Squamous Cell Carcinoma

Squamous Cell Carcinoma

Squamous Cell Carcinoma is a common type of skin cancer that typically appears on sun-exposed skin because of increased Ultraviolet (UV) ray exposure. In these areas, SCCs can develop from untreated Actinic Keratoses. However, it is important to know that SCCs can appear elsewhere on the body, including inside the mouth, on the lip, or on the genitals.

  • Like Basal cell carcinomas (BCCs), SCCs can grow deeply and become locally disruptive, but it is important to note that they are slightly more aggressive and likely to spread to other parts of the body. This can be deadly. Certain locations are more prone to developing more dangerous SCCs: the lips, ears, and genitals.
  • SCCs can have the following appearance:
    • Hard, scaly or crusty, reddish bump or patch
    • Open sore that itches and bleeds; it may heal, but will return
    • Scaly or thickened patch on the lip

Risk Factors

People of all skin colors get SCC although it is more common in caucasians. Your everyday activities expose you to ultraviolet (UV) rays, which damage your skin. You receive this exposure every time you go outdoors during the day, when you drive your car or sit near your office window.

People who use tanning beds have a much higher risk of getting SCC. They also tend to get SCC earlier in life. Your risk of developing SCC increases if you have any of the following factors:

  • Your physical traits
    • Pale or light-colored skin
    • Blue, green, or gray eyes
    • Blonde or red hair
    • An inability to tan
  • Your life experiences
    • Spent a lot of time outdoors, for work or leisure, without using sunscreen or covering up with clothing
    • Used tanning beds or sunlamps
  • Your medical history
    • Diagnosed with actinic keratoses (AKs)
    • Badly burned your skin
    • Have an ulcer or sore on your skin that has been there for many months or years
    • Taking medicine that suppresses your immune system, like those after an organ transplant
    • Infected with human papillomavirus (HPV)
    • Had many PUVA light treatments
    • Have an inherited condition that increases the risk of SCC like xeroderma pigmentosa, epidermolysis bullousa, or albinism

Some SCCs begin as a precancerous growth called an actinic keratosis or AK. Most AKs share common qualities such as being dry, scaly, and rough-textured. A single AK may range from the size of a pinhead to larger than a quarter.

Diagnosis

To diagnose SCC, a dermatologist performs a skin biopsy. This is the only way to confirm a diagnosis of skin cancer, including SCC. Your dermatologist can perform a biopsy using local anesthesia during an office visit.

Your dermatologist will biopsy all or a representative sample of the growth depending on its size and location on your body. This tissue will be sent to a pathologist to evaluate under the microscope and determine the diagnosis.

If the diagnosis is SCC, your dermatologist will consider many factors to determine the best treatment for you, including where the SCC appears on your body, the size and features of the SCC, and your overall health.

Prevention

  • Keep all appointments with your dermatologist. When found early, skin cancer can often be cured.
  • Perform skin self-examinations. Examine your skin as often as your dermatologist recommends. Be sure to check your scalp, ears, genitals, and buttocks.
  • If you notice anything on your skin that is changing, itching, or bleeding, immediately make an appointment to see your dermatologist.
  • Protect your skin every day by:
    • Seeking shade. Shade helps protect your skin from the sun’s harmful UV rays. Shade is especially important between 10 a.m. and 2 p.m. when the sun’s rays are strongest. But any time your shadow is shorter than you are, seek shade.
    • Wearing protective clothing. This means wearing a long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses, when possible.
    • Generously applying sunscreen that offers broad-spectrum (UVA and UVB) protection, water-resistance, and a Sun Protection Factor (SPF) of 30 or more. Be sure to apply the sunscreen 15 minutes before going outside. Apply it to all skin that clothing will not cover. You should reapply sunscreen every two hours, even on cloudy days. After swimming or sweating, you also need to reapply your sunscreen.
    • Protect your skin when around water, snow, and sand. These reflect and intensify the damaging rays of the sun.
    • Never use a tanning bed. UV light from tanning beds can cause skin cancer and wrinkling. If you want to look tan, consider using a self-tanning product or spray. Even when using one of these products, you need to use sunscreen.
    • Use condoms. This can prevent an HPV infection, which reduces the risk for getting SCC on the genitals.
    • Limit the amount of alcohol you drink and do not smoke. Smoking tobacco and drinking alcohol can increase your risk of getting SCC in your mouth.

*Source:

American Academy of Dermatology

Treatment

When detected early and treated properly, SCC is highly curable. There are many effective treatments. A dermatologist selects treatment after considering the following: the type of SCC, where it appears on the body, a patient’s overall health. After considering this, one or a combination of the following treatment options may be recommended. Left untreated, SCC can spread to other parts of the body, making treatment difficult. Treatment for SCC involves having one or more of the following.

  • Surgical treatment: Surgical reduction can be done in a dermatologist's office under local anethesia using one of the following techniques. A small amount of normal skin is also treated as skin cancer cells can microscopically involve normal looking skin.
    • Excision: The lesion and a small amount of normal-looking skin (margins) surrounding the skin cancer are cut. What is treated is sent, like the initial biopsy, to a pathologist for microscopic examination to ensure all of the margins are clear of the skin cancer. Stitches are used for wound closure.
    • Mohs surgery: A dermatologist who has completed additional training in Mohs surgery performs this procedure. The skin cancer and a much smaller margin of normal skin is removed and checked immediately in the office. If any of the margins are still involved in the skin cancer, that specific area of involved skin is taken and rechecked. This occurs until all margins are clear. Once this is achieved, the surgeon may use different techniques including flaps or grafts, to close the skin together.
    • Curettage and electrodesiccation: This surgical procedure may be used to treat shallow basal cell and squamous cell skin cancers. It involves scraping the tumor with a curette (a circular blade) followed by gentle cauterization (burning) of the site. This scraping and cauterizing process is typically repeated 3 times. The wound may heal without stitches.
  • Radiation therapy Radiation may be used to treat older adults who have a large skin cancer, skin cancers that cover a large area, or a skin cancer that is difficult to surgically treat. Radiation therapy gradually reduces the cancer cells through repeted exposure to radiation. A patient may receive 15 to 30 treatments. Many years after a person is exposed to radiation, there is a risk of new skin cancers developing in the treated skin.

Because actinic keratoses can become squamous cell carcinomas, monitoring for and treating them is important. There are several options for the treatment of AKs.

*Source:

American Academy of Dermatology

What We Do

Procedures

  • Full Body Skin Examinations
  • Biopsies to confirm the diagnosis
  • Electrodesiccation & curettage
  • Excisions

If I have SCC, am I at greater risk of developing other skin cancers?

Yes. Studies show that people who have one skin cancer are at greater risk of developing another skin cancer. Perform regular skin self-examinations, and protect your skin every day. Be sure to keep all appointments with your dermatologist, and make an immediate appointment if you notice anything changing, itching, or bleeding on your skin.

Are tanning beds ever safe?

No. Never use a tanning bed. UV light from tanning beds can cause skin cancer and wrinkling. If you want to look tan, consider using a self-tanning product. Remember that even when using one of these products, you need to use sunscreen.

What does SPF mean?

SPF stands for “Sun Protection Factor.” It is a measure of how well the sunscreen protects you from harmful UV rays from the sun. Sunscreen must be re-applied every two to three hours, even if it has a high SPF number. Adults and children should always wear at least SPF 30.

*Source:

American Academy of Dermatology

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