Disc epithelial cancer is a form of skin cancer that is usually due to the fact that you have been in the sun a lot, without having to burn yourself. Disc epithelial cancer is becoming more common, but most people who get the disease get rid of it after treatment.

The vast majority of people who have squamous cell cancer are over 40 years old.

Symptoms of disc epithelial cancer

The most common symptom of disc epithelial cancer is a knot or stain somewhere on the skin.

  • It can be the same color as your own skin or be pale red.
  • It usually sits on the face, on the head if it is cold, or on the top of the hands.
  • It can be covered by hard scales.
  • It can sometimes be sore when touched.

The symptoms may have causes other than cancer. Here you will find out more about  benign skin changes .

There are also other types of skin cancer, such as  malignant melanoma and  basal cell cancer .

A precursor to squamous cell cancer

Actinic keratosis – sun damage

Actinic keratosis is also called sun damage. It is a pale red or reddish-brown spot with a blurry border and raspy surface that can be from a few millimeters up to a few centimeters in size. It often sits on the face, on the bare part of the head or on the top of the hand. After many years, the change can turn into invasive squamous cell cancer.

The change can sometimes be confused with  malignant melanoma,  basal cell  or squamous cell cancer, but also with  eczema  or other skin diseases.

Disc epithelial cancer in situ

In squamous cell cancer in situ, or Bowen’s disease, the cancer is not fully developed and only grows on the skin’s surface. You get a reddish stain, which can get a little sore and scaly. Sometimes it is reminiscent of an eczema spot. The cancer is most common on skin that has been in the sun but can sit anywhere on the body.

The stain may progress to the next stage, called invasive disc epithelial cancer.

Invasive disc epithelial cancer

Invasive squamous cell cancer means that the cancer grows deeper into the skin. The cancer usually looks like a well-defined knot with hard skin scales on the surface. It can be the same color as your own skin or be slightly red. Sometimes the cancer gets sore with crusts.

The cancer can also look like an irritated wart that hurts if you touch it.

Disc epithelial cancer is most common on the face, neck, head or top of the hands. You can also get invasive squamous cell cancer in difficult to heal wounds or scars after a burn or radiation treatment.

When and where should I seek care?

Contact a health center or skin clinic if you think you may have squamous cell cancer. You can contact many receptions by logging in .

Contact a health care center as soon as possible if you have a change such as bleeding, growing rapidly or growing at any height, regardless of the color of the change. You do not need to seek care elsewhere if it is closed. Wait until the health center opens.

Investigations

You can get dressed and put on a breeze. The doctor examines all the spots and changes on the skin. A skin microscope, also called dermatoscopy, is used at skin clinics and many health centers. The dermatoscopy provides a more detailed image.

Experienced doctors can often see directly if a change is squamous cell cancer. Sometimes the doctor needs to take a tissue test, a so-called skin biopsy. It takes a few minutes. You get local anesthesia .

The entire skin change is removed to be examined under a microscope if the doctor suspects that you have the invasive form of squamous cell cancer.

The doctor examines the lymph nodes

Occasionally, disc epithelial cancer spreads to the  lymph nodes. The doctor senses the lymph nodes, usually those found in the neck, armpits or groin. You may leave a cell sample if any gland is felt through the skin. The sample is taken through a thin needle that is inserted into the lymph node. The cell sample is analyzed by a microscope. 

Sometimes an X-ray examination is needed

You need to investigate more if there are cancer cells in the cell sample from the swollen lymph gland. Then you are examined with computed tomography .

New medical assessment

You can get a  new medical assessment  if you have been diagnosed with squamous cell cancer and are unsure if you are receiving the care and treatment that is best for you. You will then see another doctor, usually at another specialist clinic. Ask your doctor if you want to know more about how to get a new medical assessment.

Treatment at the stage of squamous cell cancer

There are several treatment options available if you have pre-existing squamous cell cancer. Which treatment is best for you may depend on where the disease is and how you are feeling.

Freezing Treatment

The dermatologist sprays liquid nitrogen on the skin change so that the cancer cells die. The cancer tumor can be scraped first if it is thick. Then you get  local anesthesia. The wound after treatment can take four to six weeks to heal.

Scraping and burning

You get local anesthesia. Then the change is scrapped away. The dermatologist then uses an instrument with electric current to burn off any cancerous residue. What has been scrapped is sent to the laboratory if needed to confirm the diagnosis. The wound after treatment can take four to six weeks to heal.

Immune-enhancing or cell-inhibiting ointment

Drug treatment with ointment can be used if the cancer is superficial. The ointment can either stimulate the immune system to repel cancer or destroy the cancer cells directly. The treatment can take a few days or up to several weeks. It depends on which drug is used. The wounds that occur heal ten to fourteen days after the end of treatment.

Photodynamic therapy, PDT

First, you get an ointment that makes the cancer cells photosensitive. After three hours, you receive treatment with a special light for about eight to ten minutes so that the cancer cells die. It can hurt but you can get help with relieving the pain. Treatment needs to be repeated again after one to two weeks. After each treatment, the skin area becomes sore and red. It usually heals after ten to fourteen days.

Surgery

The change is cut off while you are anesthetized locally. It is usually possible to sew the wound together directly. Skin plastic or skin transplants may be needed to cover the wound if a large piece of the skin has been removed. You can go home the same day. The wound heals after one to two weeks. It may take another week if you have had a skin transplant.

After the operation, the change in a microscope is examined. The study provides a secure diagnosis and can show if everything that needed to be operated has been removed. 

Treatment for invasive squamous cell cancer

Invasive squamous cell cancer can spread and therefore it must be removed. The most common is local anesthesia. The surgeon may need to transplant skin from other parts of the body to cover large wounds. You can go home the same day.

