Squamous cell skin cancer
Squamous-cell skin cancer, also known as cutaneous squamous-cell carcinoma (cSCC), is one of the main types of skin cancer along with basal cell cancer, and melanoma.[10] It usually presents as a hard lump with a scaly top but can also form an ulcer.[1] Onset is often over months.[4] Squamous-cell skin cancer is more likely to spread to distant areas than basal cell cancer.[11]
The greatest risk factor is high total exposure to ultraviolet radiation from the Sun.[2] Other risks include prior scars, chronic wounds, actinic keratosis, lighter skin, Bowen’s disease, arsenic exposure, radiation therapy, poor immune system function, previous basal cell carcinoma, and HPV infection.[2][12] Risk from UV radiation is related to total exposure, rather than early exposure.[13] Tanning beds are becoming another common source of ultraviolet radiation.[13] It begins from squamous cells found within the skin.[14] Diagnosis is often based on skin examination and confirmed by tissue biopsy.[2][3]
Decreasing exposure to ultraviolet radiation and the use of sunscreen appear to be effective methods of preventing squamous-cell skin cancer.[5][6] Treatment is typically by surgical removal.[2] This can be by simple excision if the cancer is small otherwise Mohs surgery is generally recommended.[2] Other options may include application of cold and radiation therapy.[7] In the cases in which distant spread has occurred chemotherapy or biologic therapy may be used.[7]
As of 2015, about 2.2 million people have cSCC at any given time.[8] It makes up about 20% of all skin cancer cases.[15] About 12% of males and 7% of females in the United States developed cSCC at some point in time.[2] While prognosis is usually good, if distant spread occurs five-year survival is ~34%.[4][5] In 2015 it resulted in about 51,900 deaths globally.[9] The usual age at diagnosis is around 66.[4] Following the successful treatment of one case of cSCC people are at high risk of developing further cases.[2]
Spokane
Spokane (
i/spoʊˈkæn/ spoh-kan)[7] is a city in the state of Washington, in the northwestern United States. It is the seat of Spokane County, and the economic and cultural center of the Spokane Metropolitan Area, the Greater Spokane Area, and the Inland Northwest. It is located along the Spokane River west of the Rocky Mountain foothills in eastern Washington, 92 miles (148 km) south of the Canada–US border, approximately 20 miles (30 km) from the Washington–Idaho border, and 280 miles (450 km) east of Seattle along Interstate 90. The city, along with the whole Inland Northwest, is served by Spokane International Airport, 5 miles (8 km) west of downtown Spokane. According to the 2010 Census, Spokane had a population of 208,916, making it the second largest city in Washington and the 102nd largest city in the United States.
The first humans to live in the area, the Spokane people (their name meaning “children of the sun” in Salishan), arrived between 13,000 and 8,000 years ago, living off plentiful game. Known as the birthplace of Father’s Day, Spokane is officially nicknamed the “Lilac City”. David Thompson explored the area with the westward expansion and establishment of the North West Company‘s Spokane House in 1810. This trading post was the first long-term European settlement in Washington. Completion of the Northern Pacific Railway in 1881 brought settlers to the Spokane area, and that same year it was officially incorporated as a city with the name of “Spokan Falls”. In the late 19th century, gold and silver were discovered in the Inland Northwest. The local economy depended on mining, timber, and agriculture until the 1980s. Spokane hosted the first environmentally themed World’s Fair at Expo ’74.