Squamous Cell Carcinoma


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 (SCC).

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(d) 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 (AKs). Some AKs progress, turning into squamous cell carcinoma (SCC) of the skin.

Although SCC is most common in people who have fair skin, people of all colors get this skin cancer. In people who have skin of color, SCC tends to develop in areas that get little or no sun, such as the mouth, genitals, or anus. It’s believed that the cause of the skin cancer in these areas may be an injury or human papillomavirus (HPV) infection.

Whether the cause is sunlight, tanning beds, injury, or an HPV infection, this skin cancer can show up on the skin in various ways, such as a non-healing sore or patch of rough skin.

Many SCCs develop from an existing precancerous actinic keratosis (AK) or actinic cheilitis. SCCs usually appear as thick, rough, scaly patches that may bleed if bumped. They often look like warts and sometimes appear as open sores with a raised border and crusted surface over an elevated pebbly base. The skin around SCCs typically shows signs of sun damage such as wrinkling, pigment changes, and loss of elasticity. These lesions persist for weeks and occasionally bleed. They may also rapidly increase in size.

In general, SCCs are more threatening than BCCs and have a greater chance of spreading and becoming life threatening if untreated.

Skin Cancer Treatment Options for Squamous Cell Carcinoma:

  • Curettage and Electrodesiccation – As with AKs, the growth is scraped off with a curette, but when treating SCCs, the procedure is typically repeated a few times to help assure that all cancer cells are eliminated. Local anesthesia is required, and bleeding is controlled with an electrocautery needle.
  • Excisional Surgery – Along with the above procedure, this is one of the most common treatments for SCCs. Using a scalpel, the physician removes the entire growth along with a surrounding border of apparently normal skin as a safety margin. The incision is closed, and the growth is sent to the laboratory to verify that all cancerous cells have been removed.
  • Mohs Micrographic Surgery – The physician removes the tumor with a curette or scalpel and then removes very thin layers of the remaining surrounding skin one layer at a time. Each layer is checked under a microscope, and the procedure is repeated until the last layer viewed is cancer-free. This technique saves the greatest amount of healthy tissue and may reduce the rate of local recurrence. It is often used for tumors that have recurred or are in hard-to-treat places such as the head, neck, hands, and feet.
  • Cryosurgery, laser surgery, and photodynamic therapy – the same treatments used to eliminate AKs can also be used to treat SCCs.
  • SCCs are easily treated when they are detected at an early stage. However, the larger a tumor grows, the more dangerous and potentially disfiguring it may become and the more extensive the treatment must be.