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What Happens When Squamous Cell Carcinoma Spreads

Waited For My Scheduled Skin Check

Squamous Cell Carcinoma: What Patients Need to Know

I already had a regular skin check scheduled with my dermatologist in a few weeks, so I decided to wait until that appointment to have it looked at. And honestly, within a week I was ready to call her to have her look at it sooner because it was that painful. Every time it rubbed against my clothing, it hurt. When I turned over at night while I was sleeping, it hurt and the pain woke me up.

During the appointment, when I told my doctor it appeared out of nowhere and it hurt, she told me she thought it was squamous cell skin cancer because they tend to appear suddenly. She biopsied it, and when the results came back as squamous cell, we scheduled surgery. During the surgery, I asked her why it had hurt so much, and she said that was typical of squamous cell areas– they grow rather suddenly and become a placeholder of space in a place they dont belong.

Skin Cancer Diagnosis & Treatment

On skin cancer diagnosis, Dr. Truong says, To the untrained eye, skin cancer can mimic the appearance of natural irregularities or other common skin conditions. The deadliest form of skin cancer, melanoma, may look like a mole, therefore, it is very important to note new growths or changing lesions, and to bring them to the attention of your dermatologist. A skin biopsy may be needed for a definitive diagnosis.

Once a patient receives a definitive skin cancer diagnosis, treatment planning begins. The treatment depends on the type of skin cancer, the size, location, and level of aggressiveness. The main methods of treatment include surgery, radiation, and light-based treatments.

Surgery is the most common and effective treatment for most skin cancers. Depending on the size, aggressiveness, and location of the skin cancer, a wide local excision or Mohs micrographic surgery may be recommended. Both surgeries are minimally invasive and usually done under local anesthesia. Mohs Micrographic Surgery is a specialized skin cancer surgery designed to remove skin cancers on sensitive areas such as the head and neck. The surgery removes skin cancer completely while preserving as much healthy skin as possible. The cancerous lesion is removed layer by layer, and the margins of each specimen are examined by your Mohs surgeon while you wait. Due to the on-site 100% margin evaluation, cure rates are superior and more healthy skin can be preserved, minimizing the scar.

How Can I Prevent Scc

Reducing ultraviolet exposure will reduce the risk of getting an SCC.

Top sun safety tips

  • Protect your skin with clothing, and dont forget to wear a hat that protects your face, neck and ears, and a pair of UV protective sunglasses.
  • Spend time in the shade between 11am and 3pm when its sunny. Step out of the sun before your skin has a chance to redden or burn. Keep babies and young children out of direct sunlight.
  • When choosing a sunscreen look for a high protection SPF to protect against UVB, and the UVA circle logo and/or 4 or 5 UVA stars to protect against UVA. Apply plenty of sunscreen 15 to 30 minutes before going out in the sun, and reapply every two hours and straight after swimming and towel-drying.
  • Sunscreens should not be used as an alternative to clothing and shade, rather they offer additional protection. No sunscreen will provide 100% protection.
  • It may be worth taking Vitamin D supplement tablets as strictly avoiding sunlight can reduce Vitamin D levels. You should consult your doctor about this.

Treatment of areas of scaly sun damage may reduce your risk of an SCC.

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Also Check: Can Squamous Cell Turn Into Melanoma

What Happens If You Let Skin Cancer Go Untreated

Many patients who are diagnosed with skin cancer, especially in the earliest stages, find themselves wondering whether treatment is really necessary. Skin cancer, like other forms of cancer, is serious and requires proper treatment. According to Dr. Valerie Truong of U.S. Dermatology Partners in Dallas, Plano, Sherman, and Corsicana, Texas, The visible part of skin cancer can often be like the tip of an iceberg. What you see on the surface is only a small percentage of the actual cancer. Even if the skin cancer appears to be negligible, there is always a risk that it will grow and spread. I recommend that people who suspect they have skin cancer get a skin check for an earlier diagnosis, and therefore, earlier treatment. In this blog, Dr. Truong talks more about what happens if you let skin cancer go untreated and the potential risks that may arise for skin health as well as overall health and well-being.

What Happens If Precancers Go Untreated

Gardasil used to treat patient with squamous cell ...

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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Basal Cell And Squamous Cell Carcinoma

The two most common kinds of skin cancer are basal cell carcinoma and squamous cell carcinoma, which are sometimes called nonmelanoma skin cancer. These cancers are carcinomas that begin in the cells that cover or line an organ.

