What are the other Names for this Condition? (Also known as/Synonyms)
- Anal Invasive SCC
- Anal Invasive Squamous Cell Carcinoma
- Invasive SCC of Anus
What is Invasive Squamous Cell Carcinoma of Anus? (Definition/Background Information)
- Invasive Squamous Cell Carcinoma of Anus is a malignant condition affecting the skin or mucosal membranes of the anus, which developed from in situ squamous cell carcinoma
- This malignant carcinoma, which may be present as a lesion on the anus, has the potential to metastasize (spread), usually to the inguinal lymph nodes
- The cause of Invasive Squamous Cell Carcinoma of Anus is unknown, but factors such as HPV infection, poor immunity, high-risk sexual practices, etc., are known to contribute towards its development. Middle-aged and elderly adults are at risk for the condition
- Any combination of chemotherapy, radiation therapy, and invasive procedures (surgery) are used to treat Anal Invasive Squamous Cell Carcinoma. The outcome depends upon many factors including the stage of the tumor; earlier the diagnosis and treatment, better is the prognosis
Who gets Invasive Squamous Cell Carcinoma of Anus? (Age and Sex Distribution)
- Invasive Squamous Cell Carcinoma of Anus affects men and women, who are usually between the ages of 30 and 60 years
- The condition is observed around the world; it has no geographical, racial, or ethnic preference
What are the Risk Factors for Invasive Squamous Cell Carcinoma of Anus? (Predisposing Factors)
Invasive Squamous Cell Carcinoma of Anus develops from squamous cell carcinoma in situ. The risk factors that contribute to squamous cell carcinoma in situ formation include:
- Human papilloma virus (HPV) infection; the subtypes responsible include 16, 18, 31, 33, and 45,
- High-risk sexual behavior, such as multiple partners and unprotected sex
- Weakened immune system due to many reasons, such as organ transplant, old age, HIV/AIDS infection, or due to administration of immune suppressing drugs
- Smoking of tobacco
- Poor personal hygiene
- Ulcerative lichen planus
It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.
Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.
What are the Causes of Invasive Squamous Cell Carcinoma of Anus? (Etiology)
Untreated (or delayed treatment of) squamous cell carcinoma in situ can result in invasive squamous cell carcinoma.
- The exact cause of development of squamous cell carcinoma in situ of anus is not completely known in a majority of cases
- In case HPV infection is associated with SCC in situ of anus, it is caused by alteration in the DNA by the human papilloma virus that results in uncontrolled cell proliferation
- Other factors that may contribute to the condition include compromised immune system, sexual promiscuity, smoking, and even poor hygiene
What are the Signs and Symptoms of Invasive Squamous Cell Carcinoma of Anus?
Anal Invasive Squamous Cell Carcinoma signs and symptoms may include:
- The presence of a poorly-defined, single red lesion (in most cases) on the anus
- The lesion or tumor may grow and there may be itching sensation, ulceration, and bleeding
- The malignant lesion is not confined to the skin surface, but may have invaded adjacent tissues and structures or metastasized (commonly to the inguinal lymph nodes)
How is Invasive Squamous Cell Carcinoma of Anus Diagnosed?
Some of the tests that may help in diagnosing Invasive Squamous Cell Carcinoma of Anus include:
- Complete physical examination with detailed medical history evaluation
- Examination by a dermatologist using a dermoscopy, a special device to examine the skin
- Skin or tissue biopsy: A skin or tissue biopsy is performed and sent to a laboratory for a pathological examination, who examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. A biopsy is performed to rule out other similar conditions too
Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.
What are the possible Complications of Invasive Squamous Cell Carcinoma of Anus?
The complications of Invasive Squamous Cell Carcinoma of Anus could include:
- If the tumor becomes big, develops into a firm mass and ulcerates, it can get secondarily infected with bacteria or fungus
- Side effects of chemotherapy (such as toxicity) and radiation
- Spreading of the tumor to various organs of the body
How is Invasive Squamous Cell Carcinoma of Anus Treated?
A combination of treatment methods may be used to treat Invasive Squamous Cell Carcinoma of Anus. These include:
- Surgery: Complete surgical excision of the primary and metastatic tumors
- Laser ablation to remove solid tumors
- Administering chemotherapy, either intravenously or orally
- Radiation therapy: The use of high-energy beams to kill cancer cells
- Post-operative care is important: A minimum activity level is to be ensured, until the surgical wound heals
- Follow-up care with regular screening and check-ups are important
How can Invasive Squamous Cell Carcinoma of Anus be Prevented?
Invasive Squamous Cell Carcinoma of Anus may be prevented through the timely and adequate treatment of anal squamous cell carcinoma in situ.
What is the Prognosis of Invasive Squamous Cell Carcinoma of Anus? (Outcomes/Resolutions)
- The prognosis of Invasive Squamous Cell Carcinoma of Anus depends upon many factors, such as the age of the individual, their health status, and stage of tumor at diagnosis
- Without treatment (or with delayed treatment), invasive carcinomas can metastasize aggressively and this may result in a poor prognosis
- The outcomes are excellent with early diagnosis and treatment of squamous cell carcinoma in situ
Additional and Relevant Useful Information for Invasive Squamous Cell Carcinoma of Anus:
The following DoveMed website link is a useful resource for additional information: