Risky Squamous Cell Skin Cancers Can Kill
Although most cutaneous squamous cell carcinomas are easily treated surgically, a small group of patients with specific disease risk factors develop metastases and ultimately die of the disease, a retrospective study determined.
Among a cohort of patients treated at a single academic center, 3.7% developed nodal metastases and in 2.1% the disease was fatal, according to Chrysalyne D. Schmults, MD, and colleagues from Harvard University.
A consistent predictor of poor outcome was tumor diameter of 2 cm or more, which was associated with subhazard ratios of 7 for nodal metastasis and 15.9 for disease-specific death, the researchers reported in the May issue of JAMA Dermatology.
- Note that this retrospective study identified factors, including large tumor diameter and poor differentiation, predictive of adverse outcomes in patients with cutaneous squamous cell carcinoma.
- Be aware that the overall cancer-associated mortality in the cohort was less than 3%.
A clear definition of high-risk cutaneous squamous cell carcinoma that delineates associated risk factors has been lacking, which is a clinically important gap, they noted.
“Prognosis is poor once or locoregional recurrence develops, so determining which tumors or patients are at high risk for poor outcomes would be advantageous, allowing aggressive adjuvant treatment earlier in the course of the disease,” they wrote.
Treatment had involved standard excision in 69.5% and Mohs surgery in 20.2%.
Skin Cancer Can Look Like Many Things Therefore People Can Go Long Periods Of Time Without Recognizing That They Have A Skin Cancer Says Dr Steven Musick Md A Board Certified Dermatologist Who Runs Musick Dermatology Llc In Swansea Il Which Provides State
Not only can skin cancer mimic many benign conditions such as pimples and skin barnacles, but a tumor can develop in areas that are difficult to inspect or that are not considered during a persons self-skin exam.
For example, it would be difficult for one to examine their scalp unless theyre bald. Inside the ears is another hard-to-visualize location.
And then there are areas that people wouldnt think to check, such as between their butt cheeks, inside their belly button, between their toes, the soles of their feet and even the pupils of their eyes.
Yes, melanoma can grow in the pupils and go unnoticed for long periods of time.
Melanoma, along with squamous cell carcinoma, can also pop up internally, including within the genitals, mouth, nose and lungs.
Another factor that influences how long a person can have skin cancer and not know it is where they live.
If they live in a Third, and especially Fourth, World nation, they can have a basal cell carcinoma that goes undiagnosed for many years due to lack of skin cancer awareness campaigns and adequate skin cancer screenings.
However, this type of tumor will continue progressing, though very slowly it wont stop growing just because its untreated.
Laser Surgery Is Not Fda
Laser surgery is not currently used as a standard treatment for basal cell carcinoma or squamous cell carcinoma. It can, however, be an effective secondary treatment. Laser treatment is sometimes used after Mohs surgery to complete the removal of cancer cells. Lasers are effective at removing precancerous lesions, but have not been proven effective at treating cancer yet.
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What Do Cancer Survival Rates Mean
When learning about cancer survival rates, its important to keep in mind that these statistics are based on a very large and diverse group of people. Because no two people with squamous cell carcinoma are alike, the general survival rate cannot be used to predict a specific patients outcome. Additionally, survival rates are broad benchmarks. While useful as a baseline point of reference for physicians, this information is not detailed enough to reflect the different treatments people have had, nor is it recent enough to include the results of the latest breakthrough treatments now available to patients through clinical trials .
Can A Squamous Cell Skin Cancer Be Unpredictable
Squamous cell skin cancer can be unpredictable. My first squamous cell area did not hurt, but it bled. My second squamous cell area did not bleed, but it hurt. If you have an area appear suddenly and it doesnt go away within a relatively short period of time, please make an appointment to have it looked at.
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Symptoms Of Bowen’s Disease
Bowen’s disease usually appears as a patch on the skin that has clear edges and does not heal.
Some people have more than 1 patch.
- up to a few centimetres across
The patch can appear anywhere on the skin, but is especially common on exposed areas like the lower legs, neck and head.
Sometimes they can affect the groin area and, in men, the penis.
If the patch bleeds, starts to turn into an open sore or develops a lump, it could be a sign it’s turned into squamous cell skin cancer.
How The Stage Is Determined
Once you have been diagnosed with squamous cell carcinoma, your doctor will want to determine its stage. While the risk of this type of cancer spreading is low, determining the stage will help your doctor develop the best treatment plan.
The TNM system is a uniform system for staging many types of cancer. TNM stands for:
- T is for tumor: How far has the primary tumor grown through the layers of skin or to nearby tissues?
- N is for nodes: Have cancer cells spread to the lymph nodes near the tumor?
- M is for metastasis: Has the cancer metastasized to distant sites in the body such as the lungs or liver?
Skin Cancer Doctor Discussion Guide
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Questions To Ask The Doctor
- Do you know the stage of the cancer?
- If not, how and when will you find out the stage of the cancer?
- Would you explain to me what the stage means in my case?
