Squamous Cell Carcinoma

A common type of cervical cancer accounting for 80% to 90% of all cervical cancer cases

Lets first explore what does squamous cell carcinoma mean ?

he flat cells lining the outer part of a woman’s cervix, known as the ectocervix, are called squamous cells. When cancer develops from these cells, it is referred to as squamous cell carcinoma (SCC).

Most cases of squamous cell carcinoma arise from the transformation zone, where the ectocervix meets the endocervix. This type of cancer is considered invasive and occurs when precancerous changes in the cervical cells, classified as cervical intraepithelial neoplasia (CIN), are not detected and treated in time.

The primary cause of squamous cell carcinoma in most cervical cancer cases is a persistent infection with high-risk types of human papillomavirus (HPV).

Awareness of squamous cell carcinoma , including its symptoms, risk factors, early detection, and prevention, can lead to timely action. Detecting squamous cell carcinoma at the precancerous stage, before it progresses to invasive cancer, significantly improves outcomes.

Therefore below we have explained the aspects of squamous cell carcinoma in detail.

Let’s understand the various aspects related to squamous cell carcinoma in cervical cancer

Early Symptoms

  • Vaginal Bleeding: This can occur after sexual intercourse, between menstrual periods, or after menopause.
  • Vaginal Discharge: Patients may experience a watery discharge that has a strong odor or contains blood.
  • Pelvic Pain: Discomfort or pain during sexual intercourse may also be present.are very overweight

Advanced Symptoms

As cervical cancer progresses, additional symptoms may develop, including:

  • Painful Urination: Difficulty or pain during urination, sometimes accompanied by blood in the urine.
  • Bowel Issues: Difficult or painful bowel movements, or bleeding from the rectum.
  • Back Pain: A dull ache in the back may occur.
  • Leg Swelling: Swelling in the legs can be a sign of advanced disease.
  • Fatigue: General feelings of tiredness and weakness.are very overweight

Causes

  • Human Papillomavirus (HPV) Infection:
    • Almost all cases of cervical cancer, including SCC, are linked to infection with high-risk HPV types, particularly HPV 16 and 18. Persistent HPV infections can lead to cellular changes that may progress to cancer over time.
  • Cellular Changes:
    • The infection can cause dysplasia, where normal cervical cells undergo abnormal changes. If these changes are not detected and treated, they can develop into invasive cancer.

Risk Factors

  • Multiple Sexual Partners:
    • Having multiple sexual partners increases exposure to HPV, raising the risk of infection and subsequent development of cervical cancer.
  • Early Age at First Sexual Activity:
    • Engaging in sexual activity at a young age can increase the likelihood of contracting HPV.
  • Weakened Immune System:
    • Individuals with compromised immune systems (e.g., those with HIV/AIDS) are at a higher risk for persistent HPV infections and developing cervical cancer.
  • Smoking:
    • Tobacco use has been shown to increase the risk of cervical cancer, particularly in those infected with HPV, as smoking can prolong the infection.
  • Long-term Use of Oral Contraceptives:
    • There is evidence suggesting that using birth control pills for five years or more may increase the risk of cervical cancer in women with HPV.
  • History of Other Sexually Transmitted Infections (STIs):
    • Having other STIs can increase susceptibility to HPV and contribute to the risk of developing cervical cancer.
  • Lack of HPV Vaccination:
    • Not receiving the HPV vaccine increases the risk of contracting high-risk HPV types that can lead to cervical cancer.
  • Socioeconomic Factors:
    • Limited access to healthcare and screenings can increase the risk, as regular Pap tests are essential for early detection and prevention.
  • Exposure to Diethylstilbestrol (DES):
    • Women whose mothers took DES during pregnancy may have an increased risk of developing certain types of cervical cancer

According to the FIGO (International Federation of Gynecology and Obstetrics) system Squamous cell carcinoma cervical cancer is categorized in stages based on its extent of spread. The stages are as follows:

  • Stage 0: Carcinoma in situ; abnormal cells are present in the cervix but have not invaded deeper tissues.
  • Stage I: Cancer is confined to the cervix.
  • Stage II: Cancer has spread beyond the cervix to the upper two-thirds of the vagina or surrounding tissues.
  • Stage III: Cancer has spread to the lower third of the vagina, pelvic wall, or lymph nodes.
  • Stage IV: Advanced cancer that has spread beyond the pelvis.
Explore More about Stages of cervical cancer

Diagnosis typically involves several steps such as:

  • Screening Tests:
    1. Pap Smear (Papanicolaou Test): Detects abnormal cells in cervical tissue. Regular screening can identify precancerous changes (squamous intraepithelial lesions).
    2.HPV DNA Test: Identifies high-risk HPV types associated with cervical cancer.
  • Colposcopy and Biopsy:
    If abnormal results are found, a colposcopy may be performed. This procedure uses a magnifying instrument to examine the cervix more closely and may involve taking a biopsy for further analysis.
  • Imaging Studies:
    If cancer is confirmed, imaging tests such as CT scans, MRI, or PET scans may be used to determine the extent of disease spread and staging.
  • Histopathological Examination:
    A pathologist examines biopsy samples under a microscope to confirm SCC and assess its grade.
Explore More about Diagnosis of cervical cancer

Treatment for cervical SCC varies based on the stage of cancer, but common approaches include:

  • Surgery:
    For early-stage cancers (Stage I), surgical options may include:
    – Cone Biopsy: A cone-shaped piece of tissue is removed to preserve fertility.
    – Radical Hysterectomy: Removal of the cervix, uterus, and surrounding tissues.
    -Trachelectomy: Removal of the cervix while preserving the uterus for potential future pregnancies.
  • Radiation Therapy:
    Often used in conjunction with surgery or as a primary treatment for more advanced stages. It can be delivered as:
    – External Beam Radiation Therapy (EBRT): Targeting the pelvic area.
    – Brachytherapy: Internal radiation delivered directly to the tumor site.
  • Chemotherapy:
    Typically used in combination with radiation therapy for locally advanced stages (II and III) to enhance treatment effectiveness. Common drugs include cisplatin and carboplatin.

    Chemotherapy may also be used in palliative settings for advanced disease.
  • Targeted Therapy and Immunotherapy:
    Agents like pembrolizumab may be used for recurrent or metastatic cervical cancer, particularly if PD-L1 positive.
  • Palliative Care:
    Focuses on relieving symptoms and improving quality of life for patients with advanced disease.
Explore More about treatment options for cervical cancer

Early Detection for common types of Cervical cancer

Early detection of cervical cancer, particularly in its precancerous stages, can significantly reduce the risk of invasive cancer.

Learn More
References for the article