processes.

In addition, very often people who suffer from chronic dermatitis and ulcers are not aware of the possibility of this insidious disease. Sometimes cancer occurs as a result of skin trauma, inflammatory diseases, such as carbuncles, boils. What squamous cell carcinoma looks like is shown below.

Squamous cell carcinoma: symptoms

Most often, tumors occur on the skin, which is most often exposed to ultraviolet rays. As a rule, this is the area of ​​\u200b\u200bthe face (nose), hands and head.

There are two types of squamous cell skin cancer:

This species is characterized by the formation of plaques that have an intense red color. This formation is dense to the touch, small tubercles are visible on its surface, which show bleeding. The plaque form has a very active spread with damage to the surface layers of the skin, as well as metastasis to the inner layer of the epidermis.

The nodular form of a malignant disease is characterized by the formation of nodules that look like cauliflower. They develop very quickly. At the base of such a nodule is very wide, and the surface is bumpy. The appearance of this manifestation has a red-brown hue, and a dense structure is revealed on palpation. Various formations begin to form on the skin with rapid damage to the surface of the epidermis.

It is characterized by the manifestation of ulcers on the surface of the epidermis, in appearance they look like craters. The edges of the tumor are in the form of rollers and are slightly raised over the entire area of ​​the neoplasm. Ulcers have a specific smell, and you should beware. This is the main symptom of this form of cancer. However, they still bleed. Their spread is very fast. Ulcers affect not only the surface of the skin, but also penetrate inside.

It is worth paying attention to the fact that squamous cell carcinoma is characterized by a very high rate of spread.

In most cases, the tumor affects the scars. In this place, small cracks first form, which are very painful, and then some nodes begin to form, having their own mobility and painlessness. Over time, the nodes lose their mobility and pain appears, this is their fusion with the skin.

If the tumor increases in size and exceeds 2 cm in diameter, then in this case, we are talking about the active development of the oncological process. It is accompanied by the formation of metastases.

Squamous cell carcinoma on the skin

Degrees of differentiation and their differences:

In order to perform the diagnosis, the oncologist refers the patient to histology, to analyze the biopsy, scrapings from the affected areas of the skin or ulcers. According to the results of the analysis of the histological examination, the type of squamous cell skin cancer is revealed.

1. Undifferentiated squamous cell carcinoma (nonkeratinizing). The most malignant form, which is characterized by rapid growth. The mutation occurs in the cell of the spiny layer, after which its development stops, and all subsequent clones have a similar structure. Keratin does not accumulate in cancer cells and the process of their death does not occur.
2. Differentiated squamous cell carcinoma (keratinizing). In this case, the mutation also occurs at the level of the spinous layer cell, but after several divisions, the resulting clones, on the contrary, begin to accumulate a large amount of keratin. Cancer cells gradually lose their cellular elements and die, which is externally manifested by the deposition of crusts (keratin masses) on the surface of the tumor, which have a yellowish color. Unlike normal keratinization, with keratinizing cancer this process is accelerated several times.

Classification of stages of development of the disease

In oncology, cancer has four stages:

1. the first stage is characterized by the detection of a small skin lesion 2 cm in size. At stage 1, the cancer has not yet had time to hit a large area and has not metastasized. The base of the tumor is mobile, but the patient does not feel pain;
2. in the second stage, the disease progresses rapidly, the size of the tumor exceeds two centimeters and the area of ​​distribution becomes more extensive. However, at this stage, the cancer does not manifest itself so actively, but there may be single metastases in nearby tissues. It is worth considering that squamous cell carcinoma spreads through the lymph nodes, and therefore metastases at this stage appear in them;
3. as cancer develops, it captures not only the neighboring lymph nodes, but also the tissues that are nearby. This stage of cancer is typical for stage 3;
4. at the last stage, the fourth, squamous cell carcinoma has a serious spread and affects not only tissues and bones, but also cartilage. Even if the tumor is still small, this stage is characterized by distant metastases, which are sometimes found in multiple quantities. In this case, the joints begin to lose their mobility.

Squamous cell carcinoma: treatment

For most cancers, therapies are similar. However, depending on the type of malignant tumor and the affected area, they may have their own specifics. An important process is the timely removal of the affected tissue. Moreover, the earlier the therapy process begins, the greater the patient's chances of survival.

How to treat squamous cell carcinoma is decided by the doctor. The main criteria that are taken into account in the treatment of the tumor process are the age category and the health of the patient.

Malignant formations of small size are treated with the help of curettage, electrocoagulation, cryodestruction. If the tumor is localized in the scalp, then the latter method is not used.

Chemosurgical therapy (Moh's method) has a significant advantage in squamous cell carcinoma prognosis of 99% towards efficiency. The advantage of this technique is that healthy areas of the skin can be preserved. This type of therapy is effective in the treatment of tumors with poorly defined borders.

At the initial stage, radiotherapy is also very effective.

Chemotherapy for squamous cell carcinoma allows you to treat tumors that are not of a serious size. To do this, use special tools for external use. Thus, they do not allow cancer cells to grow.

The applied photodynamic method of therapy is used if the areas of the eyes and nose are affected, as other methods can lead to visual impairment and damage to the cartilage of the nose.

Video: Chemoradiation treatment of patients with squamous cell carcinoma

Folk remedies

When treating squamous cell cancer, you can alleviate the condition using prescriptions traditional medicine. However, you should not give up traditional treatment at the oncologist.

Places that are affected by squamous cell carcinoma should be treated with birch bud tincture. Verbena lotions, to which table vinegar is added, also showed themselves well.

