Squamous Cell Carcinoma

Definition

Squamous cell carcinoma is a form of skin cancer. It is the second most common form of skin cancer.

The cancer develops in the upper layer of skin cells. It is rarely fatal if treated early. However, the cancer can be deadly if it spreads beyond the skin.

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Causes

Cancer happens when cells divide without control or order. These cells grow together to form a tumor. They can invade and damage nearby tissues. They can also spread to other parts of the body.

It is not clear what causes changes in the cells. It is likely a combination of genes and environment.

Risk Factors

Squamous cell carcinoma is more common in men and those over 60 years old. It is also more common in those who live near the equator or in high altitudes. The risk is higher in skin with scars, previous burns, or ulcers.

Other things that raise the risk are:

• Childhood sunburns or long periods of sun exposure
• History of radiation or ultraviolet light treatment
• A personal or family history of skin cancer
• Having:
  • Blonde or red hair
  • Blue or green eyes
  • Light skin that rarely tans
  • Freckles on the skin
• A weakened immune system
• Frequent use of tanning beds
• Medicines that cause sun sensitivity
• Smoking or exposure to cancer-causing chemicals

Symptoms

Symptoms may be:

• A raised red patch that:
  • Is scaly or rough
  • Appears to have horn-like rough edges
• A long-term patch that may be reddish, pink, flesh-colored, or reddish-brown
• A long-term sore that will not heal

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done.

The skin growth will be examined. A sample of the growth will be taken and examined for cancer cells. This will help determine the type and stage of the cancer. The stage is based on the size of the growth and how far it has spread.

Treatment

The goal is to treat the cancer as soon as possible. Treatment depends on the type, stage, and location of the cancer. It also depends on the person's age and health.

Surgery options are:

• Mohs micrographic surgery—removes skin in thin layers for exam
• Simple surgery to remove the growth
• Plastic surgery to fix the appearance of the skin after treatment—if needed
• Removal of lymph nodes—if cancer has spread to the lymph nodes

Other treatments may be needed. Some may be used instead of surgery or after surgery. It depends on exam of the cancer. Options may be:

• Medicines put on the skin, such as fluorouracil or imiquimod
• Freezing the growth off with liquid nitrogen
• Laser treatment
• Photodynamic therapy—a type of light therapy
• Radiation therapy—if more cancer is found or is in the lymph nodes
• Chemotherapy—if the cancer is advanced or has spread to other areas

Counseling may also be advised—to help with coping.

Prevention

To help lower the risk of squamous cell carcinoma:

• Do not spend too much time in the sun
• Protect skin from the sun:
  • Wear a long-sleeved shirt and long pants, a wide-brim hat, and sunglasses
  • Use sunscreens with a sun protection factor (SPF) of at least 30
  • Avoid exposure during the peak hours of the day
• Do not use sun lamps and tanning booths