What It Looks Like
Squamous cell cancer involves the runaway growth of keratinocytes, cells in the outermost layer of skin, which produce the protein keratin. Squamous means scaly in 60%80% of cases, the lesions emerge on or near scaly patches called actinic keratoses that develop from sun-damaged skin.
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How Is Skin Cancer Treated
Treatment depends upon the stage of cancer. Stages of skin cancer range from stage 0 to stage IV. The higher the number, the more cancer has spread.
Sometimes a biopsy alone can remove all the cancer tissue if the cancer is small and limited to your skins surface only. Other common skin cancer treatments, used alone or in combination, include:
Cryotherapy uses liquid nitrogen to freeze skin cancer. The dead cells slough off after treatment. Precancerous skin lesions, called actinic keratosis, and other small, early cancers limited to the skins top layer can be treated with this method.
Excisional surgery
This surgery involves removing the tumor and some surrounding healthy skin to be sure all cancer has been removed.
Mohs surgery
With this procedure, the visible, raised area of the tumor is removed first. Then your surgeon uses a scalpel to remove a thin layer of skin cancer cells. The layer is examined under a microscope immediately after removal. Additional layers of tissue continue to be removed, one layer at a time, until no more cancer cells are seen under the microscope.
Mohs surgery removes only diseased tissue, saving as much surrounding normal tissue as possible. Its most often used to treat basal cell and squamous cell cancers and near sensitive or cosmetically important areas, such as eyelids, ears, lips, forehead, scalp, fingers or genital area.
Curettage and electrodesiccation
Chemotherapy and immunotherapy
Who Is Most At Risk For Skin Cancer
Although anyone can develop skin cancer, youre at increased risk if you:
- Spend a considerable amount of time working or playing in the sun.
- Get easily sunburned have a history of sunburns.
- Live in a sunny or high-altitude climate.
- Tan or use tanning beds.
- Have light-colored eyes, blond or red hair and fair or freckled skin.
- Have many moles or irregular-shaped moles.
- Have actinic keratosis .
- Have a family history of skin cancer.
- Have had an organ transplant.
- Take medications that suppress or weaken your immune system.
- Have been exposed to ultraviolet light therapy for treating skin conditions such as eczema or psoriasis.
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Are There Complications Of Skin Cancer Treatment
Most skin cancer treatments involve some localised damage to surrounding healthy skin such as swelling, reddening or blistering of the skin where the cancer is removed. Your doctor will explain any specific risks, which may include:
- pain or itching where the skin has been treated, or if lymph nodes have been removed
- scarring or changes to skin colour, after a skin cancer has been removed
- bleeding during or after surgery for more complicated skin cancers
- reactions sometimes your body may react to medicines used in treatment or surgery
- lymphoedema if your lymph nodes have been removed your neck, arm or leg may swell with fluid.
Its best to manage complications as early as possible, so ask your doctor for advice.
What Is The Outlook For People With Skin Cancer
Nearly all skin cancers can be cured if they are treated before they have a chance to spread. The earlier skin cancer is found and removed, the better your chance for a full recovery. Ninety percent of those with basal cell skin cancer are cured. It is important to continue following up with a dermatologist to make sure cancer does not return. If something seems wrong, call your doctor right away.
Most skin cancer deaths are from melanoma. If you are diagnosed with melanoma:
- The five-year survival rate if its detected before it spreads to the lymph nodes is 99%.
- The five-year survival rate if it has spread to nearby lymph nodes is 66%.
- The five-year survival rate if it has spread to distant lymph nodes and other organs is 27%.
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Basal Cell Skin Cancer
BCC is the most common type of skin cancer. About 75 out of every 100 non melanoma skin cancers are BCCs. They develop from basal cells and these are found in the deepest part of the outer layer of the skin .
They develop mostly in areas of skin exposed to the sun, including parts of the face such as the nose, forehead and cheeks. Also, on your back or lower legs.
They are most often diagnosed in people who are middle aged or older.
Doctors might also call a basal cell cancer a rodent ulcer.
There are a number of different types of BCC. Each type can look and behave differently. They include:
- nodular basal cell skin cancer
- superficial basal cell skin cancer
- morphoeic basal cell skin cancer â also known as sclerosing or infiltrating basal cell skin cancer
- pigmented basal cell skin cancer
Nodular basal cell cancer is the most common subtype.
Itâs very rare for basal cell skin cancer to spread to another part of the body to form a secondary cancer. Itâs possible to have more than one basal cell cancer at any one time and having had one does increase your risk of getting another.
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Types Of Melanoma Skin Cancer
Melanoma skin cancer can grow into and destroy nearby tissue. It can also spread to other parts of the body. Melanoma skin cancer is also called cutaneous melanoma and malignant melanoma of the skin.
There are 4 main types of melanoma skin cancer superficial spreading, nodular, lentigo maligna and acral lentiginous.
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What Is The Outlook For People With Squamous Cell Cancer
Early detection of SCC is key to successful treatment. If SCC isnt treated in its early stages, the cancer may spread to other areas of the body, including the lymph nodes and organs. Once this occurs, the condition can be life threatening.