Also, an ointment is used to treat ulcers and plaques, which is prepared from dried pomegranate seeds and honey.

Very useful for external use against this type of cancer, an ointment that is prepared on the basis of vegetable oil with a powder from the inside of walnuts. The amount in the oil is added in such an amount that it looks like an ointment.

How not to get squamous cell carcinoma and what is the prognosis?

In the treatment of any cancer, early detection of the problem is extremely important. If the cancer is treated at an early stage, the chances of being cured are very high. But in any case, during the life of the former patient will have to be under the supervision of a doctor.

As a rule, after discharge from the hospital, the examination is performed monthly, but gradually the intervals become longer.

What is the disease prevention?

1. you need to be careful in the sun in the summer, when it is most active;
2. you should not abuse the tan in the solarium;
3. if dermatitis occurs, they must be treated in a timely manner, as they are precancerous diseases;
4. If you plan to go to the beach, you should use sunscreen. They should be applied approximately 20 minutes before the start of the procedure. This should be repeated every three hours;
5. you need to carefully monitor the condition of the skin. If moles have acquired a strange shape, or some strange seals have appeared, then you need to urgently seek advice from an oncologist.

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Types and forms of squamous cell skin cancer, treatment, prognosis

Squamous cell skin cancer is a group of malignant neoplasms that develop from keratinocytes in the spinous layer of the skin epidermis and are capable of producing keratin.

The prognosis of life in squamous cell skin cancer is characterized by the following statistics: during the first 5 years, 90% of people whose tumor size is less than 1.5-2 cm survive, and if these sizes are exceeded and the neoplasm grows into the underlying tissues, only 50% of patients.

Reasons for the development of pathology

The main reason for the development of squamous cell skin cancer is considered a genetic predisposition. It can be hereditary or acquired and is expressed in:

1. Damage to cellular DNA under the influence of certain factors, resulting in a mutation of the TP53 gene, which encodes the p53 protein. The latter, as a regulator of the cell cycle, prevents tumor transformation of cells. "TP53" is one of the main genes involved in blocking the development of malignant neoplasms.
2. Function disorder immune system directed against tumor formations (antitumor immunity). In the human body, many cellular mutations constantly occur, which are recognized and destroyed by the cells of the immune system - macrophages, T- and B-lymphocytes, natural killers. Certain genes are also responsible for the formation and functioning of these cells, the mutation in which reduces the effectiveness of antitumor immunity and can be inherited.
3. Violation of carcinogenic metabolism. Its essence lies in the mutation of genes that regulate the intensity of the function of certain systems, which are aimed at neutralizing, destroying and quickly removing carcinogenic substances from the body.

Favorable background for the development of squamous cell skin cancer are:

• Age. Among children and young people, the disease is extremely rare. The percentage of cases increases sharply among people over 40 years old, and after 65 years this pathology is quite common.
• Skin type. The disease is more susceptible to people with blue eyes, red and blond hair and with fair skin that is difficult to tan.
• Male gender. Among men, squamous cell carcinoma develops almost 2 times more often than women.
• Skin defects. Cancer can also develop on clinically healthy skin, but much more often against the background of freckles, telangiectasias and genital warts, precancerous diseases (Bowen's disease, Paget's disease, pigment xeroderma), in the area of ​​scars formed as a result of burns and radiation therapy, after which cancer can occur even after 30 years or more, post-traumatic scars, trophic skin changes (with varicose veins), fistula openings in osteomyelitis of the bone (metastasis rate is 20%), psoriasis, lichen planus, lesions in tuberculous and systemic lupus erythematosus, etc. d.
• Prolonged decrease in general immunity.

Among the provoking factors, the main ones are:

1. Ultraviolet radiation with intense, frequent and prolonged exposure to it - sunbathing, PUVA therapy with psoralen, carried out in order to treat psoriasis and desensitization in case of allergy to sunlight. UV rays cause a mutation of the TP53 gene and weaken the body's antitumor immunity.
2. Ionizing and electromagnetic types of radiation.
3. Prolonged exposure to high temperatures, burns, prolonged mechanical irritation and damage to the skin, precancerous dermatological diseases.
4. Local exposure for a long time (due to the specifics of professional activity) of carcinogenic substances - aromatic hydrocarbons, soot, coal tar, paraffin, insecticides, mineral oils.
5. General therapy with glucocorticoid drugs and immunosuppressants, local therapy with arsenic, mercury, chlormethyl.
6. HIV and papillomavirus infection 16, 18, 31, 33, 35, 45 types.
7. Irrational and not balanced diet, chronic nicotine and alcohol intoxication of the body.

The prognosis without treatment is unfavorable - the incidence of metastases is an average of 16%. Of these, 85% of them metastasize to regional lymph nodes and 15% to the skeletal system and internal organs, most often to the lungs, which always ends in death. The greatest danger is represented by tumors of the head and skin of the face (affects 70%), especially squamous cell carcinoma of the skin of the nose (back of the nose) and neoplasms localized in the forehead, in the nasolabial folds, periorbital zones, in the area of ​​the external auditory canal, the red border of the lips, especially the upper one, on the auricle and behind it. Highly aggressive in terms of metastasis are also tumors that have arisen in closed areas of the body, especially in the vulva, both women and men.

Morphological picture

Depending on the direction and nature of growth, the following types of squamous cell carcinoma are distinguished:

1. Exophytic, growing on the surface.
2. Endophytic, characterized by infiltrating growth (grows into deeper tissues). It is dangerous in terms of rapid metastasis, destruction of bone tissue and blood vessels, bleeding.
3. Mixed - a combination of ulceration with tumor growth deep into the tissues.

