When Should I See My Healthcare Provider
Make an appointment to see your healthcare provider or dermatologist as soon as you notice:
- Any changes to your skin or changes in the size, shape or color of existing moles or other skin lesions.
- The appearance of a new growth on your skin.
- A sore that doesnt heal.
- Spots on your skin that are different from others.
- Any spots that change, itch or bleed.
Your provider will check your skin, take a biopsy , make a diagnosis and discuss treatment. Also, see your dermatologist annually for a full skin review.
Causes Of Skin Cancer
Different forms of skin cancer develop when there are mutations in the DNA of skin cells. Skin cancer begins with a mutation in the epidermis, which is the top layer of the skin. Cells begin to multiply and grow out of control, eventually forming a cancerous mass.
While various risk factors have been identified, it is not always apparent what factor actually causes skin cell DNA to mutate.
One cause of skin cancer that is clear is exposure to sunlight . The ultraviolet rays in sunlight and tanning beds can cause extensive damage to the DNA in skin cells. In turn, these damaged cells may someday become cancerous. Harmful UV radiation can occur relatively soon before the appearance of skin cancer, but it can also pre-date a cancer diagnosis by many years.
However, UV radiation cant explain skin cancers that occur on body parts that arent exposed to the sun. This suggests that different causes exist for certain cases of skin cancer. Among these causes, for instance, may be a drastic or repeated exposure to toxic substances.
In some cases, a person may inherit genes that lead to melanoma. Certain gene changes received from a parent could cause a failure in the body to control unruly cell growth, eventually resulting in melanoma. These inherited, or familial, melanomas are relatively rare.
What Do Stage 4 Tumors Look Like
A change to an existing mole or normal skin can be the first sign that the cancer has spread. But the physical symptoms of stage 4 melanoma arent the same for everyone. A doctor will diagnose stage 4 melanoma by looking at the primary tumor, the spread to nearby lymph nodes, and whether the tumor has spread to different organs. While your doctor wont base their diagnosis only on what your tumor looks like, part of their diagnosis involves looking at the primary tumor.
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Red Flag #: Bone Pain Or Fractures
The bones are considered a late-stage site of melanoma metastasestypically, it doesnt spread to the bones until its already spread to another area of the body first. Melanoma can cause pain in the bones where its spread, and some peoplethose with very little body fat covering their bonesmay be able to feel a lump or mass. Metastatic melanoma can also weaken the bones, making them fracture or break very easily. This is most common in the arms, legs, and spine. If you feel any sharp, sudden, or new pains that wont go away, talk to your doctor.
How Cancer Can Spread To Other Areas Of The Body
Cancer cells can spread to other parts of the body through the bloodstream or lymphatic system . There they can start to grow into new tumours.
Cancers are named according to where they first started developing. For example, bowel cancer that has spread to the liver is called bowel cancer with liver metastases or secondaries. It is not called liver cancer. This is because the cancerous cells in the liver are cancerous bowel cells. They are not liver cells that have become cancerous.
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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.
How Long Does It Take For A Squamous Cell Skin Cancer To Spread
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Spreading To The Organs
After the cancer has spread to the lymph nodes, the lymph nodes and/or blood vessels help the cancer move to other areas of the body, like the organs. Which organ it will spread to first, varies depending on where the cancer started, the type and the person, but the liver, lungs, and brain are common sites for metastases.
Once its in the organs, it is known as stage four melanoma.
Questions To Ask The Doctor
- Do you know the stage of the cancer?
- If not, how and when will you find out the stage of the cancer?
- Would you explain to me what the stage means in my case?
- What will happen next?
There are many ways to treat skin cancer. The main types of treatment are:
Most basal cell and squamous cell cancers can be cured with surgery or other types of treatments that affect only the spot on the skin.
The treatment plan thats best for you will depend on:
- The stage and grade of the cancer
- The chance that a type of treatment will cure the cancer or help in some way
- Your age and overall health
- Your feelings about the treatment and the side effects that come with it
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Tests That May Be Done
The doctor will ask you questions about when the spot on your skin first showed up and if it has changed in size or the way it looks or feels. The rest of your skin will be checked. During the exam your doctor will check the size, shape, color and texture of any skin changes. If signs are pointing to skin cancer, more tests will be done.
