Squamous cell carcinoma: Symptoms
1. Actinic keratosis
These are precancerous spots that are rough, scaly, brown or pink patches caused due to prolonged exposure to the sun. Actinic keratosis can cause itching, irritation and inflammation and may bleed at times. Common spots for actinic keratosis are face, hands, forearms, back of the neck, upper chest, cheeks and bridge of the nose. These are precancerous lesions which, if left untreated, slowly develop into squamous cell carcinoma. It is prevalent among pale or fair-complexioned people who are frequently exposed to the sun, and is normally associated with sun damage. Again, the rate of incidence depends on the geographical location and age. Studies indicate that untreated lesions have greater risk of developing into squamous cell carcinoma.
Organ transplant patients are normally prescribed drugs to suppress the immunity to prevent organ or tissue rejection. Such patients are at a higher risk of developing actinic keratosis. Early treatment of the lesions prevents the possibility of developing this cancer.
2. Basal cell carcinoma
This usually develops on the head and the neck: the body parts that are often exposed to sun and other types of radiation. It is found to affect people in their 30s and older people. It is usually slow and is not painful. People with light colored skin, green, grey or blue eyes, having many moles, family history of skin cancer, sun burns and long term sun exposure are more susceptible to basal cell carcinoma. Symptoms include:
a. A skin growth that is small, waxy and either pink or brown colored.
b. Skin sore that is taking a long time to heal and that bleeds.
c. A sore that has a depression in the middle or has crusting spots on it.
Basal cell carcinoma does not spread but if left untreated, can affect surrounding bone and other tissues, especially in the nose, eyes and ears. The location, size and depth of the lesion determine the type and intensity of treatment.
3. Bowen’s disease
This is considered as the early stage or a form of squamous cell carcinoma. Skin appears scaly and brownish and may appear similar to eczema or psoriasis. A single or a number of patches may be present, with each patch having irregular edge but distinct from the surrounding skin. It can occur on any part of the skin, including palms and soles of the feet. The scaling slowly grows with irregular border and has crust on the surface. This disease is seen especially in women over 30 years of age. Though this is one of the curable cancers, it can spread to the other layers of the skin. Long term exposure to the sun is one of the important risk factors for Bowen’s disease. However, statistics also reveal that this form of cancer can occur in parts which are not exposed to the sun. It is normally found on the lower part of the leg. Urgent medical attention is required if the patch bleeds or turns tender.
4. Actinic cheilitis
This is the counterpart of actinic keratosis which can develop to squamous cell carcinoma, if left unchecked. Lips are the main part that are affected, there is discoloration on the border of the lips and the surrounding skin. As actinic cheilitis progresses, the lips become hard and scaly. These are normally found in males who have chronic sun exposure and have a pale complexion that is prone to sun damage. The lesions are painless and are usually continuous in nature. Lips become pale pink or red in color and can lead to chronic mouth ulcers. It can also make the demarcation between the lip and the vermilion zone disappear. Apart from exposure to the sun, other factors such as use of tobacco, poor oral hygiene and lip irritation risk the development of actinic cheilitis. Six percent of actinic cheilitis cases have the risk of progressing into squamous cell carcinoma. Chronic lesions require removal of lip mucosa and need replacement of mucosa inside the mouth.
This is yet another precancerous skin condition that mainly occurs in the mouth and the lips. Leukoplakia patches are seen on the tongue, inside the cheek or even on the outer female genitals. The path develops slowly over weeks and eventually hardens and has a rough texture. It is mainly caused due to irritation of teeth, dentures, smoking, chewing tobacco or holding snuff in the mouth for a long time, HIV or AIDs, and sun exposure of the lips. This disease is often found in the elderly. Too much exposure to the sun also leads to leukoplakia. Five to twenty five percent of lesions are pre-malignant and treatable. “Hairy” leukoplakia is another disorder which is associated with HIV infection and in other people who have weak immunity. This is often seen as a fuzzy white patch on the tongue and resembles a thrush: a fungus infection that occurs in adults if the immune system is not functioning properly. Leukoplakia lesions normally clear in a few weeks once the source of irritation is removed. If it persists, then it may require to be removed surgically. Hairy leukoplakia is treated with anti-viral medicines. If left untreated, leukoplakia can turn into squamous cell carcinoma.
6. Arsenical keratosis
Consumption and exposure to various chemical compounds present in agricultural products, drugs, drinking water and industrial products, lead to the development of arsenical keratosis: a precancerous skin disorder. These are typical skin lesions that result from long term arsenic exposure. They cause pigmentation of the skin. Metastatic arsenic keratosis can lead to cancer of the liver, bladder, kidney, colon and the skin. Arsenical keratosis produce small lesions which primarily occur on the palms, soles and toes of the feet and can affect people of all age groups. They are hard, small, spotted, yellowish, corn like papules and are usually symmetric. As it progresses, it forms large plaques. Arsenical keratosis may develop into invasive metastatic squamous cell carcinoma and may result in death.
A mole is a growth of cells called melanocytes that provide color to the skin. A few atypical moles, though usually not cancerous, can become cancerous. These are usually found both in areas that are protected against sun as well as exposed to sun. Atypical are larger and irregular in size and have fading borders. They can either be flat or raised, rough or smooth with pink, red, brown or tan color. Such moles have chances of developing into squamous cell carcinoma.
8. Cutaneous horns
Cutaneous horns often grow in conjunction with actinic keratosis. This form of keratosis can be precancerous and may develop into squamous cell carcinoma. Cutaneous horns growth forms on the skin and is funnel-shaped like a tiny horn. It is normally found on the base of the skin. The rash appears on areas that are exposed to the sun such as nose, arms, face and back of hands. However, even unexposed areas have chances of developing cutaneous horns. It occurs in the elderly who are fair skinned and have significant exposure to the sun. These are usually asymptomatic. The corn causes inflammation at the base of the skin making it quite painful. If the rash is tender and if the lesions are of large size, chances of them being malignant are more.
9. Solar keratoses
These are patchy, scaly and dry skin caused due to excessive exposure to UV rays from the sun. It occurs among elderly people. These are red, pink or sometimes have the same color as normal skin and can be either flat or raised. They are normally found in areas that get maximum exposure to the sun: face, shoulders, neck, arms and so on. Not all solar keratoses are cancerous but, if let untreated, may develop into squamous cell carcinoma.
Exposure to the sun plays an important role in causing keratoacanthoma. A minor injury, often of not real concern, triggers off development of keratoacanthoma. It is usually seen to occur on the part of skin that has lot of hair, such as top of the head, face and neck. Cancerous cells start multiplying in the hair follicle and grow into a mass. The lesion is pink in color and becomes hard and scaly. It becomes an ulcer when it breaks off. Women are more affected by keratoacanthoma than men, especially over the age of 70.
11. Know your ABCDE
It is important to know the characteristics of moles or lesions that are not looking similar. It might need medical attention if
a. the lesion/mole is Asymmetrical.
b. the Border is uneven.
c. the mole has many shades of Colors.
d. the Diameter is larger than 6 millimeters.
e. the growth is Evolving in shape or size.