A micropreparation examined under a microscope is characterized by a picture common to all forms of this disease. It consists in the presence of cells similar to cells of the spinous layer, growing deep into the dermal layers. Characteristic features are the growth of cell nuclei, their polymorphism and excessive staining, the absence of connections (bridges) between cells, an increase in the number of mitoses (division), the severity of keratinization processes in individual cells, the presence of cancerous strands with the participation of cells of the spiny layer of the epidermis and the formation of so-called , "horn pearls". The latter are rounded foci of excessive keratosis with the simultaneous presence of signs of incomplete keratinization in the center of the foci.

According to the histological picture, there are:

• squamous cell keratinizing skin cancer (highly differentiated);
• undifferentiated form, or non-keratinizing cancer.

Common to both forms is the chaotic arrangement of groups of atypical flat epithelial cells with their growth in the deeper layers of the dermis and subcutaneous tissues. The severity of atypia in different cells can be different. It is manifested by a change in the shape and size of the nuclei and the cells themselves, the ratio of the volumes of the cytoplasm and the nucleus, the presence of pathological division, a double set of chromosomes, and many nuclei.

Highly differentiated squamous cell skin cancer

It is characterized by the most benign course, slow growth and gradual spread to deeper tissues. Signs of keratinization are determined both on the surface and in the thickness.

A keratinizing tumor may have the appearance of multiple formations, but, as a rule, it is single, flesh-colored, yellowish or red. Its shape is round, polygonal or oval, sometimes with a depression in the center. On visual inspection, the neoplasm may look like a plaque, nodule or papule, the surface of which is covered with dense scales of the horny epithelium that are difficult to separate. In the central part, an ulcer or erosion is often determined with dense keratinized edges that rise above the surface of the skin. The erosive or ulcerative surface is covered with a crust. When pressing on the tumor, horny masses are sometimes separated from its central or lateral sections.

Squamous cell nonkeratinizing skin cancer

It has a more malignant course, compared with the previous form, manifested by rapid infiltrating growth into the deep dermal layers, faster and more frequent metastasis to regional lymph nodes.

With this form, cellular atypism and many pathological mitoses are pronounced with a slight reaction of the structural elements of the stroma. There is no keratinization at all. In cells, either decaying or hyperchromic (excessively stained) nuclei are determined. In addition, with an undifferentiated form of cancer, layers of epithelial cells that look like nests are separated from the epidermal layer, keratinization is absent or slightly expressed.

The main elements of the tumor are represented by granulation "fleshy" soft formations like papules or nodes with growth elements (vegetation). The most common localization is the external genitalia, much less often - the face or various parts of the body.

The neoplasm can be single or multiple, has an irregular shape and occasionally takes on a resemblance to cauliflower. It quickly transforms into an erosion or ulcer that bleeds easily with little contact with a necrotic bottom covered with a reddish-brown crust. The edges of the ulcer are soft, rise above the surface of the skin.

Symptoms of squamous cell skin cancer

Depending on the clinical manifestations, the following main types of the disease are conditionally distinguished, which can be combined or changed at various stages of development:

• nodular or tumor type;
• erosive or ulcerative-infiltrative;
• plaque;
• papillary.

Nodular or tumor type

Superficial or nodular form of squamous cell skin cancer is the most common variant of tumor development. The initial stage is manifested by one or more painless nodules of dense consistency merging with each other, the diameter of which is about 2-3 mm. They slightly rise above the skin surface and have a dull white or yellowish color, very rarely brown or dark red, the skin pattern above them is not changed.

Quite quickly, the size of the nodule (nodules) increase, as a result of which the tumor becomes like a painless yellowish or whitish plaque with a gray tint, the surface of which may be slightly rough or smooth. The plaque also protrudes slightly above the skin. Its dense edges look like a roller with uneven, scalloped contours. Over time, a depression is formed in the central part of the plaque, covered with a crust or scale. When they are removed, a drop of blood appears.

In the future, there is a rapid increase in the size of the pathology, the central depression is transformed into erosion, surrounded by a roller with steep, uneven and dense edges. The erosive surface itself is covered with a crust.

For the initial stage of the ulcerative-infiltrative type of squamous cell carcinoma, the appearance of a papule as a primary element that has endophytic growth is characteristic. Over the course of several months, the papule is transformed into a knot of dense consistency, soldered to the subcutaneous tissue, in the center of which, after 4-6 months, an ulcer appears that has an irregular shape. Its edges are raised in the form of a crater, the bottom of which is dense and rough, covered with a whitish film. Ulcerations often take on a fetid odor. As the node increases, bleeding occurs even in the case of a slight touch to it.

In the peripheral parts of the main node, “daughter” nodules can form, during the decay of which ulcers are also formed, which merge with the main ulcer and increase its area.

This form of cancer is characterized by rapid progression and destruction of blood vessels, germination in the underlying muscles, cartilage and bone tissue. Metastases spread both by the lymphogenous route to regional nodes, as a result of which dense infiltrates are sometimes formed, and by the hematogenous route to the bones and lungs.

Plaque form of squamous cell skin cancer

It has the appearance of a sharply prominent dense red area of ​​the skin surface, against the background of which small tubercles that are barely visible during visual inspection sometimes appear. The element has a rapid peripheral and endophytic growth in neighboring tissues, often accompanied by severe pain and bleeding.