Basal cell carcinoma accounts for more than 90 percent of all skin cancers in the United States and is the most common of all cancers. Typically, it is a slow-growing cancer that seldom spreads to other parts of the body.

Squamous cell carcinoma also rarely spreads, but does so more often than basal cell carcinoma. It is important that skin cancers are found and treated early because they can invade and destroy nearby tissue. Organ transplant recipients have a 65-fold higher risk of developing squamous cell carcinoma than others. UCSF Medical Center offers a High Risk Skin Cancer Clinic for those at high risk for non-melanoma skin cancers, such as transplant recipients.

Scc Warning Signs And Symptoms

Sun-damaged skin is more prone to SCC growths. The scalp, ears, face, hands, chest and arms are all more likely to develop SCC, but these growths can occur in areas that do not see sun, like inside the mouth or the bottom of the feet. Some of the warning signs of SCC include:

  • Sores that do not heal
  • Scaly patch of skin
  • Rough, raised growth
  • Firm, rounded growth
  • A horned-shaped growth on skin
  • Hard, red nodule

Any new skin growth or sore that appears on the skin and does not go away should be examined by a dermatologist. Dr. Katherine Chiang at Precision Medical Specialists is a board certified dermatologist and a skin cancer expert. If you have a concerning skin growth that has symptoms of squamous cell carcinoma or any other type of skin cancer, she can provide an accurate diagnosis and squamous cell carcinoma treatment if you have the disease.

With early detection of squamous cell carcinoma, treatment can be very effective. In early stages of smaller SCC growths, surgical removal is the least invasive and most effective option. Our surgical team at Precision Medical Specialists prefers ED&C for many skin cancer removal surgeries. Each patient receives a personalized treatment plan based on their specific type of cancer and medical workup.

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What Types Of Skin Cancers Are Deadly

Skin cancers are some of the most complex and serious conditions treated by dermatologists, and the U.S. Dermatology Partners team takes our role in preventing and treating all types of skin cancers very seriously. While some forms of skin cancer are not typically life-threatening, without proper treatment, there are serious health risks associated with all forms of skin cancer. According to Dr. Jessica Dorsey of U.S. Dermatology Partners in Cedar Park, Texas, Most skin cancers are slow-growing and unlikely to spread to other parts of the body, but without treatment, just about any form of skin cancer has the potential to be destructive or even fatal. Keep reading to learn more about the importance of regular screenings to catch skin cancer in the earliest stages and prevent the severe repercussions of untreated skin cancers.

Mcc Stages: Making Sense Of It All

2 Minutes on Squamous Cell Carcinoma

After testing is finished, your medical team will try to pinpoint how far the disease has progressed. This process is known as staging. Staging is a way to understand how much the cancer has grown and how far it has spread. This helps determine how to best treat it, and the risk of it coming back.

The TNM system is frequently used to stage MCC. Its a classification based on three factors:

  • T represents the size of the original;tumor, its growth rate and other factors.
  • N indicates whether the cancer has spread to the local lymph;nodes and to what extent.
  • M stands for the spread or metastasis to distant lymph nodes and organs.

Once the patients TNM categories have been established, the overall stage number is assigned. As a rule, the lower the stage number, the less the disease has progressed.

MCC Staging

Stage 0

Tumor has not advanced beyond the outermost layer of skin. This stage is also called carcinoma in situ, which means in its original place.

Stage III

Tumor cells have advanced beyond the original tumor and may have traveled as far as the nearby lymph nodes, but not beyond.

Stage I and II

Tumor has not spread to nearby lymph nodes. Stage I includes smaller tumors and stage II includes larger and/or higher-risk tumors.

Stage IV

Tumor cells have spread to distant body areas, lymph nodes or organs.

These stages are each further broken down, from lowest to highest risk, depending on different characteristics of the original tumor and the areas where it has spread.

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What Are The Stages Of Squamous Cell Carcinoma

Squamous cell carcinoma is classified into the following stages, which are partly based on how far the cancer has spread throughout the body:

  • Stage 0 Squamous cell carcinoma develops in the squamous cells, which are located in the epidermis . During Stage 0, the cancer hasnt spread beyond the epidermis.
  • Stage 1 When squamous cell carcinoma progresses to Stage 1, it means that the cancer has spread deeper into the skin, but not into any lymph nodes or healthy tissues.
  • Stage 2 A Stage 2 classification means that, in addition to progressing deeper into the skin, the cancer also displays at least one high-risk feature. This might include metastasizing to the lower skin layers or the nerves. However, at this stage, the cancer still hasnt spread to lymph nodes or healthy tissues.
  • Stage 3 Once squamous cell carcinoma reaches Stage 3, the cancer has spread into lymph nodes but not any other tissues or organs.
  • Stage 4 This is the final stage of squamous cell carcinoma, where the cancer has spread to at least one distant organ, whether that be the brain, the lungs or a separate area of skin.