- What will happen next?
There are many ways to treat skin cancer. The main types of treatment are:
Most basal cell and squamous cell cancers can be cured with surgery or other types of treatments that affect only the spot on the skin.
The treatment plan thats best for you will depend on:
- The stage and grade of the cancer
- The chance that a type of treatment will cure the cancer or help in some way
- Your age and overall health
- Your feelings about the treatment and the side effects that come with it
Squamous Cell Carcinoma Survival Rate
In general, the squamous cell carcinoma survival rate is very highwhen detected early, the five-year survival rate is 99 percent. Even if squamous cell carcinoma has spread to nearby lymph nodes, the cancer may be effectively treated through a combination of surgery and radiation treatment. Nevertheless, a patient who has been treated for squamous cell carcinoma in the past always faces the possibility of a recurrence, so lifelong monitoring to increase the chance of early detection is highly encouraged.
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Can A Person Die From Squamous Cell Carcinoma
Can you die from squamous cell carcinoma In his study, the researchers reviewed all the reports on skin cancer pathology from Brigham and the Womens Hospital in Boston between 2000 and 2009, revealing 1.832 tumors in 985 patients. Just over half of the patients were male, almost all white, and immunosuppression was present at 14.5%.
Cancer Stage Determines Risk Of Spreading And Line Of Treatment
A cancer of the upper layers of the skin in the epidermis, SCC is the second most common form of skin cancer after basal cell carcinoma and affects an estimated 1 million new people every year in the United States alone. Cancer staging is done for SCC with the intention of categorizing the size of cancer and to judge how much it has grown. And theres a clear line of treatment and way forward for each stage.1
With skin cancers like basal cell carcinoma, the likelihood of cancer spreading to other parts of the body is very low and early diagnosis and treatment usually tackles the problem before it spreads. SCC, however, is a little trickier. While the risk of spreading is still quite small, there is a relatively higher chance of it progressing depending on what stage the cancer is at. For those with weakened immune systems, say, people whove had organ transplants or anyone infected with HIV, the risk is a little higher. Also, when the cancer is in the head and neck region, it may have a slightly higher risk of recurring or spreading.2
The actual stage of this form of cancer is determined based on the TNM protocol devised by the American Joint Commission on Cancer.3
- T : The size/extent of the tumor
- N : Whether it has spread to lymph nodes
- M : Whether it has spread to other parts of the body
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What Is Squamous Cell Skin Cancer
Squamous cells are found throughout the body. They make up the outer part of your skin. They also line the inside of many organs, including your lungs, bladder, and kidneys.
When cancer starts in squamous cells, it may be referred to as squamous cell carcinoma. It may also be named for the part of the body where the cancerous cells are located. If the squamous cells in your skin are cancerous, you have squamous cell carcinoma of the skin .
If these cancerous cells multiply instead of dying off, they may grow into a solid tumor on your skin. Not all squamous cell skin cancers look the same. Signs may include:
- A firm, red bump. It may have raised edges with a lower center
- A flat patch of scaly skin
- Growths that resemble warts
- A sore on your lip or inside your mouth
- A sore that wont heal. It may repeatedly ooze, bleed or crust over
Squamous cell skin cancer usually occurs on skin with lots of sun exposure, like the face, lips, ears and neck. But it can occur anywhere on the body. This includes hidden places like the inside of your mouth or genitals.
You can find squamous cell carcinoma and other skin cancers early with regular skin exams. Your primary care doctor or a dermatologist can check your skin during routine medical visits. They can check areas that are hard for you to see, like your scalp and back.
Between medical exams, you should regularly check your own skin. When youre familiar with the look and feel of your skin, you can identify new or suspicious changes.
How Serious Is My Cancer
If you have skin cancer, the doctor will want to find out how far it has spread. This is called staging.
Basal and squamous cell skin cancers don’t spread as often as some other types of cancer, so the exact stage might not be too important. Still, your doctor might want to find out the stage of your cancer to help decide what type of treatment is best for you.
The stage describes the growth or spread of the cancer through the skin. It also tells if the cancer has spread to other parts of your body that are close by or farther away.
Your cancer can be stage 0, 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread beyond the skin. Be sure to ask the doctor about the cancer stage and what it means for you.
Other things can also help you and your doctor decide how to treat your cancer, such as:
- Where the cancer is on your body
- How fast the cancer has been growing
- If the cancer is causing symptoms, such as being painful or itchy
- If the cancer is in a place that was already treated with radiation
- If you have a weakened immune system
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What Survival Rates Mean
The survival rate is the percentage of people who live for a certain period of time with this cancer. The number is based on research done on large groups of people with the same stage of cancer.
Experts dont know the exact survival numbers for late-stage SCC, because cancer registries dont track statistics for this cancer. However, your doctor may be able to give you an estimate of your prognosis.
When it comes to surviving cancer, everyone is different. Your outcome will depend on the specific treatments you have and how well you respond to them. Talk to your doctor about your outlook and what it means.