Papillary squamous cell skin cancer

It is relatively rare and is one of the exophytic forms. At first, it manifests itself as a primary, rising above the surface of the skin and rapidly growing, nodule. A large number of horny masses form on it, as a result of which the surface of the node becomes bumpy with a central depression and a large number of small dilated blood vessels. This gives the tumor, located, as a rule, on a wide and slightly displaced base, the appearance of a dark red or brown "cauliflower". In the later stages of its development, papillary cancer transforms into ulcerative-infiltrative.

A variation of the papillary form is verrucous, which in old age can manifest itself as a skin horn. The verrucous form is characterized by very slow development and extremely rare metastasis. It has a yellowish or reddish-brownish color, a bumpy surface covered with warty elements and a hyperkeratotic crust.

Treatment of squamous cell skin cancer

The choice of treatment method is influenced by:

1. Histological structure of the tumor.
2. Its localization.
3. The stage of the cancer process, taking into account the presence of metastases and their prevalence.

A small tumor without metastases is surgically excised within the boundaries of unaffected tissues, retreating 1-2 cm from its edges. If the operation is carried out correctly, the cure for 5 years is an average of 98%. Particularly good results are observed when the tumor is excised in one block with subcutaneous tissue and fascia.

With small tumor sizes at T1 and T2 stages, it is possible to use close-focus X-ray radiation as an independent method. At T3-T4 stages, the radiation method is used for preoperative preparation and postoperative therapy. It is especially effective in the treatment of deep-growing skin tumors. In addition, radiation exposure is used to suppress possible metastases after surgical excision of the underlying tumor and as a palliative method for inoperable cancer (to slow its spread).

The large size of a cancerous tumor in the absence of metastases is an indication for the use of remote gamma therapy, and if they are present, combined therapy is carried out by means of X-ray and gamma irradiation, radical removal of the tumor itself with regional lymph nodes.

Cryodestruction and electrocoagulation

Treatment of small superficial highly differentiated squamous cell carcinoma with localization on the body is possible with cryodestruction, but with mandatory preliminary confirmation of the nature of the tumor using a preliminary biopsy. Removal of a malignant skin tumor of the same nature with a diameter of less than 10 mm in the face, lips and neck can be carried out using the electrocoagulation technique, the advantage of which is less trauma.

Chemotherapy for squamous cell skin cancer is prescribed mainly before surgery in order to reduce the size of the neoplasm, as well as in combination with radiation therapy for inoperable cancer. For this, drugs such as Fluorouracil, Bleomycin, Cisplastin, Interferon-alpha, 13-cis-retinoic acid are used.

Treatment of folk remedies for cancer is unacceptable. This can only lead to a loss of time and the development of metastases. Use folk remedies as auxiliary it is possible only on the recommendation of a doctor for the treatment of radiation dermatitis.

Alternative Therapies

Modern physical treatment in oncology also includes methods of photodynamic therapy using a pre-selected special sensitizing dye (PDT), as well as laser-induced light-oxygen therapy (LISCT). These methods are used mainly for the treatment of elderly patients, in cases of severe concomitant diseases, with localization of neoplasms over cartilage and on the face, especially in the periorbital zone, since they do not adversely affect the eyes, healthy soft and cartilaginous tissues.

Timely determination of the cause and background on which the malignant process develops, elimination (if possible) or reduction of the influence of provoking factors are important points in the prevention of metastasis and the prevention of recurrence of squamous cell carcinoma, which occurs on average in 30% after radical treatment.

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All about squamous cell skin cancer: types, symptoms, treatment methods

As a type of cancer, skin cancer is quite common. Its varieties have a different course and differ from each other in external manifestations, as well as a tendency to metastasize.

Currently, there are much more cases of diagnosing the considered skin condition, and this is largely due to deteriorating environmental conditions in large metropolitan areas,

Squamous cell carcinoma should be considered a type of oncological lesion that can occur anywhere on the skin. Rare is its appearance in the tissues of bones and lungs, even more rare - in the glands (sweat and sebaceous). No more than 10% of cases of this form of oncological lesions of the skin are observed with the formation of metastases.

A feature of all forms of this type of cancer is the high rate of its development and the transition from one stage to the next. Sprouting into neighboring tissues is observed, and aggressive cancer cells spread through the body with lightning speed through the blood and lymph.

What types of this type of skin cancer exist?

Forms of squamous cell skin cancer

For the considered form of oncological lesions, the following types are characteristic, which differ in their external manifestations, as well as the types of treatment used:

• plaque form - this type of skin lesion looks like a sharply colored area that stands out above the surface of the body, on which small tubercles can be seen even with the naked eye. The area is rough to the touch, the skin becomes denser than in other areas, and its growth rate is quite high.

As the plaque form of cancer develops, it grows into the tissues of neighboring areas, bleeding and severe pain may occur;

• nodular form - externally, this type of squamous cell carcinoma resembles a large accumulation of nodules of various sizes, with a large accumulation of them outer part the affected tissue resembles a cauliflower inflorescence. To the touch, the flatness of such a neoplasm is dense, the color is pronounced brown, its base is significant, and top part bumpy.

Often, the nodal form of the considered type of oncological disease occurs at the locations of the scar and the site of old injuries.

First, cracks appear on the skin, which are very painful, then gradually small nodules can be found, which at first do not cause painful manifestations and have pronounced mobility, and as the pathological process develops, the nodules increase, lose mobility and become painful.

