Squamous Cell Carcinoma

Squamous cell carcinoma: Signs and symptoms

This skin cancer often develops on skin that has soaked up the sun for years. The face, ears, lips, backs of the hands, arms, and legs are common places for squamous cell carcinoma (SCC) to form. Signs include:  

SCC can begin in a pre-cancerous growth

Some SCCs begin in a pre-cancerous growth called an actinic keratosis (ak-ti-nik ker-ah-TOE-sis), or AK. In adults 40 and older, it is believed that about 40 to 60 percent of SCCs begin in an AK. Signs and symptoms of an AK include:

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

What you’ve done

Your medical history

Causes

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

Squamous cell carcinoma: Diagnosis, treatment, and outcome

The only way to diagnose any type of skin cancer, including squamous cell carcinoma (SCC), is with a skin biopsy. Your dermatologist can perform this procedure during an office visit.

A skin biopsy should not cause anxiety. To perform a skin biopsy, your dermatologist will remove the entire growth or part of it. Your dermatologist may send this to a laboratory or look at it under a microscope. The findings will be communicated in a biopsy report.

If the biopsy report states that you have SCC, your dermatologist will consider many factors to determine which treatment will be best. 

The type of treatment a patient receives depends on how deep the cancer has grown and whether it has spread. SCC is often treated with:

Excision: This is a surgical procedure that your dermatologist often can  perform during an office visit. It involves numbing the area to be treated and cutting out any remaining tumor plus some normal-looking skin around the tumor. 

Like the skin biopsy, this removed skin is examined under the microscope. This may be done at a laboratory or by your dermatologist. The doctor who looks at the removed skin needs to see whether the normal-looking skin is free of cancer cells. If not, more skin will need to be removed. This is a common way to treat SCC.

Mohs surgery: Named for the doctor who developed this surgery, Mohs (pronounced "moes") is a specialized surgery used to remove some skin cancers. It offers the highest cure rate for difficult-to-treat squamous cell cancers. Your dermatologist will tell you if Mohs surgery is right for you.

If Mohs surgery is recommended, this is what you can expect. The surgeon will cut out the tumor plus a very small amount of normal-looking skin surrounding the tumor. While the patient waits, the Mohs surgeon uses a microscope to look at what was removed. The surgeon is looking for cancer cells. 

If necessary, the Mohs surgeon will continue to remove a very small amount of skin and look at it under the microscope. This continues until the surgeon no longer sees cancer cells. 

Radiation: This treatment is usually reserved for SCCs that cannot be cut out, or when cutting may not be the best choice. A patient may need 15 to 30 radiation treatments. 

When the SCC is caught early, it may be treated by: 

Curettage and electrodesiccation: This treatment consists of two steps. First, your dermatologist scrapes away the tumor. Then electricity is used to destroy any remaining cancer cells. These two steps are repeated.

Photodynamic therapy (PDT): This treatment uses light to remove some very early skin cancers. PDT is a two-step process. First, a chemical is applied to the skin. The chemical remains on the skin for some time so that it can be absorbed. Then the skin is exposed to a special light to kill the cancer cells.

Laser treatment: Lasers can be used to remove an SCC that sits on the surface of the skin. This treatment is only recommended for early SCCs.

Chemotherapy cream: Cream that contains a chemotherapy drug, 5-fluorouracil (5-FU), can be used to treat SCC in the earliest stage.  

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. 

Squamous cell carcinoma: Tips for managing

Most people diagnosed with squamous cell carcinoma (SCC) have a very good prognosis. When caught early and removed, this skin cancer has an excellent cure rate.

Risk

Anyone who has had SCC has a higher risk for getting another skin cancer. To help patients manage this higher risk, dermatologists recommend the following:

Keep all follow-up appointments with your dermatologist. When found early, skin cancer usually can be cured. Even melanoma, the deadliest skin cancer, has a cure rate of nearly 100% when found early and treated.

Perform skin self-exams. Patients who are diagnosed with skin cancer are taught how to examine their own skin for signs of skin cancer. Be sure to examine your own skin as often as recommended by your dermatologist.

If you see anything on your skin that is growing, bleeding, or in any way changing, immediately call your dermatologist’s office. Change can be a sign of skin cancer. Found early and treated, skin cancer can be cured.

Protect your skin from the sun and indoor tanning. This is essential to prevent further damage, which can increase the risk of getting another skin cancer. Here are tips that dermatologists give their patients to help them protect their skin:

Use condoms. Your dermatologist may recommend using condoms. This can prevent an HPV infection, which reduces the risk for getting SCC on the genitals. 

Limit the amount of alcohol you drink and do not smoke. Smoking and drinking alcohol can increase your risk of getting SCC in your mouth.