What Is Squamous Cell Carcinoma?
The second most common skin cancer, squamous cell carcinoma forms on the outer tissue of the skin, most often around sun-exposed skin such as the face, mouth and ears.
It’s often overlooked due to its less frequent appearances as only two out of ten skin cancers are diagnosed as squamous cell carcinoma. However, it’s potentially more aggressive than the most common skin cancer — basal cell carcinoma — and gets more complex and painful as it grows.
Once it grows to over two centimeters in diameter, it has a much higher rate of metastasis. Like any form of cancer, the earlier we can detect it, the easier we can stop it from spreading.
What Are the Symptoms of Squamous Cell Carcinoma?
Squamous cell carcinoma can start as a superficial rough patch on the skin that grows over time.
More severe symptoms can include a quickly-appearing tumor directly on the skin or a chronic, non-healing ulcer that can’t be managed at home.
While squamous cell carcinoma is largely found in areas that are heavily exposed to UV rays, these growths can also be found in areas with little to no UV exposure.
What Causes Squamous Cell Carcinoma?
Like most skin cancers, chronic sun exposure drastically increases your risk of developing squamous cell carcinoma, especially if you have fair skin or a history of tanning bed usage or blistering sunburns.
But UV exposure isn’t the only cause of squamous cell carcinoma. Squamous cell carcinoma is also developed by certain strains of the human papillomavirus (HPV).
When it appears in the head and neck area, especially in the mucous membranes, it’s been driven by smoking and drinking — particularly in combination. Transplants and other cancers also increase the risk of getting this disease. Squamous cell carcinoma becomes the predominant type of skin cancer over basal cell carcinoma in transplant patients when they undergo immunosuppression to protect their transplant.
Also, immunosuppressed patients with leukemia or lymphoma are predisposed to squamous (and basal) cell carcinoma. Patients with these conditions should be on high alert for any suspicious lesions on the skin and should regularly visit their dermatologist.
What Are the Treatment Options for Squamous Cell Carcinoma?
Electrodesiccation and Curettage
As a rule, squamous cell carcinoma is first considered a surgical problem. For small and superficial tumors, a local destructive technique called electrodesiccation and curettage (ED&C) is used. For this procedure, the area will be numbed before the cancerous cells are scraped out with a curette and then cauterized with a electro-cauterizer. The process is repeated two more times to ensure that all cancer cells have been removed.
Often, we opt to add one additional step to this procedure — freezing. Using liquid nitrogen, we freeze the entire lesion and a margin around it to further destroy any lurking skin cancer cells.
With electrodesiccation and curettage, there is no downtime and most patients are able to take themselves home.
For very small, superficial lesions we consider topical chemotherapy but usually opt for a Mohs surgery excision instead. In this technique, we apply local anesthesia, then scrape the base of the tumor. We take a 4-mm margin around the diagnosed squamous cell area and process it with frozen horizontal sections. In about 15 minutes, we can determine if the surrounding margins are positive or negative. If any positive margins remain, we can repeat the process to clear the carcinoma.
Radiotherapy is a squamous cell carcinoma treatment option for non-surgical candidates. With regular radiotherapy treatments over the course of three to six weeks, we can target these radio-sensitive areas and eliminate most of the cancer cells.
For squamous cell carcinomas that are either locally aggressive or metastatic, chemotherapy is an option to target those growing cancer cells. If other treatments aren’t an option, your dermatologist may recommend this treatment plan for you.
Squamous Cell Carcinoma FAQs
How can I prevent squamous cell carcinoma?
Unfortunately, squamous cell carcinoma prevention isn’t completely in your control. There are other health factors (like leukemia, HPV, and organ transplants) that play a role in the spread of this disease. However, with early detection, sun protection, and a skin care specialist to walk you through treatment, there’s a high chance of curing it.
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