The process of development of this form of a malignant neoplasm is quite fast, there is a penetration of an oncological malignant tumor into the deeper layers of the epidermis;

• ulcerative form - this type of malignant lesion of the skin surface is characterized by the appearance of crater-like ulcers on the upper layer of the epidermis, which are slightly elevated above the surface of the body, the edges look like a roller, and the depression smoothly descends.

Ulcers tend to grow rapidly, and their growth is observed both in width and in the deeper layers of the epidermis.

A characteristic feature of this form of squamous cell type of oncology is the appearance of a specific smell - it is this symptom that should alert and become the reason for examining the surface of the whole body. When pressing on the surface of the crater ulcer, bloody discharge may appear.

In the photo, squamous cell skin cancer of the face in the initial stage of development

It is also necessary to single out the conditional division of squamous cell carcinoma into non-keratinizing differentiated cancer, which tends to form from cells that do not undergo keratinization, and a keratinizing appearance.

• The non-keratinizing type can be highly differentiated, which does not spread too quickly, since a small number of atypical cells appear in the body.
• Poorly differentiated non-organizing squamous type of the disease develops rapidly, the number of aggressive atypical cells in the body is large.
• The keratinizing differentiated skin cancer of the considered form is more difficult to diagnose, since the neoplasms do not have a pronounced color, and the rate of its growth is quite high.

What caused the pathology?

Oncological diseases in general do not have clear causes. However, there are a number of factors provoking this condition that can cause the onset of the tumor process. Let's list the main ones.

The factors that can cause the development of squamous cell type of oncology of the skin surface include:

• elderly age- it is the age category over 55 years that is considered the most susceptible to the occurrence of cancer; older people suffer from it more often than young people: this is partly due to a decrease in the body's resistance to infections and extraneous aggressive influences, a decrease in the production of immune bodies;
• the presence of a light shade of the skin and living in the southern regions;
• excessive sun exposure and insufficient use of sunscreen;
• work in conditions of hazardous production - regular exposure to the body of substances such as tar, arsenic, soot cause the emergence and rapid development of cancer in general;
• untreated skin diseases frequent occurrences herpes, papillomas;
• low level of immunity;
• hereditary factor - genetic predisposition plays important role in the possibility of cancer.

There are also a number of precancerous skin diseases that, without necessary treatment capable of developing into a malignant disease. These include dermatitis of a different nature, pustular lesions, not fully cured sores.

What are the manifestations of the onset and development of the disease?

Clinical picture

The onset of squamous cell carcinoma is the formation in the upper layer of the epidermis, on the very surface of the skin, of small scattered neoplasms, more often they have a slightly yellowish color, pain on palpation is not felt.

Gradually, the neoplasms become larger in size, begin to merge into one, the density of the skin in this place becomes much higher, gradually the color changes to a more pronounced one.

A noticeable plaque is formed, which is located above the plane of the body. As the malignant tumor develops, the color of the formation becomes more pronounced - from reddish to brown with various shades.

The edges of the neoplasm are more elevated, characterized by high roughness, depending on the type of squamous cell carcinoma, the tumor acquires specific features. The common thing is an increase in size, the appearance of pain when pressed, as well as the release of exudate with a purulent, bloody or mixed composition.

The upper plane of the growing neoplasm is covered with a dense crust, which, at the slightest damage, breaks through and begins to bleed. Its edges become like a roller, the upper part is covered with ulcers.

Symptoms

The squamous form of this condition has quite pronounced manifestations, which are less noticeable at the initial stage of the development of this condition, but can alert and prompt a visit to a medical institution.

The first symptoms of this form of oncological disease include the appearance of a small plaque or a seal on the surface of the body, which has a yellowish color. To the touch, such a formation is somewhat compacted, it can rise slightly above the level of the skin.

Gradually, malignant cells grow and the tumor becomes more pronounced - the affected area becomes wider, tuberosity - more pronounced. Since the rate of development of the disease is high, such a neoplasm gradually ulcerates, the surface becomes rough, and pain may occur during palpation.

The process of the development of the disease has several pronounced stages, which differ in external manifestations and the degree of penetration of metastases into adjacent tissues.

Stages of development

There are four periods of development of this type of oncological skin lesions. Let's consider them in more detail.

First

At the onset of the disease, a small seal appears on the surface of the body, which does not attract attention and does not cause pain, it can be mobile. The area of ​​the affected area is not more than 2 cm in diameter.

Metastases have not yet begun to appear, the color of such a neoplasm is from yellowish to light brown.

Diagnosis rarely detects oncology in the first stage - patients do not often pay attention to the affected area that has appeared, which allows the disease to develop, and the first stage passes into the next.

Second

This stage is already characterized by the appearance of the first metastases, which mainly appear in the lymph nodes and cancer cells are carried by the blood flow to all tissues and organs.

The size of the affected area goes beyond 2 cm, a pronounced compaction of the skin appears, the color becomes more pronounced.

When pressed, soreness may not yet appear, but discomfort may occur when pressed.

Third

The progression of the disease is manifested both in an increase in the area of ​​​​the lesion, and in greater metastasis; not only closely located lymph nodes are affected, but also the tissues of healthy neighboring organs. Soreness with pressure becomes more noticeable, discharge from the sores on the surface of the tumor may appear.

The edges of the affected area have rollers of strongly compacted epidermis, the entire surface ulcerates.

Fourth

At the fourth, last stage of its development, squamous cell carcinoma has already metastasized to the lymph nodes and tissues, soreness is pronounced and can be permanent, discharge from ulcers on the surface of the affected area is often observed.

