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]
Waco
Waco (/ˈweɪkoʊ/ way-koh) is a city which is the county seat of McLennan County, Texas, United States.[3] It is situated along the Brazos River and I-35, halfway between Dallas and Austin. The city had a 2010 population of 124,805, making it the 22nd-most populous city in the state.[4] The US Census 2015 population estimate is 132,356.[5] The Waco Metropolitan Statistical Area consists of McLennan and Falls Counties, which had a 2010 population of 234,906.[6] Falls County was added to the Waco MSA in 2013. The US Census 2016 population estimate for the Waco MSA is 265,207.[7]
Indigenous peoples occupied areas along the river for thousands of years. In historic times, the area of present-day Waco was occupied by the Wichita Indian tribe known as the “Waco” (Spanish: Hueco or Huaco).
In 1824, Thomas M. Duke was sent to explore the area after the Waco people tried to defend themselves and their lands from settlers. His report to Stephen F. Austin, described the Waco village:
After further violence due to settler incursion, Austin halted an attempt to destroy their village in retaliation. In 1825, he made a treaty with them. The Waco were eventually pushed out of the region, settling north near present-day Fort Worth. In 1872, they were forced onto a reservation in Oklahoma with other Wichita tribes. In 1902, the Waco received allotments of land and became official US citizens. Neil McLennan settled in an area near the South Bosque River in 1838.[8] Jacob De Cordovabought McLennan’s property[9] and hired a former Texas Ranger and surveyor named George B. Erath to inspect the area.[10]In 1849, Erath designed the first block of the city. Property owners wanted to name the city Lamartine, but Erath convinced them to name the area Waco Village, after the Indians who had lived there.[11] In March 1849, Shapley Ross built the first house in Waco, a double-log cabin, on a bluff overlooking the springs. His daughter Kate was the first settler child to be born in Waco.[12]