Hi everyone. We spend a lot of time talking about skin cancers in sun exposed areas. Today I want to talk about a specific kind of skin cancer that is caused by a virus and not sun exposure. Squamous cell carcinoma (SCC) is the second most commonly diagnosed skin cancer (basal cell carcinoma is the most common) and often arises in sun exposed areas. However, it also occurs on the genitals, and this kind of SCC is related to the human papilloma virus, commonly known as HPV.
HPV is a very common virus that leads to genital warts, cervical cancer, and skin cancer. It is most often associated with warts, which are not dangerous in themselves, but which are a symptom for this very easily transmitted virus. Certain strains of HPV are associated with cervical cancer, which is why you may have heard a lot about the new HPV vaccine Gardasil that dramatically reduces the evidence of the cervical cancer. But while the link to cervical cancer is widely known, HPV's link to genital squamous cell carcinomas is not.
A recent study showed that tens of thousands of deaths were attributed to SCC that originated on the genitals. And women were almost three times as likely as men to die from metastatic SCC of the genitals. This is an important statistic to note because the genitals are an area that is not often inspected closely during a routine skin exam. Many people with genital lesions may not be aware of them so they may not know to call attention to them when they visit their doctor. On the other hand, a person may have a lesion but may be embarrassed to ask about it due to the stigmas associated with sexually transmitted diseases.
HPV of the genitals is sexually transmitted and condoms should be used to prevent the spread of the virus during intercourse. Gardasil, the new HPV vaccine, will likely reduce the incidence of HPV related cancers in the future. But what do we do now as adults who have not been vaccinated and are at risk for genital SCC?
The most important thing you can do is examine your own skin and genital area on a regular basis for any new or growing lesions. SCC of the genitals can start as warty growths that become large or start to bleed, or sores that just do not heal properly. At your yearly skin exam, be sure to mention any concerns to the dermatologist so he/she can look more closely at the genital area to make sure no suspicious growth is appearing. Do not assume that wearing sunscreen will prevent all skin cancers and certainly do not be embarrassed to ask your dermatologist about HPV. If skin cancer of the genitals is detected, treatment is usually surgical, although certain small or early skin cancers may be treated with topical creams.