Metastases at this stage have already penetrated the cartilaginous tissues, as well as the bones. As a result, closely spaced joints begin to lose mobility.

What methods of diagnosing this type of malignant tumor can be used to obtain an accurate diagnosis?

Diagnostics

Three main methods are used to diagnose this type of cancer:

• histological examination - for this, a small piece of tissue is taken under a microscope, and this study allows you to determine both the presence of atypical cells in the tissue and their belonging to a certain type of malignant neoplasm;
• cytological scraping - tissue taken with a scraping method from the surface of an ulcer or wound is also examined here;
• laboratory methods.

The combination of these methods allows you to determine both the type of malignant tumor and the stage of its development.

To diagnose the presence of metastases, MRI is usually used, as well as computed tomography. It is mandatory to separate squamous cell carcinoma from diseases similar in appearance, such as Bowen's disease, basalioma and skin horn.

Treatment

After the diagnosis is made, treatment is prescribed.

And to determine its method, one should take into account such factors as the stage of development of the disease, the location of the tumor, the presence and number of metastases, as well as the general health indicators of the patient and belonging to a certain age category.

Currently, there are several most effective methods for the treatment of this type of oncological lesion. These include the following:

In parallel with the listed methods of cancer treatment, restorative procedures should be used that increase the level of the patient's immunity and improve his general condition.

Let's take a closer look at some of these methods.

Surgery

This method of treatment assumes a satisfactory condition of the patient who can endure surgical operation. This method is used in the presence of significant skin lesions, as well as in the late stages of cancer development.

Cryodestruction

This technique, in combination with electrocoagulation, is used for multiple lesions, as well as for small lesions of the skin and relapses of the disease.

Chemotherapy

This method of treatment of manifestations of squamous cell carcinoma is also considered one of the most effective. It is used both for relapses and in the presence of advanced stages of cancer and its extensive damage to the body.

X-ray therapy

This method of exposure is used for lesions of squamous cell carcinoma of the skin of the face (eyelids, the area near the lips, nose and mouth). Also an indication for the use of this method is the advanced age of the patient.

Removal of skin cancer metastases is also carried out with irradiation of the affected areas.

Forecast and prevention

Prediction should be made by the attending physician and the conclusion is made on the basis of such data as the stage of development of the disease, the age of the patient, his state of health at the time of detection of squamous cell carcinoma, the treatment used and the state after the therapeutic effect.

If the disease is in the third or fourth stage of its development, then the prognosis for the next five years of life is about 60%, and with successful treatment and early stages of this form of cancer - more than 90%.

Much here depends on the degree of damage to the body by this form of cancer and the method of treatment.

to the most important preventive action To prevent the occurrence of squamous cell carcinoma, the following should be included:

• regular preventive examination - this allows you to detect any deviations from the norm in the condition of the skin and start the necessary treatment in a timely manner;
• knowledge of the manifestations of squamous oncological conditions at the earliest stages;
• attentive attitude to one's own condition;
• rapid initiation of treatment when an area of ​​cancer is detected;
• lack of self-treatment - this can only lead to the appearance of more advanced stages of cancer;
• keeping healthy lifestyle life - active sports, walks in the fresh air, a rational and balanced diet, a positive attitude.

By paying attention to your health, you will protect yourself from many diseases, including oncological lesions of the skin.

Squamous cell skin cancer is a group of malignant neoplasms that develop from keratinocytes in the spinous layer of the skin epidermis and are capable of producing keratin.

The prognosis of life in squamous cell skin cancer is characterized by the following statistics: during the first 5 years, 90% of people whose tumor size is less than 1.5-2 cm survive, and if these sizes are exceeded and the neoplasm grows into the underlying tissues, only 50% of patients.

Reasons for the development of pathology

The main reason for the development of squamous cell skin cancer is considered a genetic predisposition. It can be hereditary or acquired and is expressed in:

1. Damage to cellular DNA under the influence of certain factors, resulting in a mutation of the TP53 gene, which encodes the p53 protein. The latter, as a regulator of the cell cycle, prevents tumor transformation of cells. "TP53" is one of the main genes involved in blocking the development of malignant neoplasms.
2. Disorder of the functions of the immune system directed against tumor formations (antitumor immunity). In the human body, many cellular mutations constantly occur, which are recognized and destroyed by the cells of the immune system - macrophages, T- and B-lymphocytes, natural killers. Certain genes are also responsible for the formation and functioning of these cells, the mutation in which reduces the effectiveness of antitumor immunity and can be inherited.
3. Violation of carcinogenic metabolism. Its essence lies in the mutation of genes that regulate the intensity of the function of certain systems, which are aimed at neutralizing, destroying and quickly removing carcinogenic substances from the body.

Favorable background for the development of squamous cell skin cancer are:

• Age. Among children and young people, the disease is extremely rare. The percentage of cases increases sharply among people over 40 years old, and after 65 years this pathology is quite common.
• Skin type. The disease is more susceptible to people with blue eyes, red and blond hair and with fair skin that is difficult to tan.
• Male gender. Among men, squamous cell carcinoma develops almost 2 times more often than women.
• Skin defects. Cancer can also develop on clinically healthy skin, but much more often against the background of freckles, telangiectasias and precancerous diseases (Bowen's disease, Paget's disease, pigment xeroderma), in the area of ​​scars formed as a result of burns and radiation therapy, after which cancer can even occur. after 30 years or more, post-traumatic scars, trophic changes in the skin (with varicose veins), fistula openings in osteomyelitis of the bone (metastasis rate is 20%), lesions in tuberculous and systemic lupus erythematosus, etc.
• Prolonged decrease in general immunity.

