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]
Midland
Midland is a city in the U.S. state of Michigan in the Tri-Cities region of Central Michigan. It is the county seat of Midland County.[7] The city’s population was 41,863 as of the 2010 census. It is the principal city of the Midland Micropolitan Statistical Area, part of the larger Saginaw-Midland-Bay City Combined Statistical Area. In 2010, Midland was named the no. 4 Best Small City to raise a family in by Forbes magazine.[8]
By the late 1820s, Midland was established as a fur trading post of the American Fur Company supervised by the post at Saginaw. Here agents purchased furs from Ojibwe trappers. The Campau family of Detroit operated an independent trading post at this location in the late 1820s.[9]
The Dow Chemical Company was founded in Midland in 1897, and its world headquarters are still located there. Through the influence of a Dow Chemical plant opening in Handa, Aichi, Japan, Midland and Handa have become sister cities.[10] The Dow Corning Corporation and Chemical Bank are also headquartered in Midland.
In 1969 the city unilaterally defined a Midland Urban Growth Area (MUGA), which at the time was a territory two-miles around the city limits of Midland in an attempt to control urban sprawl. [11] The central policy was that as the only capable supplier of drinking water, the city would provide water services to commnities outside the MUGA such as the nearby village of Sanford, but would not provide to water services to the area within the MUGA without annexation to the city of Midland thus controlling most of the growth in the county. Since 1991 however, the policy has since been revised with a series of Urban Cooperation Act Agreements with surrounding townships which has allowed case-by-case redrawings of the MUGA line to allow Midland to sell water to the surrounding townships without annexation.[11]