A type of skin cancer that occurs due to overproduction of squamous cells in the epidermis (the top layer of the skin) is called squamous cell carcinoma (SCC). People who are continuously exposed to the sun’s UV rays are at increased risk of developing this type of cancer. Usually, doctors recommend surgery to remove the tumor. Furthermore, in the early stages, this can be the only treatment needed.
Sometimes, this condition is called cutaneous squamous cell carcinoma (CSCC), and it is the second most common skin cancer after basal cell carcinoma. SCC may also develop in the parts of the body that contain mucous membranes (the inner lining of the organs and body cavities), such as the lungs, mouth, and anus.
Types of Squamous Cell Carcinoma
Healthcare providers have divided this cancer into two types, according to the location where the tumor develops. These include:
- Cutaneous – This type negatively affects the top layer of the skin only.
- Metastatic – In such cases, cancerous cells spread from the skin to other parts of the body.
This condition occurs quite commonly in the U.S. About 1 million people develop SCC each year. Furthermore, the rate of SCC has increased roughly 200% over the past 30 years.
Symptoms
Usually, people who develop SCC may notice the following symptoms. For example:
- A rough-feeling growth or bump that may crust over, similarly to a scab, and bleed
- Growths that are higher than the skin around and sink down in the middle
- A sore or wound that would not heal or heals and then returns
- Skin areas that are flat, scaly, and red and are larger than 1 inch (2.5 centimeters)
Check below also some symptoms that may indicate squamous cell carcinoma:
- A lump or bump that may feel dry, itchy, scaly, or have a different color compared to the skin around it (actinic keratosis)
- Lesions on the lower lip where the tissue may become dry, cracked, or pale (cheilitis)
- White spots in the mouth on the gums, cheeks, or tongue (leukoplakia)
In addition, this type of cancer may develop on any part of the skin. However, it mostly appears in the following areas. Examples include:
- Stomach (esophageal or epidermoid carcinoma)
- Hands, arms, and legs
- Anal cavity
- Skin
- Face, lips, nose, ears, eyelids, and scalp
- Mouth, tongue, and throat (also known as oral carcinoma)
If you notice any of the previous symptoms in any of the areas of the body listed above, immediately contact your healthcare professional.
Causes
This type of cancer occurs due to a mutation (change) in the p53 gene. It usually mutates from ultraviolet (UV) exposure from the sun or indoor tanning beds. In normal circumstances, this gene contains instructions that tell cells when to grow, multiply, and die. However, when this gene mutates, it gives the cells different instructions that make them grow and multiply abnormally. If these abnormal cells become too numerous, they form a mass called a tumor. When this tumor becomes too large, it may break and spread throughout the body, affecting other structures and organs in the body. However, SCC rarely spreads to other tissues, but when it occurs, it can be life-threatening.
Risk Factors
This cancer may affect anyone, but some people are at increased risk of developing it. Check below some examples:
- Prolonged exposure to the sun
- Sun damage to the skin at a young age
- Older adults (over 65 years old)
- A pale complexion, blue or green eyes, blonde or red hair
- Weakened immune system
- Organ transplants
- Continuous exposure to chemicals (including smoking, Arsenic, and others)
Moreover, men are 2 times more likely to develop SCC than women.
What Happens if Squamous Cell Carcinoma is Left Untreated?
People with this condition may also experience some complications, especially if they ignore the symptoms and leave them untreated. For example:
- An increased risk of recurrence even after successful treatment
- Damage to the nearby blood vessels
- Metastasis (the tumor may break and spread to the lymph nodes, lungs, brain, liver, and other structures and organs in the body)
- Infections
- New skin cancers
This article does not contain a full list of complications that may occur in people with SCC. However, you can consult with your healthcare professional about ways to reduce the risk or even prevent previous complications.
How to Prevent Squamous Cell Carcinoma?
Generally, it is not possible to prevent this type of cancer, but you can consider the following tips that may help reduce the risk. Check below some examples:
- Avoid tanning beds and prolonged exposure to the sun
- You should use SPF protection, especially when outdoors
- Wear protective accessories and clothing with UPF protection. These include sunglasses and hats.
- Quit smoking
- Limit or avoid exposure to chemicals or wear protective equipment
Diagnosis
First, doctors will perform a physical examination to check for abnormalities linked to this type of cancer. After that, they may also ask some questions about the symptoms and medical history to get more clues about the disease. However, to confirm the condition, doctors may need to perform some tests. For example:
- Imaging tests – The following tests are used to get detailed images of different structures and organs of the body. They often help identify the exact location and size of the tumor. Doctors often perform a CT (computerized tomography) scan or an MRI (magnetic resonance imaging) scan.
- Skin biopsy – During previous tests, physicians may take a small sample of the affected tissue to test it under a microscope for cancerous cells.
Furthermore, once you are diagnosed with SCC, doctors may perform additional imaging tests to determine the extent (stage) of the cancer. It helps make the best treatment plan for you.
Treatment
The only way to cure this type of cancer is early detection and proper treatment. In other cases, doctors may recommend different treatments, depending on the size and extent of the tumor, existing health problems, and your age and preferences. Check below some treatments often recommended by doctors for people with SCC:
- Cryosurgery – This option involves freezing the cancerous cells, causing them to die.
- Photodynamic therapy (PDT) – This treatment uses blue light and light-sensitive agents to destroy cancerous cells from the skin.
- Curettage and electrodesiccation – During this procedure, doctors will scrape the cancerous lump with a spoon-like tool (curette) and then will burn the area with an electrical needle.
- Excision – This is a surgery in which doctors remove the cancer from the skin and then stitch the skin back.
- Mohs surgery – During this procedure, all affected layers of the skin are removed. Usually, doctors prescribe this treatment when SCC affects the face.
- Systemic chemotherapy – This treatment uses strong medicines to kill cancer cells throughout the body.
Medicines
Your doctor may also recommend some medicines either before or after previous treatments. These include:
- Skin creams with Imiquimod or 5-Fluorouracil
- Immunotherapy with Cemiplimab-rwlc (it is usually used to treat advanced forms of SCC) or with Pembrolizumab when surgery is not an option
Frequently Asked Questions
How soon after treatment will I feel better?
Generally, people begin to feel better within 2-4 weeks after starting the treatment. You may need to see a doctor after this period to make sure the treatment works and the body is healing properly.
What is the life expectancy of a person with squamous cell carcinoma?
In the early stages, the 5-year survival rate is around 99%. However, if the tumor becomes large or spreads throughout the body, the same survival rate significantly decreases. Consult with your doctor for more details.
What could be mistaken for squamous cell carcinoma?
In some cases, this type of cancer can be mistaken for other disorders. These include basal cell carcinoma, melanoma, and multiple benign skin lesions (including warts, keratoacanthoma, and even eczema or psoriasis). Ask your healthcare provider if you have additional questions.