Among the provoking factors, the main ones are:

1. Ultraviolet radiation with intense, frequent and prolonged exposure - sunbathing, with psoralen, carried out in order to treat psoriasis and desensitization in case of allergy to sunlight. UV rays cause a mutation of the TP53 gene and weaken the body's antitumor immunity.
2. Ionizing and electromagnetic types of radiation.
3. Prolonged exposure to high temperatures, burns, prolonged mechanical irritation and damage to the skin, precancerous dermatological diseases.
4. Local exposure for a long time (due to the specifics of professional activity) of carcinogenic substances - aromatic hydrocarbons, soot, coal tar, paraffin, insecticides, mineral oils.
5. General therapy with glucocorticoid drugs and immunosuppressants, local therapy with arsenic, mercury, chlormethyl.
6. HIV and papillomavirus infection 16, 18, 31, 33, 35, 45 types.
7. Irrational and unbalanced nutrition, chronic nicotine and alcohol intoxication of the body.

The prognosis without treatment is unfavorable - the incidence of metastases is an average of 16%. Of these, 85% of them metastasize to regional lymph nodes and 15% to the skeletal system and internal organs, most often to the lungs, which always ends in death. The greatest danger is represented by tumors of the head and skin of the face (affects 70%), especially squamous cell carcinoma of the skin of the nose (back of the nose) and neoplasms localized in the forehead, in the nasolabial folds, periorbital zones, in the area of ​​the external auditory canal, the red border of the lips, especially the upper one, on the auricle and behind it. Highly aggressive in terms of metastasis are also tumors that have arisen in closed areas of the body, especially in the vulva, both women and men.

Morphological picture

Depending on the direction and nature of growth, the following types of squamous cell carcinoma are distinguished:

1. Exophytic, growing on the surface.
2. Endophytic, characterized by infiltrating growth (grows into deeper tissues). It is dangerous in terms of rapid metastasis, destruction of bone tissue and blood vessels, bleeding.
3. Mixed - a combination of ulceration with tumor growth deep into the tissues.

A micropreparation examined under a microscope is characterized by a picture common to all forms of this disease. It consists in the presence of cells similar to cells of the spinous layer, growing deep into the dermal layers. Characteristic features are the growth of cell nuclei, their polymorphism and excessive staining, the absence of connections (bridges) between cells, an increase in the number of mitoses (division), the severity of keratinization processes in individual cells, the presence of cancerous strands with the participation of cells of the spiny layer of the epidermis and the formation of so-called , "horn pearls". The latter are rounded foci of excessive keratosis with the simultaneous presence of signs of incomplete keratinization in the center of the foci.

According to the histological picture, there are:

• squamous cell keratinizing skin cancer (highly differentiated);
• undifferentiated form, or non-keratinizing cancer.

Common to both forms is the disorderly arrangement of groups of atypical squamous epithelial cells with their growth into the deeper layers of the dermis and subcutaneous tissues. The severity of atypia in different cells can be different. It is manifested by a change in the shape and size of the nuclei and the cells themselves, the ratio of the volumes of the cytoplasm and the nucleus, the presence of pathological division, a double set of chromosomes, and many nuclei.

Highly differentiated squamous cell skin cancer

It is characterized by the most benign course, slow growth and gradual spread to deeper tissues. Signs of keratinization are determined both on the surface and in the thickness.

A keratinizing tumor may have the appearance of multiple formations, but, as a rule, it is single, flesh-colored, yellowish or red. Its shape is round, polygonal or oval, sometimes with a depression in the center. On visual inspection, the neoplasm may look like a plaque, nodule or papule, the surface of which is covered with dense scales of the horny epithelium that are difficult to separate. In the central part, an ulcer or erosion is often determined with dense keratinized edges that rise above the surface of the skin. The erosive or ulcerative surface is covered with a crust. When pressing on the tumor, horny masses are sometimes separated from its central or lateral sections.

Squamous cell nonkeratinizing skin cancer

It has a more malignant course, compared with the previous form, manifested by rapid infiltrating growth into the deep dermal layers, faster and more frequent metastasis to regional lymph nodes.

With this form, cellular atypism and many pathological mitoses are pronounced with a slight reaction of the structural elements of the stroma. There is no keratinization at all. In cells, either decaying or hyperchromic (excessively stained) nuclei are determined. In addition, with an undifferentiated form of cancer, layers of epithelial cells that look like nests are separated from the epidermal layer, keratinization is absent or slightly expressed.

The main elements of the tumor are represented by granulation "fleshy" soft formations like papules or nodes with growth elements (vegetation). The most common localization is the external genitalia, much less often - the face or various parts of the body.

The neoplasm can be single or multiple, has an irregular shape and occasionally takes on a resemblance to cauliflower. It quickly transforms into an erosion or ulcer that bleeds easily with little contact with a necrotic bottom covered with a reddish-brown crust. The edges of the ulcer are soft, rise above the surface of the skin.

Depending on the clinical manifestations, the following main types of the disease are conditionally distinguished, which can be combined or changed at various stages of development:

• nodular or tumor type;
• erosive or ulcerative-infiltrative;
• plaque;
• papillary.

Nodular or tumor type

Superficial or nodular form of squamous cell skin cancer is the most common variant of tumor development. The initial stage is manifested by one or more painless nodules of dense consistency merging with each other, the diameter of which is about 2-3 mm. They slightly rise above the skin surface and have a dull white or yellowish color, very rarely brown or dark red, the skin pattern above them is not changed.