What Happens If Precancers Go Untreated
As the name suggests, precancers are damaged skin cells that arent considered cancerous, but if they are left untreated, these lesions are at high risk to become skin cancer. There are two main types of precancerous skin conditions: actinic keratosis and dysplastic nevi. Actinic keratosis looks like a rough, scaly patch of the skin that is usually red or brown. This condition may develop into squamous cell carcinoma if left untreated.
Nevi are moles, and dysplastic nevi is a term that means a mole is abnormal. Dysplastic nevi may develop into melanoma without proper treatment. While precancerous skin cancers are not malignant on their own, the potential to develop into life-threatening forms of this condition means they need to be evaluated regularly.
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Oral Medications For Advanced Bcc
It is rare for skin cancer to reach advanced stages, but when it does, oral medications may help. In addition to chemotherapy, targeted drugs may be used to treat advanced skin cancer. Targeted therapy means that the medication is able to directly target the cancer cells without destroying healthy cells. This can help to reduce side effects from treatment.
Vismodegib and sonidegib are hedgehog pathway inhibitors that work to prevent cancer cells from growing and spreading. The capsules are taken once per day and may be considered after surgery and other treatments. These medications come with several possible side effects and should never be taken during pregnancy since they can affect fetal growth.
Cetuximab is an EGFR inhibitor that can help to stop the spread of cancerous squamous cells. Its possible side effects include skin infections, diarrhea, mouth sores, and loss of appetite.
Some Squamous Cell Skin Cancers Are Deadly
Cutaneous squamous cell carcinoma is usually easily treated with surgery however, a subsection of patients with specific disease risk factors are more likely to develop metastases and die from the disease, according to the results of a study published in JAMA Dermatology.
Squamous cell carcinoma accounts for roughly 20% of all cases of non-melanoma skin cancer. Squamous cell carcinoma commonly involves the head or neck. The tumor may appear as a red bump or as a rough or scaly area on the skin. Squamous cell carcinoma is more likely than basal cell carcinoma to spread to lymph nodes or distant parts of the body, though this happens infrequently. Treatment of squamous cell carcinoma often involves surgery to remove the cancer.
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Treatments For Very Small Skin Cancers
If your skin cancer is very small and has a low risk of spreading, you might consider less invasive treatments, including:
- Curettage and electrodessication .C and E treatment involves removing the surface of the skin cancer with a scraping instrument and then searing the base of the cancer with an electric needle. This treatment is often used for small or very superficial squamous cell cancers of the skin.
- Laser therapy. An intense beam of light vaporizes growths, usually with little damage to surrounding tissue and with a reduced risk of bleeding, swelling and scarring. Laser treatment may be an option for very superficial skin lesions.
- Freezing. This treatment involves freezing cancer cells with liquid nitrogen . It may be an option for treating superficial skin lesions. Freezing might be done after using a scraping instrument to remove the surface of the skin cancer.
- Photodynamic therapy combines photosensitizing drugs and light to treat superficial skin cancers. During photodynamic therapy, a liquid drug that makes the cancer cells sensitive to light is applied to the skin. Later, a light that destroys the skin cancer cells is shined on the area.
How Is Squamous Cell Skin Cancer Of The Head And Neck Diagnosed
Diagnosis is made by clinical exam and a biopsy. Squamous cell cancers are staged by size and extent of growth. Squamous cell cancers can metastasize to nearby lymph nodes or other organs, and can invade both small and large nerves and local structures.
Biopsy can help determine if the squamous cell cancer is a low-risk tumor or a high-risk tumor that requires more aggressive treatment. Low-risk tumors are less than 10 millimeters in size, less than or equal to 5 millimeters deep and do not involve structures beyond the surrounding fat. High-risk tumors in the head and neck are those that involve the central face, nose and eye area, as well as those tumors that are greater than or equal to 10 millimeters on the cheeks, scalp and neck, tumors that are more than 5 millimeters thick or involve adjacent structures, tumors that invade nerves, tumors that are recurrent or arising from previously radiated tissue, and tumors arising in patients who are immunosuppressed.
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What Does Squamous Cell Carcinoma Look Like
Squamous cell skin cancers can vary in appearance, but here, weve provided some examples of how it might appear on your skin.
Squamous cell carcinoma initially appears as a skin-colored or light red nodule, usually with a rough surface. They often resemble warts and sometimes resemble open bruises with raised, crusty edges. The lesions tend to develop slowly and can grow into a large tumor, sometimes with central ulceration.
SCCs can occur on any part of the body, but they are more common on areas of skin exposed to the sun like the scalp, ear or face, so pay attention to these areas.
Squamous cell carcinoma usually develops slowly but can spread to the lymph nodes and other organs if left untreated. If caught early though, it is highly treatable. Early detection strategies are crucial for a successful outcome.
You will notice that all these skin cancer pictures are quite different from one another. Note that not all squamous cell cancers have the same appearance so these photos should serve as a general reference for what they can look like.