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]
Murfreesboro
Murfreesboro is a city in and the county seat of Rutherford County, Tennessee.[7] The population was 108,755 according to the 2010 census, up from 68,816 residents certified in 2000. In 2015, census estimates showed a population of 126,118.[5]The city is the center of population of Tennessee[8] and is part of the Nashville metropolitan area, which includes thirteen counties and a population of 1,757,912 (2013). It is Tennessee’s fastest growing major city and one of the fastest growing cities in the country.[9] Murfreesboro is also home to Middle Tennessee State University, the largest undergraduate university in the state of Tennessee, with 22,729 total students as of fall 2014.[10]
In 2006, Murfreesboro was ranked by Money as the 84th best place to live in the United States, out of 745 cities with a population over 50,000.[11][12]
In 1811, the Tennessee State Legislature established a county seat for Rutherford County. The town was first named “Cannonsburgh” in honor of Newton Cannon, then Rutherford County’s member of the state legislature, but it was soon renamed “Murfreesboro” for Revolutionary War hero Colonel Hardy Murfree.[13] Author Mary Noailles Murfree was his great-granddaughter.
As Tennessee settlement expanded to the west, the location of the state capital in Knoxville became inconvenient for most newcomers. In 1818, Murfreesboro was designated as the capital of Tennessee. Eight years later, however, it was itself replaced by Nashville.[14]