Squamous Cell

Squamous Cell Carcinoma

The second most common type of skin cancer diagnosed in the United States is squamous cell carcinoma (SCC).  This cancer is usually seen in parts of the body exposed to the sun such as the head/scalp, face, arms, and hands.  However, SCC can be found on all parts of the body including inside the mouth and genitals.

Squamous cell carcinoma is normally found in people over the age of 50, but younger people who commonly use tanning beds often present with SCC as well.

SCC is more aggressive than basal cell carcinoma and can spread through the body.  When caught early and treated, it is highly curable.

SIGNS AND SYMPTOMS

Squamous cell carcinoma can form anywhere on the body, but some of the most common places to see this cancer are the face, ears, lips, backs of the hands, arms, and legs.  Signs of a potential cancer include:

• A bump or lump on the skin that can feel rough.
• As the bump or lump grows, it may become dome-shaped or crusty and can bleed.
• A sore that doesn’t heal, or heals and returns.
• Flat, reddish, scaly patch that grows slowly (Bowen’s disease).
• In rare cases, SCC begins under a nail, which can grow and destroy the nail.
• SCC can being in a pre-cancerous growth called actinic keratosis (AK).

Squamous cell carcinoma: Who gets and causes

This skin cancer is most common in fair-skinned people who have spent years in the sun, but people of all skin colors get squamous cell carcinoma (SCC). Your risk of developing SCC increases if you have any of the following risk factors:

• Your physical traits
  • Pale or light-colored skin.
  • Blue, green, or gray eyes.
  • Blond or red hair.
  • An inability to tan.
• What you’ve done
  • Spent a lot of time outdoors, for work or leisure, without using sunscreen or covering up with clothing.
  • Used tanning beds or sunlamps.
  • Been exposed to cancer-causing chemicals (e.g., arsenic in drinking water, tar, worked with some insecticides or herbicides).
  • Smoked tobacco.
  • Spent lots of time near heat, such as a fire.
• Your medical history
  • Diagnosed with actinic keratoses (AKs).
  • Badly burned your skin.
  • Ulcer or sore on your skin that has been there for many months or years.
  • Taking medicine that suppresses your immune system.
  • Infected with human papillomavirus (HPV).
  • Overexposure or long-term exposure to x-rays, such as patients who received x-ray treatments for acne in the 1940s.
  • Received many PUVA treatments.
• Have one of these medical conditions: xeroderma pigmentosum, epidermolysis bullous, or albinism.

Squamous Cell Carcinoma on ear

Causes

Most SCC is caused by ultraviolet (UV) rays from the sun or tanning beds. Other less common causes include:

• Long-term exposure to cancer-causing chemicals, such as when a person smokes tobacco, is exposed to tar, drinks from a water supply that contains arsenic, or uses some insecticides or herbicides.
• A serious burn.
• Ulcer or sore on the skin that has been there for many months or years.
• Some types of the human papillomavirus (HPV).

Squamous cell carcinoma: Diagnosis and treatment

The only way to affirmatively diagnose skin cancer is with a skin biospy.  This is a simple procedure done in the office, normally during your scheduled office visit.  It is done with a local anesthetic and is relatively quick.  During the biopsy, your dermatologist will remove the lesion (or part of the lesion) and send it to a pathologist for examination.

The pathologist will send a report back to your dermatologist who will then decide on a course of treatment if the report shows you have SCC.  There are several ways to treat SCC and each depends on a number of factors including the type of SCC (superficial vs deep), location of SCC, your medical history, and if the cancer has spread.

Some of the treatments for SCC include the following:

• Excision of the lesion
• Curettage and electrodessication
• Mohs Surgery – This is a specialized surgery designed to treat non-melanoma skin cancers.  The Mohs surgeon will cut out the tumor and a small amount of surrounding tissue.  This will be examined under a specialized microscope to see if any cancer remains while you wait.  If cancer remains, the surgeon will remove more tissue and re-examine.  This will be repeated until all signs of the cancer are gone.
• Chemotherapy creams: Cream that contains a chemotherapy drug, 5-fluorouracil (5-FU), can be used to treat SCC in the earliest stage.
• Radiation: This treatment usually is reserved for SCCs that cannot be cut out, or when surgery may not be the best choice. A patient may need 15 to 30 radiation treatments.

SCC with Cutaneous Horn

Outcome

With treatment, most SCCs are cured. Early treatment is recommended. When allowed to grow, this skin cancer can grow deep, destroying tissue and even bone. In some cases, SCC spreads to the lymph nodes and other parts of the body. This can cause serious health problems.