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.
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?
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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S Of Squamous Cell Carcinoma On The Skin
The following pictures show many of the ways that SCC can appear on the skin.
Rough-feeling, reddish patch
This is an early sign of squamous cell carcinoma.
Round growth with raised borders
This squamous cell carcinoma developed from a pre-cancerous growth called an actinic keratosis.
A sore that wont heal or heals and returns
On the skin or lips, squamous cell carcinoma can look like a sore.
This can be a sign of squamous cell carcinoma, which is why you want a board-certified dermatologist to examine your skin before you treat any age spot.
Raised, round growth
This is a common sign of squamous cell carcinoma of the skin.
When squamous cell carcinoma looks like this, it tends to grow quickly.
Because this common skin cancer can begin on any part of the body that has squamous cells, it can also develop inside the mouth, on the genitals, inside the anus, or in the tissue beneath a fingernail or toenail.
In these areas, this skin cancer may look like a:
Sore or rough patch
Brown or black line beneath a nail
Sore inside your mouth
This squamous cell carcinoma started inside the mouth and grew to cover a larger area.
Dark streak beneath a nail
Squamous cell carcinoma can look like a brown or black line beneath a nail, as shown here.
When it develops around the nail, it can look like a wart that just wont go away. If youve had a wart around a fingernail for years, its time for a dermatologist to examine it.
How Do People Find Bcc On Their Skin
Many people find it when they notice a spot, lump, or scaly patch on their skin that is growing or feels different from the rest of their skin. If you notice any 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 BCC. Youll find out what can increase your risk of getting this skin cancer at, Basal cell carcinoma: Who gets and causes.
Images used with permission of:
The American Academy of Dermatology National Library of Dermatologic Teaching Slides.
J Am Acad Dermatol. 2019 80:303-17.
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Does Squamous Cell Carcinoma Have A High Recurrence Rate
Squamous cell carcinoma doesn’t have an extremely high recurrence rate, meaning it isn’t extremely likely that the cancer will come back after treatment. However, it is possible for it to come back, especially if the squamous cell carcinoma had already advanced to a later stage when it was first treated. If it recurs, it will most likely be within the first 5 years after being treated. Also, having squamous cell carcinoma does increase your chance of developing another skin cancer in another place. Because of this, it’s important to have regular check-ups with your doctor after treatment to make sure the cancer hasn’t come back.
Keeping Health Insurance And Copies Of Your Medical Records
Even after treatment, its very important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think of their cancer coming back, this could happen.
At some point after your cancer treatment, you might find yourself seeing a new doctor who doesnt know about your medical history. Its important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment. Learn more in Keeping Copies of Important Medical Records.
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How Is Squamous Cell Carcinoma Diagnosed
The first step in diagnosing squamous cell carcinoma is regular self-examination. By checking your skin and skin spots regularly, you become familiar with what is normal for you. Then, if you see something abnormal, you can see your doctor.
Your doctor will examine your skin. He or she will look at the size, shape, color, and texture of any concerning areas. If you have changes that could be skin cancer, your doctor will remove a piece of the affected skin. This is called a biopsy. The piece of skin will be sent to a lab for testing.
If skin cancer is diagnosed, you may need to undergo more tests to see if the cancer cells have spread. These tests could include a CT scan, MRI, or lymph node biopsy.
Treatment Options For Recurrent Scc
A recurrent skin tumor is treated the same way as a high-risk primary tumor.4 Mohs surgery is the preferred option. Wide excision, radiation therapy, and chemotherapy are alternatives. Your doctor may recommend adjuvant therapy with radiation therapy or additional surgery.
If the cancer recurs in the lymph nodes or distant organs, treatment options include surgery, radiation therapy, and chemotherapy. Treatment options for advanced SCC are limited. Your doctor may recommend participating in a clinical trial.
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Lung Cancer Screening Criteria
The U.S. Preventive Services Task Force recommends annual screenings using CT for people who:
- Are 50 to 80 years old
- Have a 20 pack-year history of smoking
- Currently smoke or have quit smoking within the past 15 years
- Are healthy enough overall to tolerate and benefit from treatment if diagnosed with lung cancer
How Is Squamous Cell Skin Cancer Of The Head And Neck Diagnosed
Diagnosis is made by clinical exam and a biopsy. Squamous cell cancers are staged by size and extent of growth. Squamous cell cancers can metastasize to nearby lymph nodes or other organs, and can invade both small and large nerves and local structures.
Biopsy can help determine if the squamous cell cancer is a low-risk tumor or a high-risk tumor that requires more aggressive treatment. Low-risk tumors are less than 10 millimeters in size, less than or equal to 5 millimeters deep and do not involve structures beyond the surrounding fat. High-risk tumors in the head and neck are those that involve the central face, nose and eye area, as well as those tumors that are greater than or equal to 10 millimeters on the cheeks, scalp and neck, tumors that are more than 5 millimeters thick or involve adjacent structures, tumors that invade nerves, tumors that are recurrent or arising from previously radiated tissue, and tumors arising in patients who are immunosuppressed.
