What Makes Yale Medicines Approach To Squamous Cell Carcinoma Unique
Simple, small cancers can often be treated very well by a local dermatologist, according to Dr. Leffell. We rarely see the small cancers. We get referred to the cases that need special attention.
Dr. Leffell emphasizes that at Yale Medicine, the patient always comes first. We like to have a discussion with the patient about what happens after the skin cancer is removed, he says. We talk about what’s involved with plastic surgery and what’s involved with letting the area heal naturally. We prefer to take a minimalist approach and let the patient decide what they want us to do and how they want to let their skin heal.
If the decision is made to repair the wound using plastic surgery, we do that immediately in the office setting, Dr. Leffell says. Alternatively, allowing the wound to heal naturally is often a great option, and does not rule out doing plastic surgery down the road if needed, though that is very rarely the case.
Squamous Cell Carcinoma Risk Factors
Certain things make you more likely to develop SCC:
- Older age
- Blue, green, or gray eyes
- Blonde or red hair
- Spend time outside, exposed to the sun’s UV Rays
- History of sunburns, precancerous spots on your skin, or skin cancer
- Tanning beds and bulbs
- Long-term exposure to chemicals such as arsenic in the water
- Bowens disease, HPV, HIV, or AIDS
Your doctor may refer you to a dermatologist who specializes in skin conditions. They will:
- Ask about your medical history
- Ask about your history of severe sunburns or indoor tanning
- Ask if you have any pain or other symptoms
- Ask when the spot first appeared
- Give you a physical exam to check the size, shape, color, and texture of the spot
- Look for other spots on your body
- Feel your lymph nodes to make sure they arent bigger or harder than normal
If your doctor thinks a bump looks questionable, theyll remove a sample of the spot to send to a lab for testing.
What Is Squamous Cell Skin Cancer Of The Head And Neck
Skin malignancies are the most common cancer in the United States, responsible for more than half of all new cancer cases. These can be broken down into melanoma and non-melanoma malignancies, which are squamous cell cancer and basal cell cancer. These skin malignancies are caused by ultraviolet radiation from exposure to the sun and tanning beds.
Squamous cell cancer is the second most common form of skin cancer. It is more aggressive and may require extensive surgery depending on location and nerve involvement. Radiation, chemotherapy and immunotherapy are used in advanced cases.
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What Are The Symptoms Of Squamous Cell Carcinoma
The first sign of an SCC is usually a thickened, red, scaly spot thatdoesnt heal. You are most likely to find an SCC on the back of your hands,forearms, legs, scalp, ears or lips. If its on your lips, it can look like asmall ulcer or patch of scaly skin that doesnt go away.
An SCC may also look like:
- a crusted sore
- a sore or rough patch inside your mouth
- a red, raised sore around your anus or genitals
An SCC will probably grow quickly over several weeks or months.
Squamous Cell Carcinoma Information
Squamous cell carcinoma is the second most common type of skin cancer. As the name suggests, this type of cancer develops in the squamous cells, which are found in the top layers of the skin. Usually, squamous cell carcinomas look like small, scaly red patches or open sores, although they can also appear as small, raised nodules that crust or bleed.
Most squamous cell carcinomas develop in parts of the skin that are regularly exposed to the sun, such as the neck, hands, arms, lips, ears and face. Thats because UV exposure is the primary risk factor for this type of cancer. However, some squamous cell carcinomas develop on the genitals or the inside of the mouth.
While squamous cell carcinoma can spread to other parts of the body, it is usually very responsive to treatment. When detected and treated early, squamous cell carcinomas have a survival rate of more than 95 percent.
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Diagnosing Squamous Cell Carcinoma
The main way to diagnose squamous cell carcinoma is with a biopsy. This involves having a small piece of tissue removed from the suspicious area and examined in a laboratory.
In the laboratory, a pathologist will examine the tissue under a microscope to determine if it is a skin cancer. He or she will also stage the cancer by the number of abnormal cells, their thickness, and the depth of penetration into the skin. The higher the stage of the tumor, the greater the chance it could spread to other parts of the body.
Squamous cell carcinoma on sun-exposed areas of skin usually does not spread. However, squamous cell carcinoma of the lip, vulva, and penis are more likely to spread. Contact your doctor about any sore in these areas that does not go away after several weeks.
What Does Scc Look Like
SCCs can appear as scaly red patches, open sores, rough, thickened or wart-like skin, or raised growths with a central depression. At times, SCCs may crust over, itch or bleed. The lesions most commonly arise in sun-exposed areas of the body.
SCCs can also occur in other areas of the body, including the genitals.
SCCs look different on everyone. You can find more images, as well as signs, symptoms and early detection strategies on our SCC Warning Signs page.
Please note: Since not all SCCs have the same appearance, these photos serve as general reference for what they can look like. If you see something new, changing or unusual on your skin, schedule an appointment with your dermatologist.
A persistent, scaly red patch with irregular borders that sometimes crusts or bleeds.