Radiation can be an alternative to surgery

You can get radiation treatment if the disc epithelial cancer has grown a lot or if it sits where it is difficult for the surgeon to access.

Good to quit smoking

If you smoke, the winnings are many to stop before an operation. The wounds heal faster, blood circulation and fitness improve so you recover faster. The best thing is to quit smoking completely, but if it fails, it is good if you can refrain from smoking before the surgery and even the first weeks afterward. If you need help to quit smoking, your doctor can tell you what support is available.

It is uncommon for the disease to return

It is called relapse if the disease recurs. Then a new operation is usually needed. You may need radiation therapy if surgery is not possible.

It is quite uncommon for relapses in squamous cell cancer-

If cancer has spread

Disc epithelial cancer can spread to lymph nodes or other organs in the body. Then you need more treatment.

The lymph nodes are operated

The lymph nodes closest to the cancerous tumor are removed if cancer has spread. Usually, the lymph nodes in groin, armpit or throat need to be removed. The treatment can cause you to get lymphedema  which means, for example, an arm or a leg swelling. There is help to get.

Cytostatic stop spreading

You can get treatment with anti-cellulite drugs that are also called cytostatic drugs if the squamous cell cancer is spread to other parts of the body.

Care if it is not possible to get rid of the disease

It is unusual, but sometimes it is not possible to remove the squamous cell cancer if it has spread. Then you instead receive care that slows or relieves the symptoms. It is called palliative care. Palliative care can make it possible to live a good life despite the disease, sometimes for a long time.

After the treatment for disc epithelial cancer

For most people who have had squamous cell cancer, there are no physical or practical obstacles to living life as it was before the disease. Still, it is common for life to be different compared to what it was before the illness message. You always have the experience of what you have been with.

It is common for it to feel painful periodically, but usually, it gets better – although it may take time. Some may feel vulnerable and anxious long after treatment is over.

Do I need to go after checking?

Most people do not have to go after checking. What determines is what type of cancer tumor you have had, where it was put and what treatment you have received. At the after check-ups, the doctor examines the scar, other skin, and lymph nodes. The risk of the disease coming back decreases over time.

It is always good that you look at your skin yourself and seek care again if you get new skin changes.

What is the cause of squamous cell cancer?

Disc epithelial cancer is a cancer of a type of skin cells called keratinocytes. The cells have been damaged in a way that they are unable to repair themselves. Then they stop behaving properly. The cells divide uncontrollably and form cancerous tumors that displace healthy tissue.

The most common cause of disc epithelial cancer is the sun’s ultraviolet rays, also called UV rays. You do not need to have burned yourself, but you may have spent a lot of time outside and thus been exposed to a lot of sunlight. 

It is most likely to have disc epithelial cancer on the parts of the face that are most exposed to the sun, such as the upper ears, nose, lower lip, cheeks, forehead or scalp if you are bald. You may also have squamous cell cancer on your forearms, the top of your hands and lower legs, or on other skin that has received a lot of suns.

How can I reduce the risk of squamous cell cancer?

Take special care with the sun if one or more of the following points are true of you:

  • You are often and very much in the sun.
  • You have light skin and red or light hair. Then you have pigments that give the skin lower protection against sun damage.
  • You are taking immunosuppressive drugs. Then the body has a reduced ability to care for sun-damaged skin cells. You will receive immunosuppressive drugs if, for example, you have had an organ transplant.
  • You have had disc epithelial cancer or prior epithelial cancer.
  • You have had long-lasting wounds and scars. It is rare, but they can be converted to squamous cell cancer. Watch out if the healing of a leg ulcer, for example, stops and some of the wound edges is raised. You may also have disc epithelial cancer in scars after old burns. Then a knot or a difficult-to-heal wound is formed in the scar.
  • You have received PUVA treatment for psoriasis. Then, long-wave ultraviolet radiation is used in conjunction with drugs that increase the light sensitivity of the skin.
  • You have received radiotherapy. It is uncommon, but squamous cell cancer can occur after many years if you have received radiation therapy for cancer.

It is unclear if the risk of squamous cell cancer increases if you sunbathe in a solarium, however, it increases the risk of malignant melanoma. Therefore, it is good to avoid sunbathing.

Getting a cancer message

You can respond in many ways to a cancer message. It is common to need a lot of time to talk to your doctor and other healthcare professionals about what the message means.

If possible, please let a relative accompany you. The related person can act as a support and help to remember what has been said.

You can also ask to have the information written down so you can read it peacefully. Ask questions if you don’t understand. You have the right to receive information in your own language. You also have the right to receive interpreting assistance if you have a hearing impairment.

In many hospitals, there are special nurses called contact nurses who should be especially accessible to the sick person and to their relatives. The contact nurse can provide support and also help with various practical things.

Here you can read more about contact nurses.

You can get support in several places

Talk to the contact nurse or the hospital’s curator if you feel anxious or have questions.

It is common to feel easier once treatment has begun and you know what is going to happen.

Children need to know

Children have the right to receive information and support based on their own needs if a relative is ill. You can get help with what you have to say if you want to and can tell the child yourself.

Often it is good to make children as involved as possible, regardless of age. But you may need to customize the information and not have to tell everything. It may be good to start with the child’s own questions. Here you can read more about talking to children when a parent is seriously ill.

Being related

It can feel difficult to be close to someone who is sick. It is common to want to support while you have a strong concern and feel bad.

If you have people close to you, they can be a support. Often it will be easier for them to help you if you tell them how it feels. You can also talk to the contact nurse if you are close and need supportive calls.

You can get relief if you help take care of or support the sick person. You can also get support, for example in the form of calls or help with practical things.

Muhammad Nadeem

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