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What Is Squamous Cell Skin Cancer

Squamous Cell Carcinoma Prognosis And Survival Rate

What Is Squamous Cell Carcinoma? | Skin Cancer

If caught early, squamous cell carcinoma is highly treatable. While skin cancer is the most common cancer type among U.S. adults, cases are not required to be reported to cancer registries, so exact incidence breakdowns of types like squamous cell carcinoma are not known. However, according to numbers tracked by the Canadian Cancer Society, the five-year relative survival rate is 95 percent.

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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.

What Are The Signs And Symptoms Of Squamous Cell Carcinoma

SCC signs and symptoms include skin changes like:

  • A rough-feeling bump or growth which might then crust over and bleed.
  • A growth that is higher than the skin but has a depression in the middle.
  • A sore that will not heal, or a sore that heals and then comes back.
  • A piece of skin that is flat, is scaly and red.
  • A precancerous growth called actinic keratosis, which is a bump or lump that can feel dry, itchy, scaly, or be discolored.
  • A precancerous skin lesion called actinic cheilitis, which happens mainly on the lower lip. The tissue becomes pale, dry, and cracked.
  • A precancerous condition called leukoplakia, in which white spots develop in the mouth, on the tongue, gums, or cheeks

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What Causes Squamous Cell Carcinoma

A mutation to the p53 gene causes squamous cell carcinoma. The most common way that your p53 gene mutates is from ultraviolet exposure from the sun, or from using indoor tanning beds.

The p53 gene provides instructions for your cells to divide and replicate to replace cells when they reach the end of their lifespan. Your p53 gene is a tumor suppressor, which means that the gene controls how much and how often your cells should create new cells. Too many cells create tumors, which can be cancerous.

A mutation to the p53 gene means that your cells dont have the instructions they need to do their job correctly. As a result, your squamous cells divide and replicate too often, causing tumors to form in and on your body.

Treatment Of Squamous Cell Carcinoma

Squamous Cell Carcinoma (SCC)
  • Usually locally destructive techniques

Treatment of squamous cell carcinoma is similar to that for basal cell carcinoma Treatment Basal cell carcinoma is a superficial, slowly growing papule or nodule that derives from certain epidermal cells. Basal cell carcinomas arise from keratinocytes near the basal layer, which are read more and includes curettage and electrodesiccation, surgical excision, cryosurgery, topical chemotherapy and photodynamic therapy, or, occasionally, radiation therapy. Treatment and follow-up must be monitored closely because of the greater risk of metastasis compared with a basal cell carcinoma.

Squamous cell carcinoma on the lip or other mucocutaneous junction should be excised at times, cure is difficult.

Recurrences and large tumors should be treated aggressively with Mohs microscopically controlled surgery, in which tissue borders are progressively excised until specimens are tumor-free , or by a team approach with surgery and radiation therapy. Because tumors with perineural invasion are aggressive, radiation therapy should be considered after surgery.

Metastatic disease is responsive to radiation therapy if metastases can be identified and are isolated. Widespread metastases do not respond well to chemotherapeutic regimens. For inoperable advanced disease or metastatic disease, programmed death receptor 1 inhibitors are now an option.

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Can Bcc Be Cured

Most BCCs can be treated and removed with minor surgery or other local treatment. The goals of treatment are to completely remove all cancer cells while preserving the function and appearance of the affected body part. Less than 5 percent of BCCs come back after Mohs surgery and wide excision compared to 15 percent or higher for some other treatment options.8

Your doctor will recommend a treatment approach based on how likely the cancer is to grow back and its location. Even when one BCC is removed, your risk of another separate BCC is higher. Ask your doctor how oftenand for how many yearsyou should have follow-up exams.

How Can Cutaneous Squamous Cell Carcinoma Be Prevented

There is a great deal of evidence to show that very careful sun protection at any time of life reduces the number of SCCs. This is particularly important in ageing, sun-damaged, fair skin in patients that are immune suppressed and in those who already have actinic keratoses or previous SCC.

  • Stay indoors or under the shade in the middle of the day
  • Wear covering clothing
  • Avoid indoor tanning

Oral nicotinamide in a dose of 500 mg twice daily may reduce the number and severity of SCCs in people at high risk.