Those with weakened immune systems due to certain medical conditions, such as HIV, AIDS, or leukemia, have a greater risk of developing more serious forms of SCC.
What Happens If Squamous Cell Carcinoma Is Left Untreated
Like basal cell carcinoma, squamous cell carcinoma is relatively common, slow-growing, and at low risk to metastasize in most cases. This form of skin cancer is also likely to develop on the areas of the body that are exposed to sunlight like the face, hands, neck, shoulders, and lower legs, especially for people who have a history of sunburns. Unlike the smooth appearance of basal cell carcinoma lesions, squamous cell carcinoma tumors often appear as rough, thickened, scaly patches of skin. The growths may appear wart-like or like a donut shape. Squamous cell carcinoma lesions may form sores and bleed often or develop into a large, thick, and firm mass. Squamous cell carcinoma typically impacts people over the age of 50. While the condition does spread slowly, the risk that squamous cell carcinoma will spread to other parts of the body is higher than that of basal cell carcinoma. Additionally, these have the potential to arise suddenly and grow rapidly in some cases.
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Prognosis For Skin Cancer
It is not possible for a doctor to predict the exact course of a disease. However, your doctor may give you the likely outcome of the disease. If detected early, most skin cancers are successfully treated.
Most non-melanoma skin cancers do not pose a serious risk to your health but a cancer diagnosis can be a shock. If you want to talk to someone see your doctor. You can also call Cancer Council 13 11 20.
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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What Are Some Of The Lesser
Some of the less common skin cancers include the following:
Kaposi sarcoma is a rare cancer most commonly seen in people who have weakened immune systems, those who have human immunodeficiency virus /AIDS and people who are taking immunosuppressant medications who have undergone organ or bone marrow transplant.
Signs and symptoms of Kaposi sarcoma are:
- Blue, black, pink, red or purple flat or bumpy blotches or patches on your arms, legs and face. Lesions might also appear in your mouth, nose and throat.
Merkel cell carcinoma
Merkel cell carcinoma is a rare cancer that begins at the base of the epidermis, the top layer of your skin. This cancer starts in Merkel cells, which share of the features of nerve cells and hormone-making cells and are very close to the nerve ending in your skin. Merkel cell cancer is more likely to spread to other parts of the body than squamous or basal cell skin cancer.
Signs and symptoms of Merkel cell carcinoma are:
- A small reddish or purplish bump or lump on sun-exposed areas of skin.
- Lumps are fast-growing and sometimes open up as ulcers or sores.
Sebaceous gland carcinoma
Sebaceous gland carcinoma is a rare, aggressive cancer that usually appears on your eyelid. This cancer tends to develop around your eyes because theres a large number of sebaceous glands in that area.
Signs and symptoms of sebaceous gland carcinoma are:
- A painless, round, firm, bump or lump on or slightly inside your upper or lower eyelid.
Dermatofibrosarcoma protuberans
Keeping Cancer In Check
Chronic exposure to the sun or intermittent sunburns can lead to skin cancer. Skin cancer risk doubles with five or more sunburns in a lifetime, but just one bad sunburn can double the risk of melanoma. While skin cancer is uncommon in African Americans, Latinos and Asians, it can also be more deadly because they are often diagnosed later in the course of the disease.
Its important to examine your skin regularly. You should report any changes in an existing mole or any new moles to your physician. People with fair complexions have the highest risk of developing skin cancer, but everyone should avoid the sun and practice safety measures to protect their skin.
The American Cancer Society recommends the Slip, Slop, Slap and Wrap policy. When you go out in the sun, slip on a shirt, slop on sunscreen, slap on a hat and wrap on sunglasses to protect your eyes and the sensitive skin around them.
Exposure to the UV rays of tanning lamps is not safe. Tanning lamps give out UV rays, which can cause long-term skin damage and can contribute to skin cancer. Tanning bed use has been linked with an increased risk of melanoma, especially for people under 30. Most doctors and health organizations recommend not using tanning beds and sun lamps.
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Can You Prevent Skin Cancer
According to Dr. Dorsey, Skin cancer is an extremely serious condition, but with proactive care, most cases can be avoided altogether. In fact, taking a few small steps to limit sun damage and conducting regular skin self-exams is all you need to do to keep your skin healthy. Because sun exposure is the main underlying cause of skin cancer, sun protection is essential to prevent this condition. Patients need to apply sunscreen every day and reapply at least every two hours during prolonged sun exposure. Whenever possible, limit or avoid time spent outdoors during peak sun hours between 10 am and 4 pm. If patients need to be outdoors during these times, its important to wear protective coverings, seek shade, and reapply sunscreen frequently.
In addition to daily sun protection steps, patients also need to perform self-exams at least every month. Early detection is key to providing effective skin cancer treatment, so regular self-exams are an essential part of keeping people healthy. Your Board Certified Dermatologist can walk you through a self-exam when you visit the office, but the basic process involves carefully examining your skin, from the top of your head to the bottoms of your feet , and noting any spots, lesions, bumps, discoloration, or other skin changes or irregularities. When you know where marks are on your skin, youll be more likely to notice if they are growing or changing in ways that are concerning or that indicate skin cancer.