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What Are The Signs And Symptoms Of Basal Cell Carcinoma
Basal cell carcinoma is a type of skin cancer that can show up on the skin in many ways. Also known as BCC, this skin cancer tends to grow slowly and can be mistaken for a harmless pimple, scar, or sore.
Common signs and symptoms of basal cell carcinoma
This skin cancer often develops on the head or neck and looks like a shiny, raised, and round growth.
To help you spot BCC before it grows deep into your skin, dermatologists share these 7 warning signs that could be easily missed.
If you find any of the following signs on your skin, see a board-certified dermatologist.
Understanding The Recurrence Of Skin Cancer
Skin cancer is an uncontrolled growth of skin cells caused by skin damage from ultraviolet light. Most people who have skin cancer have squamous cell or basal cell cancer. The third main type is melanoma. All of these are curable if you catch them at an early stage. But all of them also can come back. The medical name for that is a recurrence.
If sun exposure harmed your skin in one area, it probably harmed it in other areas as well, especially near where your first skin cancer appeared. Thats the main reason for recurrence.
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Think Libtayo Could Be An Option For You Learn More About How Libtayo Can Help You Fight Advanced Cscc
What is the most important information I should know about LIBTAYO?
LIBTAYO is a medicine that may treat certain cancers by working with your immune system. LIBTAYO can cause your immune system to attack normal organs and tissues in any area of your body and can affect the way they work. These problems can sometimes become severe or life-threatening and can lead to death. You can have more than one of these problems at the same time. These problems may happen anytime during treatment or even after your treatment has ended.
Getting medical treatment right away may help keep these problems from becoming more serious. Your healthcare provider will check you for these problems during your treatment with LIBTAYO. Your healthcare provider may treat you with corticosteroid or hormone replacement medicines. Your healthcare provider may also need to delay or completely stop treatment with LIBTAYO if you have severe side effects.
Before you receive LIBTAYO, tell your healthcare provider about all your medical conditions, including if you:
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Please see full Prescribing Information, including Medication Guide.
What is LIBTAYO?
Moving On After Skin Cancer
Some amount of feeling depressed, anxious, or worried is normal after being diagnosed with cancer. Some people are affected more than others. But everyone can benefit from help and support from other people, whether friends and family, religious groups, support groups, professional counselors, or others. Learn more in Life After Cancer.
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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.
The Answer To The Question If Skin Cancer Can Come And Go Is Rather Tricky
Skin cancer coming and going would refer to malignant cells being there one day and then withering away shortly after without any treatment.
And then returning again in the same spot. This has not been shown to occur with the deadliest form of skin cancer, melanoma.
It has also not been shown to occur with another type of skin cancer called squamous cell carcinoma there are no cases confirming that this particular cancer was literally coming and going without treatment.
The same can be said for the most common cancer in the world, a skin growth known as basal cell carcinoma.
Howeverthe concept of a skin cancer coming and going appearing and disappearing spontaneously without treatment might be applicable to precancerous lesions.
Your immune system will help destroy some early stages of skin cancer like actinic keratosis, says Janet Prystowsky, MD, board certified dermatologist in New York, NY, with 30+ years experience.
Dr. Prystowsky adds, The growth may recur, however. The process may repeat itself.
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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.
Do You Need Chemo For Squamous Cell Carcinoma
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.
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Predictions Based On Doubling Times
Looking at doubling times of tumors is helpful only if the estimated doubling times can be used to predict the growth of a person’s tumor. One study looked at predicted survival times of people who had inoperable lung cancers and found that there was a close correlation between survival predicted from doubling time and actual survival.
Can I Lower My Risk Of Cancer Coming Back Or Getting New Skin Cancers
If you have skin cancer, you probably want to know if there are things you can do that might lower your risk of the cancer coming back, or of getting a new skin cancer.
People who have had skin cancer are at higher risk for developing another skin cancer. Because of this, its important to limit your exposure to UV rays Rays?) and to examine your skin every month for signs of possible new skin cancers. Seeing your doctor regularly for skin exams is also important. Skin cancers that are found early are typically much easier to treat than those found at a later stage.
Smoking has been linked to an increased risk of squamous cell skin cancer, as well as to many other types of cancer. If you smoke and are thinking about quitting, call the American Cancer Society for information and support at 1-800-227-2345.
Adopting other healthy behaviors such as eating well, being active, and staying at a healthy weight might help as well, but no one knows for sure. However, we do know that these types of changes can have positive effects on your health, including lowering your risk for many other types of cancer, as well as other diseases.