Wednesday 24 February 2021

Squamous Cell Carcinoma- A type of skin disease


 What is Squamous cell carcinoma of the skin?

Squamous cell carcinoma (SCC) specifically is a kind of skin cancer that originates from the squamous cells of the skin. These cells are quite different from melanocytes (from which melanomas originate) as they do not usually play a role in the color of skin but compose the maximum skin’s most superficial layer, the epidermis.

How does Squamous cell carcinoma look like?

It usually looks like wounds or elevated growths that may bleed without scratching and do not heal over time. Squamous cell carcinoma may also look like scaly patches or parts of skin covered by a thick crust, surrounded by a deep red area that looks inflamed. Some squamous cell carcinoma may also resemble warts. They usually occur in sun exposed parts such as the scalp, face, rim of the ears and the back of the hands, but may also be developed on the lips as well as the genital organs.

How common is Squamous cell carcinoma? 

On behalf of existing data, SCC is known as the second most common skin cancer in the Caucasian populations and the most common skin cancer in persons of color. 

Squamous Cell Carcinoma Causes: This disease is caused basically by cumulative exposure to the sun (ultraviolet-UV) throughout a person’s life. This may include daily year-round exposure to the sun and the more intense exposure experienced while on the months of summer. Additionally, UV exposure due to tanning bed use may also be responsible for causing the damage of skin that can lead to the formation of Squamous Cell Carcinoma.

Squamous Cell Carcinoma Risk Factors: People who are with fair skin, light hair, freckles and blue, green, or gray eyes are at comparatively higher risk of developing SCC. In addition, those patients who are with diseases such as psoriasis that have undergone phototherapy treatments, or transplant patients that take immunosuppressive medications are also at risk. Regardless of any individual’s personal medical history, extensive sun exposure is also quite associated with a higher risk of occurring this kind of skin cancer.

Using tanning beds is also responsible in order to increase the risk of Squamous Cell Carcinoma substantially. Specifically, it is believed that patients using tanning beds have a multiple times higher risk of developing Squamous Cell Carcinoma than those that do not. Patients of color may also develop Squamous Cell Carcinomas on parts of preexisting inflammatory skin conditions, burn injuries or serious trauma.

Squamous Cell Carcinoma Symptoms: Patients that have new or growing lesions on the skin, or ulcers that fail to heal should contact their dermatologist for a consultation. Patients with a history of extensive exposure to sun, phototherapy or tanning beds may occur one or multiple small red scaly patches on their skin. Sometimes such patches can be skin-colored but may feel rugged at the time of touch. 

These lesions are named actinic keratoses and usually are considered as premalignant lesions that may be responsible for causing squamous cell carcinoma. If a patient observes such a lesion they must refer to a dermatologist in order to get appropriate treatment.

Squamous Cell Carcinoma Diagnosis and Treatment: It is basically diagnosed by performing a skin biopsy. The choice of treatment for Squamous Cell Carcinoma is surgical excision. This sort of surgery usually needs the use of topical anaesthesia only. Then, the skin is closed with stitches or a skin graft. Another sort of treatment can be considered for squamous cell carcinoma is radiotherapy. This kind of treatment may need multiple sessions in order to leave an effective effect. In a few cases, a combination of surgery and radiotherapy can be used, while in a few, quite advanced tumors, chemotherapy can also be recommended. 

Squamous Cell Carcinoma Prognosis: Most squamous cell carcinomas have an amazing prognosis, as if they are diagnosed a bit early, can be treated successfully with the help of surgical excision only. Although, about 2 to 5% of Squamous Cell Carcinomas have been reported to give metastases. Overall, the five-year relative survival rate has been reported for patients with squamous cell carcinoma.

What can individuals do in order to avoid getting an SCC (Squamous cell carcinoma)?

The use of various sun protection methods is quite necessary in order to prevent squamous cell carcinoma. These can include the rigorous use of UVA and UVB, seeking shade on the beach and wearing sun protective clothing, hats as well as sunglasses. The use of tanning beds needs also to be avoided.

NOTE: The information provided in this article is only for informational purposes and is not served as a substitute for the medical treatment, consultation, diagnosis, of a qualified healthcare practitioner.

Related:- What is Basal Cell Carcinoma

Thursday 18 February 2021

Temozolomide: An Oral Alkylating Agent

What is temozolomide: 

As an oral alkylating agent, Temozolomide is approved in order to treat newly diagnosed glioblastoma multiforme and refractory anaplastic astrocytoma. 

How is temozolomide dosed: The daily dose of temozolomide capsules for a given patient is usually calculated by the healthcare practitioner, based on the patient's body surface area (BSA). The resulting dose is then rounded off to around 5 mg.

The temozolomide dose for subsequent cycles can be adjusted according to nadir neutrophil as well as platelet counts in the previous cycle and during the time of starting the next cycle.

Treatment regimen: Temozolomide is recommended to be given for 5 consecutive days on a 28 day cycle. Patients need to continue taking temozolomide 20 mg until their healthcare practitioner determines that their disease has progressed, up to 22 months, or unt
il unacceptable adverse reactions or toxicities occur. 

How is temozolomide taken:

Patients should consume a daily dose with a full glass of water at about the same time every day. Taking the capsules on an empty stomach or at bedtime may help in order to ease the nausea. In case patients are also taking antinausea or other drugs to relieve the adverse reactions associated with temozolomide 5 mg, they are advised to take these drugs 30 minutes prior to taking temozolomide.

Apart from this, you may receive this drug by injection into a vein (intravenous). Your healthcare provider will decide the appropriate way for you to take this medicine. 

How is temozolomide capsules supplied: 

The drug temozolomide comes as capsules in 5 mg, 20 mg, 100 mg, 140 mg, 180 mg, and temozolomide 100 mg strengths. The temozolomide capsules basically contain a white capsule body with the white cap.

Possible Side Effects: Common temozolomide side effects include:

  • Nausea
  • Vomiting
  • Headache
  • Feeling tired
  • Hair loss 
  • Constipation
  • Bruising
  • Rash
  • Diarrhea
  • Weakness
  • Fever
  • Dizziness
  • Memory loss
  • Loss of appetite
  • Viral infection
  • Sleep problems
  • Coordination problems
  • Infusion site reactions
  • Paralysis on one side of the body

Tell your healthcare practitioner about any possible side effect that bothers you or that does not go away.

Who should not take this drug: Do not take Temodar in case you:

  • have had an allergic reaction to DTIC (dacarbazine), another cancer drug.
  • have had a red itchy rash, or a severe allergic reaction, such as trouble breathing, swelling of the face, throat, or tongue, or severe skin reaction to temozolomide injection or any of its ingredients. If you are not sure, ask your doctor. 

Precautions: Inform your healthcare practitioner about all your medical conditions, including:

  • in case you are allergic to dacarbazine (DTIC) or have had a severe allergic reaction to temozolomide injection.
  • in case you have kidney problems. 
  • in case you have liver problems. 
  • in case you are pregnant.
  • in case you are breast-feeding. This drug may pass into breast milk. You and your doctor should take a decision if you will breast-feed or take temozolomide 100 mg. You must avoid doing both without interacting with your healthcare team.

Storage Guidelines: Store the capsules at 77°F (controlled room temperature). Storage at 15°C to 30°C is permitted occasionally. The temozolomide capsules should be placed out of the reach of children and pets.

How much does temozolomide cost? 

The temozolomide cost may vary from generic to innovator drugs. Prices may range from around 2050 INR to around 25000 INR. 

NOTE: The information provided in this article is only for informational purposes and is not served as a substitute for the medical treatment, consultation, diagnosis, of a qualified healthcare practitioner.