Squamous cell carcinoma of the skin is the second most common skin cancer in the US. We don’t think of common skin cancers as being lethal but approximately the same number of people die per year from metastatic squamous cell cancer of the skin as die from melanoma.
Unfortunately, there is not a standardized treatment protocol nor a way to predict which cancers will become more aggressive. New biomarkers have been developed which share 6 genes in all squamous cell cancers of the skin and 18 genes which appear to be able to identify the cancers which can become recurrent from non-recurrent cancers.
This is very important from a treatment standpoint. Up until now oncologists could not tell which cancers had potential to become lethal and so all squamous cell carcinomas of the skin where basically treated the same. Being able to identify these more harmful cancers has the potential to save lives by individualizing a screening and treatment protocol to best enable doctors to ensure the best outcome for each patient.
Along the same lines, the New England Journal of Medicine published research on new immunotherapy for squamous cell carcinoma of the skin. PD-1 Antibody therapy appears to be active in skin cancers with a 48% response rate.
Michelle Haessler M.D.
Board Certified Radiation Oncologist
Surgery is a very effect treatment for common skin cancers such as basal cell carcinoma and squamous cell carcinoma. The surgery can consist of a simple removal of the skin cancer or a more involved procedure such a Mohs surgery. If the tumor is small and not aggressive in nature and is in a location where cosmesis is not of concern, then a simple excision should suffice. The tissue should then be sent to an outside pathologist who will review the specimen and report on if the entire tumor was removed with adequate margins.( a margin is the area around the tumor that we want to see no cancer cells just normal skin cells).
This form of treatment is very effective as well as cost saving. What I have noted in recent years is the increased, often unnecessary, usage of Mohs surgery. This is a microsurgery in which the dermatologist looks under a microscope to make sure the margins are adequate. Whereas this is very effective, it is much costlier and is often not needed. For example, if you have a skin cancer on your arm or leg a simple excision is more than adequate for control of this cancer. Mohs surgery may add up to an additional $1,000 in medical costs and the outcome will be the same.
If on the other hand you have a skin cancer in the middle of your face Mohs surgery makes more sense. The margin status can be obtained while you are in the office. This often results in smaller margins and the cosmetic result should be improved. Unfortunately, sometimes large portions of skin will still have to be removed to get adequate margins. We have all seen people with huge scars on their face, nose and ears from these surgeries. Is that the only course of treatment? No.
Radiation therapy is often a good choice for skin cancers. It can spare normal tissue and the cosmesis is often excellent with the outcome similar to surgery. The treatment uses radiation that does not penetrate the skin very deeply. You would go for daily treatments and the side effects are mainly redness and skin irritation over the radiated fields. Whatever area is being treated remains intact such as an ear or a nose. The redness rapidly clears and leaves the skin soft. It often looks smooth, young and wrinkle free. I have had numerous patients ask me (jokingly) for treatment to the other side of their face since the skin looks so good.
If you are diagnosed with a skin cancer and you are concerned about the cosmesis ask for a Radiation Oncology consultation. I can not tell you if you would be a good candidate or not without seeing you but I can tell you after over 25 years of treating skin cancer with radiation therapy, the results are excellent and patient satisfaction very high.
It doesn’t hurt to get a second opinion and it may save a big part of your nose (or ear).
Michelle Haessler M.D.
Board Certified Radiation Oncologist
I have always loved dogs and always will. October is National Adopt a Dog Month sponsored by the American Humane Society, so what better time to talk about how dogs can help your health. I grew up with dogDogs give us love. Proven scientifically although I don’t know why they spent the research money, I could have told them that
Its adopt a dog month. Go out and save a life. For every dog you save you save 2or 3 dogs. The one you adopted and if you adopted from a rescue organization you opened up a spot there for them to take in another dog from a shelter- which opens up a spot at the shelter. So 3 dogs saved. Oh, and don’t forget about adopting a cat.s. My first dog as a child was “Candy” a tough little cocker spaniel. She was a sweet, ornery little thing. My most vivid memory of her was coming home to find my Italian grandmother stuck in our recliner unable to get out of the recliner because Candy decided she didn’t want her to. Every time my little grandmother tried to get out of the chair it was a battle of wills- a snippy little cocker spaniel and an equally snippy little Sicilian Grandma. Candy won. Great memories.
Since that time, I have had many dogs who have lived long and wonderful lives. Most have been rescues. I recently looked at the statistics for euthanasia of shelter dogs over the last few decades and was pleasantly surprised to see that fewer dogs are being euthanized due to the efforts of shelters, rescue groups and heightened public awareness. I currently have two rescue Siberian Huskies. I never expected to own one Husky, let alone two, but what wonderful dogs. They both have interesting stories of abandonment and abuse, as most rescues do, but it never ceases to amaze me how they have adjusted and enhanced my life seemingly forgetting their past.
What can dogs do for you and your health and cancer?
- Dogs can smell cancer. This doesn’t surprise me as their sense of smell is so much greater than ours. This has been proven scientifically and is currently being researched as to how to benefit patients
- Dogs can give us companionship. This is very important on the dark days that we all have. They can lift depression and give us hope and the will to live.
- Dogs have health benefits like lowering our blood pressure
- Dogs provide endless entertainment and love.
- Dogs give us purpose.
- They provide exercise. You need to walk them. Take care of them. Throw a ball for them. All of this uses calories and provides exercise. Exercise is very important to fight cancer.
- Dogs give us love. Proven scientifically although I don’t know why they spent the research money, I could have told them that.
Its adopt a dog month. Go out and save a life. For every dog you save you save 2or 3 dogs. The one you adopted and if you adopted from a rescue organization you opened up a spot there for them to take in another dog from a shelter- which opens up a spot at the shelter. So 3 dogs saved. Oh, and don’t forget about adopting a cat.