Patients with multiple squamous cell carcinomas may be prescribed an oral retinoid . These reduce the number of tumours but have some nuisance side effects.

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What Is Squamous Cell Carcinoma Of The Skin

Squamous cells are found throughout the human body. These cells line organs, such as the lungs, throat, and thyroid. We also have squamous cells in our skin.

The job of squamous cells is to protect what lies beneath. In our skin, these cells sit near the surface, protecting the tissue beneath.

Anywhere we have squamous cells, we can develop a type of cancer called squamous cell carcinoma .

In the skin, this cancer is usually not life-threatening. It tends to grow slowly, but it can grow deep. When the cancer grows deep, it can injure nerves, blood vessels, and anything else in its path. As the cancer cells pile up, a large tumor can form.

Most people who develop this skin cancer have fair skin that they seldom protected with sunscreen or sun-protective clothing. Before developing this skin cancer, they tend to notice signs of sun damage on their skin, such as age spots, patches of discolored skin, and deep wrinkles.

Anyone can develop squamous cell carcinoma

While anyone can develop this skin cancer, you have a greater risk if you live with a transplanted organ, use tanning beds, or have fair skin that you seldom protected from the sun.

Another sign of sun-damaged skin is having one or more pre-cancerous growths on your skin called actinic keratoses . Some AKs progress, turning into squamous cell carcinoma of the skin.

To find out what this skin cancer can look like and see pictures of it, go to: Squamous cell carcinoma of the skin: Signs and symptoms.

ImageGetty Images

The Second Most Common Skin Cancer

What is Squamous Cell Cancer? – Squamous Cell Cancer Explained [2019] [Dermatology]

Squamous cell carcinoma of the skin is the second most common form of skin cancer, characterized by abnormal, accelerated growth of squamous cells. When caught early, most SCCs are curable.

SCC of the skin is also known as cutaneous squamous cell carcinoma . Adding the word cutaneous identifies it as a skin cancer and differentiates it from squamous cell cancers that can arise inside the body, in places like the mouth, throat or lungs.

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When Should I See My Healthcare Provider

Contact your healthcare provider if:

  • You have any skin changes that worry you, including a new lump, mole or a sore that doesnt heal, or changes to a mole or spot youve had for some time.
  • You need to schedule your annual skin check appointment with your dermatologist.
  • You have any side effects or complications related to your treatment for squamous cell carcinoma, like pain, bleeding or itching.

Squamous Cell Carcinoma Treatment

Squamous cell carcinoma can usually be treated with minor surgery that can be done in a doctors office or hospital clinic. Depending on the size and location of the SCC, your doctor may choose different techniques to remove it.

For small skin cancers:

  • Curettage and electrodessication : removing the top layer of the skin cancer then using an electronic needle to kill cancer cells
  • Laser therapy: an intense light destroys the growth
  • : a photosensitizing solution applied to your skin then activated with a light or daylight, or sometimes with intense pulsed light
  • Cryosurgery: freezing of the spot using liquid nitrogen

For larger skin cancers:

  • Excision: cutting out the cancer spot and some healthy skin around it, then stitching up the wound
  • Mohs surgery: excision and then inspecting the excised skin using a microscope this requires stitching up the wound

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Basal Cell Carcinoma Stages

Squamous Cell Carcinoma

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 basal 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 given a stage. For basal cell carcinoma staging, the factors are grouped and labeled 0 to 4. The characteristics and stages of basal cell carcinoma 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 basal 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 basal 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 basal cell carcinoma: The cancer has spread into facial bones or 1 nearby lymph node, but not to other organs.

Stage 4 basal 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.

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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.

Symptoms Of Squamous Cell Carcinoma

Squamous cell carcinoma is characterized by its thick, scaly, irregular appearance, but it can have various appearances, and a doctor may be suspicious of any sores on sun-exposed surfaces that do not heal.

Squamous cell carcinoma begins as a red area with a scaly, crusted surface. As it grows, the tumor may become somewhat raised and firm, sometimes with a wartlike surface. Eventually, the cancer becomes an open sore and grows into the underlying tissue.

