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]
Butler
Butler is a city and the county seat of Butler County in the U.S. state of Pennsylvania.[2] It is located 35 miles (56 km) north of Pittsburgh and part of the Pittsburgh metropolitan area. As of the 2010 census, the city population was 13,757.[3] Butler was named the 7th best small town in America by Smithsonian magazine in May 2012.[4]
Butler was named for Maj. Gen. Richard Butler,[5] who fell at the Battle of the Wabash, also known as St. Clair’s Defeat, in western Ohio in 1791.
In 1803 John and Samuel Cunningham became the first settlers in the village of Butler. After settling in Butler, the two brothers laid out the community by drawing up plots of land for more incoming settlers.[5] By 1817, the community was incorporated into a borough.[5]The first settlers were of Irish or Scottish descent and were driving westward from Connecticut. In 1802 the German immigrants began arriving, with Detmar Basse settling in Jackson Township in 1802 and founding Zelienople the following year. After George Rapp arrived in 1805 and founded Harmony, larger numbers of settlers followed. John A. Roebling settled Saxonburg in 1832, by which time most of the county was filled with German settlers.