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I’m 48 years old. A few months ago a small growth appeared on the upper side of my left forearm. It looked like a wart, but I went to a doctor recently and had it excised and biopsied. It was a squamous-cell carcinoma. The doctor told me there was almost nothing to worry about since squamous cell is one of the least dangerous forms of cancer. Still, it’s hard not to stress about this. I trust your always excellent feedback. What is a squamous-cell carcinoma? Does it metastasize at predictable rates? How much do I really have to worry about? If it makes any difference, I smoked cigarettes off and on for 30 years, but quit for good 14 months ago. –Neil Flowers, Santa Cruz
Nothing like cancer to make an aging baby boomer realize he’s not a kid anymore. Not to argue with your doctor, but “least dangerous” is not a term I would apply to squamous-cell carcinoma. It is much less dangerous than some cancers, but it can spread and it can kill you. What’s more, if you’ve had it once, there’s a significant risk that you’ll get it again. See a doctor immediately about any new growths. Also, while the damage has probably already been done, I’d skip any future sunbathing–squamous-cell carcinoma appears to be directly related to solar exposure.
Skin cancer generally is extremely common, accounting for a quarter to a third of all cancers. New cases appear to be increasing rapidly, perhaps because of the thinning ozone layer; some call it an epidemic. There are three main types: basal-cell carcinoma, squamous-cell carcinoma, and melanoma. Basal cell is the most common by far, with more than 500,000 new cases a year. It’s also the least dangerous. Basal-cell carcinomas grow slowly and seldom spread; deaths are rare. Squamous-cell carcinoma also occurs fairly frequently, with about 100,000 new cases per year, but the prognosis isn’t as bright; this type of cancer kills about 2,000 people a year. Still, it’s a lot less serious than melanoma, the most dangerous of all skin cancers. About 32,000 people are diagnosed with new melanomas each year; 6,500 of them will die of it.
Diagnosing skin cancer is something you want to leave to the pros, but in general basal-cell carcinomas are smooth while the squamous-cell kind have a sandpapery feel (squamous means scaly). Melanomas typically affect pigmented areas such as moles and birthmarks. Squamous cancers usually show up in areas most exposed to the sun, such as the head, neck, and the back of the hands and forearms, often on sun-damaged skin (roughened, wrinkled, discolored, etc). Light-skinned people are more vulnerable than dark; men get them twice as often as women.
The cure rate for squamous-cell carcinomas is on the order of 90 percent–not an entirely comforting figure. The thinner and smaller the tumor, the better the odds it won’t recur. One study reported a 99.5 percent cure rate for growths less than one centimeter in diameter, but only 59 percent for those larger than three centimeters, a compelling argument for not procrastinating on getting your suspicious bumps looked at.
Your smoking probably had little to do with your carcinoma. The real culprit was baking on the beach when you were a kid. One study concluded that using an SPF 15 sunscreen till age 18 could reduce the number of nonmelanoma skin cancers 78 percent. Never-tan, always-burn types would be smart to use SPF 25 to 30, and what the hell, a big umbrella and a muumuu might not be such a bad idea either. Better a little dorkiness now than a biopsy later.
Since when do CDs skip? Since last week, in my case. What gives? I thought CDs were immune to the failings of mere vinyl. –John Bagdonas, Jersey City
Alas, another bit of audio hype. Dirty CDs will skip just like dirty records. A complicated system of beam splitters and servomechanisms keeps the laser centered on the CD “groove,” but an opaque glob stuck to the disc may throw the system off and cause a skip. The cure, usually, is to clean the disc with a clean dry cloth, always by wiping from the center of the disc to the edge. That way an accidental scratch won’t obliterate so much consecutive musical data that the error-correcting circuitry gives up in disgust.
Art accompanying story in printed newspaper (not available in this archive): illustration/Slug Signorino.