Knowledge Is Your Best Defense
What Is Skin Cancer?
Skin cancer is the out-of-control growth of abnormal cells in the epidermis, the outermost skin layer, caused by unrepaired DNA damage that triggers mutations. These mutations lead the skin cells to multiply rapidly and form malignant tumors. The main types of skin cancer are basal cell carcinoma , squamous cell carcinoma , melanoma and Merkel cell carcinoma .
The two main causes of skin cancer are the suns harmful ultraviolet rays and the use of UV tanning beds. The good news is that if skin cancer is caught early, your dermatologist can treat it with little or no scarring and high odds of eliminating it entirely. Often, the doctor may even detect the growth at a precancerous stage, before it has become a full-blown skin cancer or penetrated below the surface of the skin.
Americans will develop skin cancer by age 70.
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What Are The Risk Factors For Skin Cancer
The most common risk factors for skin cancer are as follows.
- Ultraviolet light exposure, either from the sun or from tanning beds. Fair-skinned individuals, with hazel or blue eyes, and people with blond or red hair are particularly vulnerable. The problem is worse in areas of high elevation or near the equator where sunlight exposure is more intense.
- A chronically suppressed immune system from underlying diseases such as HIV/AIDS infection or cancer, or from some medications such as prednisone or chemotherapy
- Exposure to ionizing radiation or chemicals known to predispose to cancer such as arsenic
- Certain types of sexually acquired wart virus infections
- People who have a history of one skin cancer have a 20% chance of developing second skin cancer in the next two years.
- Elderly patients have more skin cancers.
Most basal cell carcinomas have few if any symptoms. Squamous cell carcinomas may be painful. Both forms of skin cancer may appear as a sore that bleeds, oozes, crusts, or otherwise will not heal. They begin as a slowly growing bump on the skin that may bleed after minor trauma. Both kinds of skin cancers may have raised edges and central ulceration.
Signs and symptoms of basal cell carcinomas include:
Signs and symptoms of squamous cell carcinomas include:
- Persistent, scaly red patches with irregular borders that may bleed easily
- Open sore that does not go away for weeks
- A raised growth with a rough surface that is indented in the middle
- A wart-like growth
Types Of Squamous Cell Carcinoma
There are several types of squamous cell carcinoma. Some are more likely to spread than others, but in general, most share similar characteristics. The primary difference between each subtype is histological .
To determine which type of squamous cell carcinoma a patient has, a pathologist will examine a tissue sample underneath a microscope. By identifying the type of cells that are present in a lesion, an oncologist can tailor a patients treatment plan to achieve the best possible outcome and quality of life.
The primary types of squamous cell carcinoma are:
- Adenoid/pseudoglandular squamous cell carcinoma
- Large cell keratinizing squamous cell carcinoma
- Large cell non-keratinizing squamous cell carcinoma
- Lymphoepithelial carcinoma
- Small cell keratinizing squamous cell carcinoma
- Spindle cell squamous cell carcinoma
- Verrucous squamous-cell carcinoma
At Moffitt Cancer Center, we diagnose and treat a complete range of skin cancers, including the unique variants of squamous cell carcinoma. Screening, staging and long-term follow-up services are also available as part of our commitment to providing comprehensive care.
Referrals are not required to seek a diagnosis or treatment at Moffitt. If youve been diagnosed with or are concerned that you are showing signs of one of the different types of squamous cell carcinoma, call or submit a new patient registration form online.
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Squamous Cell Skin Cancer
SCC is generally faster growing than basal cell cancers. About 20 out of every 100 skin cancers are SCCs. They begin in cells called keratinocytes, which are found in the epidermis.
Most SCCs develop on areas of skin exposed to the sun. These areas include parts of the head, neck, and on the back of your hands and forearms. They can also develop on scars, areas of skin that have been burnt in the past, or that have been ulcerated for a long time.
SCCs don’t often spread. If they do, it’s most often to the deeper layers of the skin. They can spread to nearby lymph nodes and other parts of the body, but this is unusual.
Melanoma: The Deadliest Skin Cancer
Melanoma is the most serious type of skin cancer, because it tends to spread if its not treated early.
This cancer starts in the melanocytes cells in the epidermis that make pigment.
About 100,350 new melanomas are diagnosed each year.
Risk factors for melanoma include:
- Having fair skin, light eyes, freckles, or red or blond hair
- Having a history of blistering sunburns
- Being exposed to sunlight or tanning beds
- Living closer to the equator or at a higher elevation
- Having a family history of melanoma
- Having many moles or unusual-looking moles
- Having a weakened immune system
Melanoma can develop within a mole that you already have, or it can pop up as a new dark spot on your skin.
This cancer can form anywhere on your body, but it most often affects areas that have had sun exposure, such as the back, legs, arms, and face. Melanomas can also develop on the soles of your feet, palms of your hands, or fingernail beds.
Signs to watch out for include:
- A mole that changes in color, size, or how it feels
- A mole that bleeds
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