An open sore that bleeds or crusts and persists for weeks.
An elevated growth with a central depression that occasionally bleeds. It may rapidly increase in size.
A wart-like growth that crusts and occasionally bleeds.
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How Serious Is A Squamous Cell Carcinoma
Id had a few skin cancers removed before, all basal cell carcinomas , the most common type. But when I was diagnosed with a squamous cell carcinoma on my scalp, it seemed different, and a little more scary. I asked C. William Hanke, MD, a Mohs surgeon at the Laser and Skin Surgery Center of Indiana and a senior vice president of The Skin Cancer Foundation, what we need to know about this second most common form of skin cancer.
Q: When people talk about nonmelanoma skin cancers, they tend to lump basal cell and squamous cell carcinomas together as the ones that are far less dangerous than melanoma. Should we take SCCs more seriously?
Dr. Hanke: Yes and no. BCCs hardly ever metastasize. Ive seen two cases in my entire career. But when SCCs that havent been treated early get big, then the chance of metastasis becomes real. Its uncommon, but its much more common than in BCC. We see it in our practice. But we dont want to scare people into thinking that just because they have squamous cell, Oh wow, Ive got a chance of metastasis. Remember, the rate is very low. Its just those big ones.
Q: OK, so its rare. But what happens when an SCC does spread?
Q: Whats the usual treatment for SCCs?
Q: How can we detect SCCs as early as possible?
How Do People Find Squamous Cell Carcinoma Cancer On Their Skin
Many people find it when they notice a spot, round lump, or scaly patch on their skin that is growing or feels different from the rest of their skin. If you notice such a spot on your skin that is growing, bleeding, or changing in any way, see a board-certified dermatologist. These doctors have the most training and experience in diagnosing skin cancer.
To find skin cancer early, dermatologists recommend that everyone check their own skin with a skin self-exam. This is especially important for people who have a higher risk of developing SCC.
Youll find out what can increase your risk of getting this skin cancer at, Squamous cell carcinoma of the skin: Who gets and causes.
Images 1,2,4,7,9: The American Academy of Dermatology National Library of Dermatologic Teaching Slides
Image 3: JAAD Case Reports 2018 4:455-7.
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Moffitt Cancer Centers Approach To Squamous Cell Carcinoma
At Moffitt Cancer Center, we take a comprehensive, multispecialty approach to diagnosing and treating squamous cell carcinoma. Our Cutaneous Oncology Program makes it possible for patients to consult with a number of specialists in a single location. Our team consists of:
- Supportive care providers
- Medical oncologists
Because these providers work exclusively toward the diagnosis and treatment of skin cancer, they have extensive experience and can provide each patient with an effective, individualized treatment plan. At Moffitt, we offer a complete range of treatments for squamous cell carcinoma, from Mohs micrographic surgery to targeted radiation therapy. Cryotherapy and dermabrasion are also options available to our patients. We individualize each patients treatment plan to reflect his or her specific diagnosis and personal preferences, while taking care to consider aesthetic outcomes and important factors related to quality of life.
Theres no need to obtain a referral to receive treatment at Moffitt. To learn more, call or submit a new patient registration form online.
What Is The Outlook For Cutaneous Squamous Cell Carcinoma
Most SCCs are cured by treatment. A cure is most likely if treatment is undertaken when the lesion is small. The risk of recurrence or disease-associated death is greater for tumours that are > 20 mm in diameter and/or > 2 mm in thickness at the time of surgical excision.
About 50% of people at high risk of SCC develop a second one within 5 years of the first. They are also at increased risk of other skin cancers, especially melanoma. Regular self-skin examinations and long-term annual skin checks by an experienced health professional are recommended.
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What Is Squamous Cell Lung Carcinoma
Squamous cell carcinoma is a type of NSCLC, which itself makes up around 84 percent of all lung cancer cases. Other types of NSCLC include adenocarcinomas and large cell carcinomas.
The main difference between each subtype of NSCLC is the lung cells that are cancerous. In squamous cell carcinomas, cancer forms in squamous cells, which are flat, thin cells that look similar to fish scales when viewed under a microscope. Squamous cell tumors tend to form in the central part of the lung or in one of the bronchi . They tend to be centrally located on X-rays.
- Exposure to secondhand smoke, radon, asbestos, diesel, and mineral dust
- Older age
- Family history
Metastatic Squamous Cell Carcinoma
Squamous cell carcinoma – a very common form of nonmelanoma skin cancer that originates in the squamous cells – becomes metastatic when it spreads beyond the primary cancer site and affects other areas of the body. Metastatic squamous cell carcinoma is uncommon but can develop if the primary cancer is not surgically removed or treated in a timely manner.
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What Are Basal And Squamous Cell Skin Cancers
Basal and squamous cell skin cancers are the most common types of skin cancer. They start in the top layer of skin , and are often related to sun exposure.
Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer cells. To learn more about cancer and how it starts and spreads, see What Is Cancer?
What Does A Squamous Cell Carcinoma Look Like
SCC can vary in their appearance, but most usually appear as a scaly or crusty raised area of skin with a red, inflamed base. SCCs can be sore or tender and they can bleed but this is not always the case. They can appear as an ulcer.
SCC can occur on any part of the body, but they are more common on sun exposed sites such as the head, ears, neck and back of the hands.
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How Is Metastatic Squamous Cell Carcinoma Treated
Each patients ideal course of metastatic squamous cell carcinoma treatment will vary according to the location of the primary cancer, how far it has spread, the overall health of the patient and several other factors. Many treatment plans include a combination of surgery to remove skin lesions and affected lymph nodes, as well as chemotherapy and radiation therapy to help shrink or destroy cancer cells that have traveled to other parts of the body.
Moffitt Cancer Centers Cutaneous Oncology Program offers a full spectrum of diagnostics and leading-edge treatment options to patients with squamous cell carcinoma of any stage. To speak with a Moffitt oncologist specializing in skin cancer, submit a new patient registration form online or call .
Can A Squamous Cell Carcinoma Kill You
All skin cancer cells can spread to other parts of the body but this isn’t common. Most cases of SCC can be cured if they’re caught early. But if you don’t get treatment, it can spread beyond the skin.
Around 2% to 4% of SCCs will spread to lymph nodes, bones, or other tissue. SCCs in people of color are more often diagnosed at a later stage, when they may have had a chance to spread.
If it spreads somewhere like your lymph nodes, that means the cancer may be aggressive and more likely to spread. This is called metastatic disease and it can become life-threatening.
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Classification Of Squamous Cell Carcinoma By Risk
Cutaneous SCC is classified as low-risk or high-risk, depending on the chance of tumour recurrence and metastasis. Characteristics of high-risk SCC include:
High-risk cutaneous squamous cell carcinoma has the following characteristics:
- Diameter greater than or equal to 2 cm
- Location on the ear, vermilion of the lip, central face, hands, feet, genitalia
- Arising in elderly or immune suppressed patient
- Histological thickness greater than 2 mm, poorly differentiated histology, or with the invasion of the subcutaneous tissue, nerves and blood vessels
Metastatic SCC is found in regional lymph nodes , lungs, liver, brain, bones and skin.
High-risk cutaneous squamous cell carcinoma
How Can A Squamous Cell Carcinoma Be Treated
Surgery is usually the recommended treatment. This involves removing the SCC with a margin of normal skin around it, using a local anaesthetic. The skin is then closed with stitches or sometimes a skin graft is needed. Sometimes other surgical methods are used such as curettage and cautery. This involves scraping the SCC away using local anaesthetic.
Radiotherapy can also be used to treat SCC. This involves shining a beam of X-rays onto the skin. Usually several sessions are required.
For advanced SCC, a combination of treatments may be used. For SCC that has spread to other parts of the body a combination of surgery, radiotherapy and/or chemotherapy may be used.
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Treating Squamous Cell Carcinoma Of The Skin
Treatment options for squamous cell skin cancer depend on the risk of the cancer coming back, which is based on factors like the size and location of the tumor and how the cancer cells look under a microscope, as well as if a person has a weakened immune system.
Most squamous cell skin cancers are found and treated at an early stage, when they can be removed or destroyed with local treatment methods. Small squamous cell cancers can usually be cured with these treatments. Larger squamous cell cancers are harder to treat, and fast-growing cancers have a higher risk of coming back.
In rare cases, squamous cell cancers can spread to lymph nodes or distant parts of the body. If this happens, treatments such as radiation therapy, immunotherapy, and/or chemotherapy may be needed.
How Common Is Squamous Cell Carcinoma
Over 1 million people are diagnosed with SCC in the US each year. The incidence of SCC has risen about 200 percent over the past 30 years. There are more than 15,000 deaths each year in the US from SCC. Excluding head and neck SCC and CSCC in situ, about 200,000-400,000 new cases of SCC are diagnosed in the US every year, resulting in about 3,000 deaths.
Men are about two times more likely than women to develop SCCs. People over the age of 50 are most likely to get SCCs, but the incidence has been rising in younger people.
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Squamous Cell Carcinoma Causes
Exposure to ultraviolet rays, like the ones from the sun or a tanning bed, affects the cells in the middle and outer layers of your skin and can cause them to make too many cells and not die off as they should. This can lead to out-of-control growth of these cells, which can lead to squamous cell carcinoma.
Other things can contribute to this kind of overgrowth, too, like conditions that affect your immune system.
Advanced Treatment For A Common Skin Cancer
Squamous cell carcinoma also called squamous cell cancer is one of the most common types of skin cancer, accounting for approximately 20 percent of all skin cancer cases.
One of the three primary types of cells that make up the skin , squamous cells are flat. They are located near the top of the epidermis and are continually shed as new squamous cells develop.
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