Different Kinds Of Skin Cancer
There are many types of skin cancer. Some are very rare. Your doctor can tell you more about the type you have.
The two most common kinds of skin cancers are:
- Basal cell cancer, which starts in the lowest layer of the skin
- Squamous cell cancer, which starts in the top layer of the skin
Another kind of skin cancer is called melanoma. These cancers start from the color-making cells of the skin . You can read about melanoma in If You Have Melanoma Skin Cancer.
Skin Cancer Treatment In Older Adults
According to Dr. Truong, Some of my older patients tell me they prefer to leave skin cancer untreated. Every patient has unique attributes and a different picture of overall health, therefore, the pros and cons of leaving cancer untreated must be thoroughly discussed to determine the most appropriate management. Most of the time, I will recommend treatment to avoid further complications in the future, however, in some cases, it is more appropriate to defer treatment. Each patient situation will be different, but at any age, a serious conversation with your dermatologist is necessary to determine whether or not skin cancer treatment is necessary for your specific situation.
My First Squamous Cell Skin Cancer
The morning of surgery, my doctor had me point out everything to him that needed to be removed. He compared it with the body map he had made in his office to make sure we would be getting everything.
As I pointed out the areas, he circled each one on me with a purple marker. The picture had 23 purple circles on my body I looked pretty funny. He counted the circles and told me we had ended up with one extra purple mark. I explained that the place on the tip of my nose had just shown up two days prior. He assumed that one would be squamous cell because they tend to show up rather quickly. And, unfortunately, pathology during surgery confirmed he was correct. This was my first squamous cell skin cancer.
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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.
Factors Other Than Growth Rate
The chance that a tumor will spread often depends on factors other than the growth rate or doubling time.
Previously, it was thought that a tumor had to reach a certain size, first spread to lymph nodes, and then onward from there. We know now that this simply isnt the case. Instead, it may be specific mutations in the tumor, or the normal cells around it, that allow new cancer cells to grow in that organ or tissue.
First, the cancer cells need to escape. Normal cells have molecules that hold them together. Different mutations in cancer cells can make it easier or harder to break loose. Then they have to travel through either the blood, lymphatic system, or airways.
Spreading through the lymphatic system takes longer, but spread through the bloodstream can seed cancer cells to other parts of the body much faster and sometimes, long before the tumor is found. Tumor cells in the bloodstream are common even in very early-stage NSCLC.
Most of the cancer cells that arrive in a new body location will die off. For growth to occur, the cells need a blood supply as well as a change in the environment so that the immune system doesnt attack them. To do this, they need to communicate with normal cells nearby. It could be that some lung cancer cells develop new mutations that allow them to establish blood supply in a new region more easily, rather than growing in size and spreading via lymph nodes.
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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?
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What Are The Risk Factors For Squamous Cell Skin Cancer
Squamous cell skin cancer is mainly caused by cumulative ultraviolet exposure from the sun, according to Dr. Leffell.
Daily year-round exposure to the suns UV light and intense exposure in the summer months add to the damage that causes this type of cancer, he says. People at the highest risk for squamous cell skin cancer tend to have light or fair-colored skin blue, green or gray eyes a history of sun exposure and a tendency to sunburn quickly. Squamous cell cancers occur four times more frequently in men than in women.
Although squamous cell cancer can be more aggressive than basal cell cancer, the risk of this type of cancer spreading is lowas long as the cancer is treated early, Dr. Leffell says. He notes that the lesions must be treated with respect because they may grow rapidly and invade deeply. While it is more difficult to treat squamous cell cancer that has metastasized, up to half of cases can be cured.
In a small percentage of cases, squamous cell skin cancer can grow along the tiny nerves in the skin. In this very serious condition, the squamous cell cancer of the face or scalp can travel along the nerves and spread to the brain.
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When To Seek Medical Care
If you have developed a new bump on sun-exposed skin, or if you have a spot that bleeds easily or does not seem to be healing, then you should make an appointment with your primary care physician or with a dermatologist. You should also make an appointment if an existing spot changes size, shape, color, or texture, or if it starts to itch, bleed, or become tender.Try to remember to tell your doctor when you first noticed the lesion and what symptoms, if any, it may have . Also be sure to ask your parents, siblings, and adult children whether or not they have ever been diagnosed with skin cancer, and relay this information to your physician.
Can Squamous Cell Carcinoma Be Prevented
The best way to prevent SCC is to avoid sunburn. Avoid going outin the sun when the UV Index is higher than 3, such as in the middle of theday. Seek shade, wear a hat, sunglasses and clothing that protects you from thesun, and always use an SPF30+ sunscreen. Do not go to tanningsalons.
If you are at very high risk of developing another skin cancer, yourdoctor may prescribe you specific vitamins.
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Can Squamous Cell Cancer Be Misdiagnosed
LISBON Two of 10 nonmelanoma skin cancers are misdiagnosed as being of a nonaggressive tumor subtype at initial biopsy, according to Dr. Nathalie Zeitouni. This raises concern that a substantial number of biopsied squamous and basal cell carcinomas are being treated suboptimally, Dr. Zeitouni said at the congress.