In a biopsy, the doctor takes out a small piece of tissue to check it for cancer cells. A biopsy is the only way to tell for sure if you have skin cancer and what kind it is.
There are many types of skin biopsies. Ask your doctor what kind you will need. Each type has pros and cons. The choice of which type to use depends on your own case.
In rare cases basal and squamous cell skin cancer can spread to the nearby lymph nodes Ask your doctor if your lymph nodes will be tested.
Basal and squamous cell cancers don’t often spread to other parts of the body. But if your doctor thinks your skin cancer might spread, you might need imaging tests, such as MRI or CT scans.
How Melanoma Moves From Its Original Site
When a tumor gets too big, it requires more oxygen and nutrients to survive. This is when the tumor sends out signals that cause new blood vessels to grow into the tumor , bringing the nutrients and oxygen to it.
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After angiogenesis occurs, cancer cells are now able to break off and enter the bloodstream. They can also break off and spread through the lymphatic system . When this happens, the cancer cells can now settle and take root in a new area of the body.
According to the American Cancer Society, three things need to happen in order for the cancer cells to metastasize in a new area.
One: they need to attach to the wall of a blood or lymph vessel and move through it into a new organ.
Two: they need to have the necessary nutrients to grow on the new site.
Three: They must resist attacks from the immune system.
If the cancer cells manage to do all of these things, then a new tumor will develop. Typically, it will look slightly different from the cancer cells in the original tumor as a result of its journey.
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How To Tell If Squamous Cell Carcinoma Has Spread
While its not common for squamous cell carcinoma to spread, it is helpful to be mindful of the signs. First, there are certain known risk factors to be aware of, as these characteristics have been associated with a higher stage of squamous cell carcinoma. Risk factors for squamous cell spreading include:
- The tumor is thicker than 2 millimeters.
- The tumor has grown into the lower dermis or subcutis layers of the skin.
- The tumor has grown into the nerves in the skin.
- The tumor is present on the ear or on a hair-bearing lip.
Knowing the stage of your cancer will help your medical team understand how serious it is and how best to treat it. Staging squamous cell carcinoma is based on a physical exam, detailed history, skin biopsy, lymph node biopsy, and imaging studies.
To determine if your cancer has spread, your physician may recommend several diagnostic tests. A skin or lymph node biopsy can show how far cancer cells have spread in the region of the primary tumor. Your medical team may also recommend a computed tomography scan to determine the spread.
You may also be able to recognize squamous cell carcinoma spreading by its appearance. Possible symptoms of squamous cell carcinoma include:
- A thick, red, scaly patch of skin
- An open sore or scar
- An elevated growth that is usually pink, red, or the color of your flesh.
- A wartlike nodule with raised edges
While most squamous cell carcinoma lesions are painless, it is possible to experience pain or numbness at the site.
Spread Through The Bloodstream
Cancer cells can go into small blood vessels and then get into the bloodstream. They are called circulating tumour cells .
Researchers are looking at using circulating tumour cells to diagnose cancer instead of a tissue sample . And at whether they can test circulating cancer cells to predict which treatments will work better. They are also looking to detect circulating tumour DNA to help diagnose cancer and monitor treatment.
The circulating blood sweeps the cancer cells along until they get stuck somewhere. Often they get stuck in a very small blood vessel such as a capillary.
Then the cancer cell must move through the wall of the capillary and into the tissue of the organ close by. The cell can multiply to form a new tumour if:
- the conditions are right for it to grow
- it has the nutrients that it needs.
This is quite a complicated process and most cancer cells donât survive it. Of the many thousands of cancer cells that reach the bloodstream, only a few survive to form a secondary cancer.
The white blood cells in our immune system find and kill some cancer cells. Others cancer cells might die because they get battered around by the fast flowing blood.
Cancer cells in the circulation may try to stick to platelets to form clumps to give themselves some protection. Platelets are blood cells that help the blood to clot. This could also help the cancer cells to move into the surrounding tissues.