Quite quickly, the size of the nodule (nodules) increase, as a result of which the tumor becomes like a painless yellowish or whitish plaque with a gray tint, the surface of which may be slightly rough or smooth. The plaque also protrudes slightly above the skin. Its dense edges look like a roller with uneven, scalloped contours. Over time, a depression is formed in the central part of the plaque, covered with a crust or scale. When they are removed, a drop of blood appears.

In the future, there is a rapid increase in the size of the pathology, the central depression is transformed into erosion, surrounded by a roller with steep, uneven and dense edges. The erosive surface itself is covered with a crust.

Ulcerative infiltrative type

For the initial stage of the ulcerative-infiltrative type of squamous cell carcinoma, the appearance of a papule as a primary element that has endophytic growth is characteristic. Over the course of several months, the papule is transformed into a knot of dense consistency, soldered to the subcutaneous tissue, in the center of which, after 4-6 months, an ulcer appears that has an irregular shape. Its edges are raised in the form of a crater, the bottom of which is dense and rough, covered with a whitish film. Ulcerations often take on a fetid odor. As the node increases, bleeding occurs even in the case of a slight touch to it.

In the peripheral parts of the main node, “daughter” nodules can form, during the decay of which ulcers are also formed, which merge with the main ulcer and increase its area.

This form of cancer is characterized by rapid progression and destruction of blood vessels, germination in the underlying muscles, cartilage and bone tissue. Metastases spread both by the lymphogenous route to regional nodes, as a result of which dense infiltrates are sometimes formed, and by the hematogenous route to the bones and lungs.

Plaque form of squamous cell skin cancer

It has the appearance of a sharply prominent dense red area of ​​the skin surface, against the background of which small tubercles that are barely visible during visual inspection sometimes appear. The element has a rapid peripheral and endophytic growth in neighboring tissues, often accompanied by severe pain and bleeding.

Papillary squamous cell skin cancer

It is relatively rare and is one of the exophytic forms. At first, it manifests itself as a primary, rising above the surface of the skin and rapidly growing, nodule. A large number of horny masses form on it, as a result of which the surface of the node becomes bumpy with a central depression and a large number of small dilated blood vessels. This gives the tumor, located, as a rule, on a wide and slightly displaced base, the appearance of a dark red or brown "cauliflower". In the later stages of its development, papillary cancer transforms into ulcerative-infiltrative.

A variation of the papillary form is verrucous, which in old age can manifest itself as a skin horn. The verrucous form is characterized by very slow development and extremely rare metastasis. It has a yellowish or reddish-brownish color, a bumpy surface covered with warty elements and a hyperkeratotic crust.

Treatment of squamous cell skin cancer

The choice of treatment method is influenced by:

1. Histological structure of the tumor.
2. Its localization.
3. The stage of the cancer process, taking into account the presence of metastases and their prevalence.

Surgical excision

A small tumor without metastases is surgically excised within the boundaries of unaffected tissues, retreating 1-2 cm from its edges. If the operation is carried out correctly, the cure for 5 years is an average of 98%. Particularly good results are observed when the tumor is excised in one block with subcutaneous tissue and fascia.

Radiation therapy

With small tumor sizes at T1 and T2 stages, it is possible to use close-focus X-ray radiation as an independent method. At T3-T4 stages, the radiation method is used for preoperative preparation and postoperative therapy. It is especially effective in the treatment of deep-growing skin tumors. In addition, radiation exposure is used to suppress possible metastases after surgical excision of the underlying tumor and as a palliative method for inoperable cancer (to slow its spread).

The large size of a cancerous tumor in the absence of metastases is an indication for the use of remote gamma therapy, and if they are present, combined therapy is carried out by means of X-ray and gamma irradiation, radical removal of the tumor itself with regional lymph nodes.

Cryodestruction and electrocoagulation

Treatment of small superficial highly differentiated squamous cell carcinoma with localization on the body is possible with cryodestruction, but with mandatory preliminary confirmation of the nature of the tumor using a preliminary biopsy. Removal of a malignant skin tumor of the same nature with a diameter of less than 10 mm in the face, lips and neck can be carried out using the electrocoagulation technique, the advantage of which is less trauma.

Chemotherapy

Chemotherapy for squamous cell skin cancer is prescribed mainly before surgery in order to reduce the size of the neoplasm, as well as in combination with radiation therapy for inoperable cancer. For this, drugs such as Fluorouracil, Bleomycin, Cisplastin, Interferon-alpha, 13-cis-retinoic acid are used.

Treatment of folk remedies for cancer is unacceptable. This can only lead to a loss of time and the development of metastases. You can use folk remedies as an auxiliary only on the recommendation of a doctor for the treatment of radiation dermatitis.

Alternative Therapies

Modern physical treatment in oncology also includes methods of photodynamic therapy using a pre-selected special sensitizing dye (PDT), as well as laser-induced light-oxygen therapy (LISCT). These methods are used mainly for the treatment of elderly patients, in cases of severe concomitant diseases, with localization of neoplasms over cartilage and on the face, especially in the periorbital zone, since they do not adversely affect the eyes, healthy soft and cartilaginous tissues.

Timely determination of the cause and background on which the malignant process develops, elimination (if possible) or reduction of the influence of provoking factors are important points in the prevention of metastasis and the prevention of recurrence of squamous cell carcinoma, which occurs on average in 30% after radical treatment.

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