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Scc Is Mainly Caused By Cumulative Uv Exposure Over The Course Of A Lifetime
If youve had a basal cell carcinoma you may be more likely to develop a squamous cell skin carcinoma, as is anyone with an inherited, highly UV-sensitive condition such as xeroderma pigmentosum.
Chronic infections, skin inflammation, HIV and other immune deficiency diseases, chemotherapy, anti-rejection drugs used in organ transplantation, and excessive sun exposure can all lead to a risk of squamous cell carcinoma.
Occasionally, squamous cell carcinomas arise spontaneously on what appears to be normal, healthy skin. Some researchers believe the tendency to develop these cancers can be inherited.
SCCs may occur on all areas of the body including the mucous membranes and genitals, but are most common in areas frequently exposed to the sun:
- Ears
- Previous BCC or SCC
- Chronic inflammatory skin conditions or chronic infections
But anyone with a history of substantial sun exposure is at increased risk. Those whose occupations require long hours outside or who spend their leisure time in the sun are also at risk.
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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
Can Squamous Cell Carcinoma Be Cured
The majority of SCC tumors are found early and treated while they are still small. Treatment at an early stage can usually remove SCC.2
SCC is more likely than BCC to invade deeper layers of skin and spread to other parts of the body.2 This is uncommon. However, about 5% to 10% of SCC tumors are considered aggressive.2,4 It is more difficult to treat aggressive SCC. By one estimate, between 3,900 and 8,800 white individuals died from SCC in 2012.1 In the Midwest and southern United States, SCC may cause as many deaths as melanoma.1
Your dermatologist may recommend regular follow up for several years after treating any SCC. Most of the cases that return do so with 2 years of initial treatment.5
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How Can Squamous Cell Carcinoma Of Oral Cavity Be Prevented
A few methods to prevent Squamous Cell Carcinoma of Oral Cavity include:
- Maintain proper oral hygiene
- Avoid chewing tobacco and smoking
- Avoid prolonged and chronic exposure to the sun
Regular medical screening at periodic intervals with blood tests, scans, and physical examinations, are mandatory, due to its high metastasizing potential and possibility of recurrence. Often several years of active vigilance is necessary.
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.
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Understanding Your Stage Of Squamous Cell Skin Cancer
The stage is based on the size of the tumor, how deeply into the skin it has grown, and whether cancer has spread beyond the tumor to the lymph nodes. Your doctor will look at the results of the biopsy to determine the stage. If you have squamous cell skin cancer, your doctor may also recommend imaging such as CT or PET-CT scan, or testing lymph nodes near the tumor to see if the cancer has spread beyond the skin.
Most non-melanoma skin cancers are Stage 0 or Stage 1. Stage 3 and 4 are relatively rare. Based on the type of cancer, the stage of cancer, your overall health, and other factors, your doctor works with you to develop a treatment plan.
Is There A Cure For Squamous Cell Carcinoma
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.
Many doctors will order a PET or CT scan once a squamous cell carcinoma diagnosis has been reached to ensure the cancer has not spread to other parts of the body and is contained within the layers of the skin. Your doctor may also test your lymph nodes near the tumor site.
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Stage Iii Squamous Cell Carcinoma
The tumor cells may be of any size at the original site. A stage III SCC has begun to invade the nearby lymph nodes on the side of the body of the original cancerous growth. This new growth is still under 3 cm in size. It may also have grown into the facial bones like the bones surrounding the eye or your jaw bone.9 It has not affected any other organs.10
How To Tell If Squamous Cell Carcinoma Has Spread
Many doctors will order a PET or CT scan once a squamous cell carcinoma diagnosis has been reached to ensure the cancer has not spread to other parts of the body and is contained within the layers of the skin. Your doctor may also test your lymph nodes near the tumor site.
Diagnostic services, staging services and a comprehensive range of treatments are all available at Moffitt Cancer Center, and referrals are not required. To learn more about squamous cell carcinoma stages and the treatment options for each, call or submit a new patient registration form online.
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Squamous Cell Carcinoma Stages
There are certain features that are considered to make the cancer at higher risk for spreading or recurrence, and these may also be used to stage squamous cell carcinomas. These include:
- Greater than 2 mm in thickness
- Invasion into the lower dermis or subcutis layers of the skin
- Invasion into the tiny nerves in the skin
- Location on the ear or on a hair-bearing lip
After the TNM components and risk factors have been established, the cancer is assigned to one of the five squamous cell carcinoma stages, which are labeled 0 to 4. The characteristics and stages of squamous cell cancer are:
Stage 0: Also called carcinoma in situ, cancer discovered in this stage is only present in the epidermis and has not spread deeper to the dermis.
Stage 1 squamous cell carcinoma: The cancer is less than 2 centimeters, about 4/5 of an inch across, has not spread to nearby lymph nodes or organs, and has one or fewer high-risk features.
Stage 2 squamous cell carcinoma: The cancer is larger than 2 centimeters across, and has not spread to nearby organs or lymph nodes, or a tumor of any size with 2 or more high risk features.
Stage 3 squamous cell carcinoma: The cancer has spread into facial bones or 1 nearby lymph node, but not to other organs.
Stage 4 squamous cell carcinoma: The cancer can be any size and has spread to 1 or more lymph nodes which are larger than 3 cm and may have spread to bones or other organs in the body.
Waited For My Scheduled Skin Check
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.
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