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The 4 Stages Of Melanoma
Two main things determine the stage of melanoma: The thickness or depth of the tumor and how far it has spread when its diagnosed, explains David Polsky, M.D., dermatologist at NYU Langone Medical Center in New York City. In stages 0, 1, and 2, the melanoma is limited to the skin. In stage 3, its spread to the lymph nodes, small structures throughout your body that help filter fluids and fight infection. In the most advanced stage, stage 4, melanoma cells have broken away from the original tumor, traveled through the body and formed a new tumor somewhere else.
How Fast Does Squamous Cell Carcinoma Spread
Squamous cell carcinoma rarely metastasizes , and when spreading does occur, it typically happens slowly. Indeed, most squamous cell carcinoma cases are diagnosed before the cancer has progressed beyond the upper layer of skin. There are various types of squamous cell carcinoma and some tend to spread more quickly than others.
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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.
Symptoms Of Squamous Cell Carcinoma
A key factor used to identify a Squamous Cell Carcinomas is any ongoing change that persists beyond a few weeks in a lesion on the skin.
Squamous Cell Carcinomas typically appear as persistent, thick, rough, scaly patches that can bleed if bumped, scratched or scraped.
If you observe two or more of the signs below, you should consult the Bondi Junction Skin Cancer Clinic immediately.
Squamous Cell Carcinoma can sometimes resemble non-cancerous skin conditions such as psoriasis or eczema.
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What Will Happen After Treatment
Youll be glad when treatment is over. Your doctor will want you to check your skin at least once a month. It will be very important to protect yourself from getting too much sun.
For years after treatment ends, you will see your skin cancer doctor. At first, your visits may be every few months. Then, the longer youre cancer-free, the less often the visits are needed. Be sure to go to all of these follow-up visits. Your doctor will ask about symptoms and check you for signs of the cancer coming back or a new skin cancer. Other exams and tests may also be done.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your cancer care team to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life making healthy choices and feeling as good as you can.
What Is The Success Rate For Treating Squamous Cell Carcinoma
Unlike basal cell carcinoma, squamous cell carcinoma tends to be more invasive and is likely to spread if left untreated. As with basal cell carcinoma, Mohs micrographic surgery has the best success rates, at 97 percent. Excision has a 92 percent success rate. For low-risk, small tumors, curettage, and electrodesiccation is successful in 96 percent of cases, but it cannot be used for larger, deeper growths.
Squamous cell carcinoma is generally not considered life-threatening if treated early. However, if left untreated, squamous cell carcinoma can spread and it can then become life-threatening. Reliable statistics are not available, however, because most of these cancers are treated in a dermatologists office.
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What Are The Symptoms Of Squamous Cell Carcinoma
Squamous cell carcinomas are usually raised growths, ranging from the size of a pea to the size of a chestnut. They may appear as scaly red patches, open sores or protruding growths with a dented center, or they may look like a wart. Most are found in areas of the body that are frequently exposed to the sun, such as the ears, lips, face, balding scalp, neck, hands, arms, and legs. Less commonly, they may appear on mucous membranes and genitals. Regardless of what form the bumps take, they do not heal or go away on their own.
Can Basal Cell Carcinoma Spread
Basal cell carcinoma, the most common type of skin cancer, develops most commonly after frequent sun exposure or tanning bed use. Basal cell carcinoma is a slow-growing cancer, but early treatment is important because, if left untreated, basal cell carcinoma can spread and grow deep into the skin. My surgeon told me many years ago that, what appears to be a small area of basal cell carcinoma on the surface of the skin, can actually be as large as a silver dollar in other layers of the skin.
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Does Skin Cancer Affect People With Skin Of Color
People of all skin tones can develop skin cancer. If you are a person of color, you may be less likely to get skin cancer because you have more of the brown pigment, melanin, in your skin.
Although less prevalent than in nonwhite people, when skin cancer does develop in people of color, its often found late and has a worse prognosis. If youre Hispanic, the incidence of melanoma has risen by 20% in the past two decades. If youre Black and develop melanoma, your five-year survival rate is 25% lower than it is for white people . Part of the reason may be that it develops in less typical, less sun-exposed areas and its often in late-stage when diagnosed.