If you think you might have squamous cell carcinoma, its important to seek prompt medical attention to minimize the risk of cancer spread. The specialists in Moffitt Cancer Centers Cutaneous Oncology Program can provide you with the comprehensive diagnostic and treatment services you need. Call or complete our new patient registration form online to request an appointment.

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Squamous Cell Skin Cancer Of The Head And Neck Treatment

Surgery is the preferred management method for the majority of squamous cell skin cancers. Low-risk, early stage, small squamous cell cancers can be removed by Mohs surgery, which is a technique that spares normal tissue through repeated intraoperative margin testing, removing only the cancer and leaving adjacent normal tissue. Excision, curettage and desiccation, and cryosurgery can also be used to remove the cancer while sparing normal tissue. Radiation alone is an alternative for low-risk tumors when surgery is not desirable because of cosmetic concerns or medical reasons.

Large tumors and tumors with nerve or lymph node involvement are not suitable for Mohs surgery and require removal of at least 5-millimeter margins of normal tissue around the cancer and neck dissection for involved lymph nodes. Larger tumors require reconstruction, which can be done at the time of surgery if margin status is clear. Reconstruction should be staged when margins status is not clear.

Patients with high-risk tumors should meet with a radiation therapist to discuss postoperative radiation. Chemotherapy may be added to radiation for extensive lymph node involvement or positive margins that cannot be cleared with additional surgery. In patients with high-risk tumors who are not surgical candidates, systemic treatment with both radiation and chemotherapy is used. Such cases require multidisciplinary care by a team of surgeons, radiation oncologists and medical oncologists.

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How Aggressive Is Squamous Cell Carcinoma

Squamous cell carcinoma is not often considered to be life threatening. This form of skin cancer that affects the squamous cells tends to create slow-growing tumors. Although squamous cell carcinoma is more likely to invade deeper layers of the skin and spread to other parts of the body than basal cell carcinoma, this is still uncommon.

Only about 5 to 10 percent of squamous cell carcinoma tumors are considered to be aggressive.

Metastatic Squamous Cell Carcinoma

Online Dermatology

In addition to a 65-fold higher risk of developing squamous cell carcinoma , SCC that develop in adult transplant recipients are at higher risk for metastasis, 5-7%, compared to the general population, ~2% . ~13% of SCC that occur in pediatric patients metastasize. SCC that occur on the lip of pediatric patients are at particularly high risk .

SCC metastasis is generally associated with a poor prognosis with a 3-year disease-free survival rate in adult patients of 56% . Relapse of SCC is common, with the cumulative relapse rate ~29% within 1-year of treatment.

Clinical Characteristics of Metastatic Squamous Cell Carcinoma

Onset:Few large studies of metastatic cutaneous squamous cell carcinoma are available. One of the largest was performed by Martinez et al 2003 who followed 68 pts with 73 distinct metastatic skin cancers . In this study, the mean onset of metastatic SCC occurred 10.7-years following transplantation. The mean time with which metastatic SCC was detected after diagnosis of the primary SCC lesion was 1.4-years.

Location:The location where metastatic SCC was detected varied. 36% of patients had in-transit metastasis, metastasic foci located between the primary tumor and the closest lymph node region. These usually represent SCC spread along lymphatic vessels and/or nerves. 78% had lymph node metastasis occurring in draining nodal basins, and 35% had distant systemic/visceral metastasis. The most common sites for distant disease were lung and bone.

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What About Other Treatments That I Hear About

When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.

Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything youre thinking about using, whether its a vitamin, a diet, or anything else.

What Are The Symptoms Of Squamous Cell Skin Cancer Of The Head And Neck

Squamous cell skin cancers usually present as an abnormal growth on the skin or lip. The growth may have the appearance of a wart, crusty spot, ulcer, mole or a sore that does not heal. It may or may not bleed and can be painful. If you have a preexisting mole, any changes in the characteristics of this spot such as a raised or irregular border, irregular shape, change in color, increase in size, itching or bleeding are warning signs. Pain and nerve weakness are concerning for cancer that has spread. Sometimes a lump in the neck can be the only presenting sign of skin cancer that has spread to lymph nodes, particularly when there is a history of previous skin lesion removal.

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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.

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