What is squamous cell carcinoma?

SCC is the second most common type of skin cancer after basal cell carcinoma. SCC accounts for 20% of all skin cancer diagnoses. It may also be called cutaneous squamous cell carcinoma (cSCC) to identify it as skin cancer, because squamous cell tumors can also develop in other parts of the body such as the mouth, throat and lungs. The middle and outer layers of the skin are made of squamous cells.

Most often SCC is not life-threatening. However, it is more aggressive than basal cell carcinoma and can grow deep into the skin and spread or metastasize to other parts of the body. SCC is the most common type of skin cancer in African Americans.

Every year, more than one million Americans are diagnosed with SCC. Most can be successfully treated if caught early. If not diagnosed and treated early, SCC can be disfiguring and even deadly. In fact, more than 15,000 Americans die from SCC each year.

What causes SCC?

The main cause is chronic UV exposure to unprotected skin from the sun or a tanning bed. The UV radiation causes DNA damage which results in cell changes that cause the cells to grow out of control. However, SCC can develop on body areas not usually exposed to the sun, including the genitals.

What are the risk factors?

• A history of sun burns.
• A previous SCC, BCC, melanoma or actinic keratosis (a precancerous lesion).
• People with a weak immune system caused by a disease or from immune suppressive drugs, as seen in organ transplant recipients commonly.
• Fair- skinned people, especially men over the age of 50.
• People who become photosensitive due to a medical condition, a prescription medication, an over the counter medication, or a genetic disorder.
• People with chronic infections and skin inflammation from burns and scars.
• People with HPV.

What are the warning signs?

SCC can develop on anywhere on the body. It can also develop in scars, skin sores and other injuries to the skin.

Not all SCCs look the same. The tumor may look like a wart or an open sore that bleeds, crusts or itches but does not heal. It may have raised edges and a crater-like center and grows rapidly or a persistent scaly red patch with irregular borders that crusts and bleeds.

How is SCC diagnosed?

A board-certified dermatologist will review your medical history and conduct an examination. Suspicious lesions will be biopsied to confirm the diagnosis. A biopsy is a small sample of the lesion which is sent to a lab for microscopic analysis and diagnosis.

What are the treatment options?

The choice of treatment depends on the location, size, depth of the tumor and your age and health. Early stage SCC can be cured before it has spread to the lymph nodes or other organs.

When determining treatment options, a key factor is whether treatment will affect your appearance. Because many SCCs are found on the eyes, lips, nose, and scalp, standard excision may be disfiguring. Therefore, micrographic surgery called Mohs surgery may be recommended to spare healthy tissue and reduce the risk of recurrence.

Options for early stage, small and superficial SCCs include:

• Excisional surgery – the tumor is cut out along with a wide margin of normal skin.
• Cryosurgery – freezing the tumor with liquid nitrogen.
• Electrosurgery – the growth is cut off and then burned with an electrocautery needle to kill any remaining cancer cells and stop the bleeding. This procedure may need to be repeated during the surgery to assure all cancer cells are removed.
• Laser surgery – the laser vaporizes the cancerous cells.
• Mohs microscopic surgery – the tumor is removed in thin layers until no more cancer cells can be seen under a microscope. This is tissue sparing and requires specialized training.
• Radiation Therapy – When the tumor is not able to be removed surgically, the tumor is large or in an area that is difficult to reach, or the patient has other medical problems and cannot undergo surgery, radiation therapy may be recommended. Radiation may also be used in combination with surgical treatment options in higher risk SCCs.

Treatment for advanced SCC will include lymph node dissection and may include immunotherapy, targeted drug therapy and chemotherapy.

When you notice an abnormal growth with unusual characteristics like bleeding, don’t wait! Contact Phoenix Surgical Dermatology Group in Phoenix, AZ. You will be evaluated by a board-certified dermatologist.