    Squamous cell carcinomas can have various appearances. This photo shows one that is raised, scaly, and crusted.

Image provided by Thomas Habif, MD.

    This red, irregular area on the arm was diagnosed as squamous cell carcinoma after a biopsy.

    Squamous cell carcinomas can have various appearances. This photo shows an area that is scaly, crusted, and darker than the surrounding skin. It was diagnosed as squamous cell carcinoma after a biopsy.

DR P. MARAZZI/SCIENCE PHOTO LIBRARY

    This squamous cell carcinoma on the lip shows excess build up of keratin that has broken down to form an open sore.

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How Will My Squamous Cell Carcinoma Be Diagnosed

If your doctor thinks that the lesion on your skin needs further investigation, you will be referred to a Dermatologist. To confirm the diagnosis, a small piece of the abnormal skin , or the whole area , will be removed using a local anaesthetic and sent to a pathologist to be examined under the microscope. The results will usually be available within a week to ten days.

What Are The Symptoms Of Squamous Cell Cancer

Squamous Cell Carcinoma Symptoms | Skin Cancer

SCC often occurs in areas exposed to UV radiation, such as the face, ears, and hands. However, it can also appear in the mouth, in the anal area, and on the genitals.

In its early stages, SCC often presents itself as a scaly, reddish patch of skin. As it progresses, it can turn into a raised bump that continues to grow. The growth may also crust or bleed. In the mouth, this cancer will take on the appearance of a mouth ulcer or a white patch.

In some cases, youll notice a new growth on a preexisting scar, mole, or birthmark. Any existing lesions or sores that arent healing can also indicate SCC.

Make an appointment with your doctor or dermatologist right away if you notice any of these symptoms. Early diagnosis and treatment are critical for preventing complications.

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What Are The Treatment Options For Squamous Cell Carcinoma Of The Skin

SCC is curable if treated in the early stages. Therapy is determined by the size and location of cancer, age, recurrence, and overall health.

  • Surgery: Surgery is usually the treatment of choice for SCC:
  • Mohs surgery: Cancerous tissue is removed and examined at the same time.
  • Excisional surgery: Malignant part of the skin is removed along with a portion of healthy tissue. Healthy tissue is examined to determine whether there has been a complete removal of malignant cells.
  • Electrosurgery: Lesion is scraped with the use of a curette and burned with an electrocautery needle to kill any leftover malignant cells and to reduce bleeding. This is usually performed on small lesions.
  • Chemotherapy:Drugs are applied directly on the lesions or injected into the tumorous growth to destroy the abnormal cells. If cancer advances and spreads, intravenous injections of chemo drugs such as cisplatin are given. Immunotherapy drugs may be given to increase the activity of immune cells and help fight cancer cells.
  • Radiation therapy: Radiation therapy has been found to be highly effective in treating SCC. The lesions or tumors are subjected to radiation to destroy the cancer cells.
  • Cryotherapy: In cryotherapy, liquid nitrogen is used to freeze the cancer cells. This therapy is often used for extremely small tumors or a patch of skin that seems odd but is not malignant.
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    What Should You Do After Receiving A Squamous Cell Carcinoma Diagnosis

    After being diagnosed with squamous cell carcinoma, its important to act quickly, since treating this malignancy early can increase the chances of survival. One of the first things you should do is choose a cancer specialistsuch as the ones at Moffitt Cancer Centerwho can stage the cancer, tell you more about your condition and the treatment options available to you and answer any questions you might have.

    Squamous cell carcinoma can be treated using a variety of different methods, and a cancer expert can recommend the one thats best suited to your specific needs . Some potential treatment options include:

    • Mohs surgery, which involves removing and examining thin layers of tissue until no more cancerous cells are found. Mohs surgery is offered in conjunction with the USF Department of Dermatology
    • Excisional surgery, which involves removing a cancerous lesion and a portion of the surrounding healthy tissue, then examining it to confirm that the cancerous cells have all been removed
    • Electrosurgery, which involves scraping away a lesion using a curette and then heating the area with an electrocautery needle in order to destroy any remaining cancerous cells and control bleeding

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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.

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