Squamous cell carcinoma

Diagnosis

Diagnosis of squamous cell carcinoma can be made through the following methods:

• Medical history and physical examination: The patients undergo detailed health evaluation when presented with abnormal skin characteristics. The oncologists may ask the patients if there is bleeding, itching, or pain. The patients are enquired about the underlying skin conditions that might cause skin symptoms. Further, the family history of the patients is evaluated to determine the risk of squamous cell carcinoma. The medical history of the patients, such as the history of skin cancer or the presence of precancerous skin lesions, is also asked to determine the risk of developing squamous cell carcinoma.
• Biopsy: Biopsy is the confirmatory test for squamous cell carcinoma. It involves obtaining samples of abnormal cells and evaluating them in the laboratory under a microscope for the presence of cancer cells. There are several types of biopsies. The type of biopsy chosen depends upon the location and size of the tumor. Some of the methods of biopsy include:
• Punch biopsy: As the name suggests, the oncologist punches the skin with a cutter-like instrument to obtain the sample deeper from the skin. The cutter is rotated on the skin to allow the exposure of the deeper skin tissues. Once the sample is removed, the wound is closed by stitching the edges together.
• Shave biopsy: This technique is used when a sample of abnormal skin cells from the outer layer is obtained. During this process, the topmost layer of the skin is shaved off.
• Excisional biopsy: An excisional biopsy is done when the complete tumor is required to be removed. An excisional biopsy involves using a surgical knife to remove the tumor.
• Incisional biopsy: During an incisional biopsy, only a small portion of the tumor is removed for further evaluation in the laboratory. This biopsy also involves the use of a surgical knife for tumor resection. The edges of the wound are stitched together after the biopsy.
• Lymph node biopsy: If it is suspected that the squamous cell carcinoma has spread to the lymph node, the patients may undergo a lymph node biopsy. If cancer spreads to lymph nodes, they usually become swollen and firm. During lymph node biopsy, the oncosurgeons remove the lymph node and analyze them for the presence of cancerous cells. There are various types of lymph node biopsies, and the method depends on the location of the concerned lymph node. Fine needle aspiration biopsy involves the use of a thin hollow needle. The needle is inserted into the site, and the sample is obtained. If the lymph node is deeper into the skin, imaging techniques, such as a CT scan, can guide the needle to the lymph node. The other type is surgical lymph node biopsy. This method is used when the lymph node or the sample from the lymph node is not obtained through fine needle aspiration. In a surgical biopsy, the skin is cut, and the lymph node is removed. The procedure is done under local anesthesia.
• Chest X-ray: Chest x-ray provides information about the organs in the thoracic cavity. The patients undergo chest X-rays when the cancer is suspected of having spread to the lungs or other organs of the chest.
• CT scan: CT scan provides detailed images of the body organs. The patients undergo CT scans if the cancer is suspected of spreading to other parts of the body, such as the brain and spinal cord.
• MRI: MRI involves the use of powerful magnets and radio waves. It provides detailed information about the spread of squamous cell carcinoma in different body parts.
• PET scan: Positron emission tomography is based on the principle that rapidly dividing cells require high-energy nutrients. The radioactive sugar derivative is injected into the vessel. A special camera detects the cells in which the radioactive derivative of sugar is accumulated.
• Bone scan: Bone is a common site for metastatic squamous cell carcinoma. The bone scan allows the oncologists to detect if the squamous cell carcinoma has spread to the bone.