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]
Sioux Falls
Sioux Falls (/ˌsuː ˈfɔːlz/) (Lakota: Íŋyaŋ Okábleča Otȟúŋwahe;[8] “Stone Shatter City”) is the largest city in the U.S. state of South Dakota. It is the county seat of Minnehaha County,[9] and also extends into Lincoln County to the south. It is the 47th fastest-growing city in the United States[10] and the fastest-growing metro area in South Dakota, with a population increase of 22% between 2000 and 2010.[11]
As of 2016, Sioux Falls had an estimated population of 178,500. The metropolitan population of 251,854 accounts for 29% of South Dakota’s population. It is also the primary city of the Sioux Falls-Sioux City Designated Market Area (DMA), a larger media market region that covers parts of four states and has a population of 1,043,450.[12] Chartered in 1856 on the banks of the Big Sioux River, the city is situated in the rolling hills on the western edge of the Midwest at the junction of Interstate 90 and Interstate 29.
The history of Sioux Falls revolves around the cascades of the Big Sioux River. The falls were created about 14,000 years ago during the last ice age. The lure of the falls has been a powerful influence. Ho-Chunk, Ioway, Otoe, Missouri, Omaha (and Ponca at the time), Quapaw, Kansa, Osage, Arikira, Dakota, Nakota and Cheyenne people inhabited and settled the region previous to Europeans and European descendants. Numerousburial mounds still exist on the high bluffs near the river and are spread throughout the general vicinity. Indigenous people maintained an agricultural society with fortified villages, and the later arrivals rebuilt on many of the same sites that were previously settled. Lakotapopulate urban and reservation communities in the contemporary state and many Lakota, Dakota, Nakota, and numerous other Indigenous Americans reside in Sioux Falls today.[13]