Squamous cell carcinoma (SCC), also known as skin squamous cell carcinoma, is one of the most common types of skin cancer, second only to basal cell carcinoma (BCC). While it is not the most dangerous type of skin cancer, it can become serious if left untreated, and in some cases, it can spread to other parts of the body. This blog aims to answer common questions about squamous cell carcinoma, how to identify it, and what you can do to prevent and treat it effectively.
What is Squamous Cell Carcinoma?
Squamous cell carcinoma (SCC) is a type of skin cancer that originates in the squamous cells, which are the flat, thin cells that make up the outer layer of the skin. It is the second most common type of skin cancer, accounting for about 20% of all skin cancer cases. SCC can occur on any part of the body, but it is most commonly found on sun-exposed areas, such as the face, ears, neck, and hands. It can also occur on the lips, mouth, and genital areas.
SCC is a type of non-melanoma skin cancer, which means it is not related to melanoma, the most aggressive type of skin cancer. However, SCC can still be serious and potentially life-threatening if left untreated. It is essential to seek medical attention if you notice any unusual skin changes or growths.
What Does Cutaneous Squamous Cell Carcinoma Look Like?
Squamous cell skin cancer often appears as a scaly, red patch of skin, a firm, raised bump, or an open sore that doesn’t heal. It may sometimes have a wart-like appearance. These lesions most commonly occur on areas of the body exposed to the sun, like the face, neck, ears, and hands. While SCC can be mistaken for other skin conditions, it’s important to keep an eye on any growths that seem unusual or persistent.
Is Squamous Cell Carcinoma a Bad Cancer?
Although squamous cell carcinoma cancer is not as aggressive as melanoma, the most dangerous form of skin cancer, it is still considered serious. If left untreated, SCC can grow and spread to other parts of the body, including the lymph nodes and internal organs, where it becomes more difficult to treat. Early detection and treatment are key to managing squamous cell carcinoma successfully.
How Fast Does Squamous Cell Carcinoma Grow and Spread?
Squamous cell cancers, including squamous cell carcinoma, can grow relatively quickly compared to other skin cancers. It may develop over weeks or months, and while it usually stays localized to the skin, more aggressive cases can invade deeper tissues or spread to other parts of the body. That’s why it’s important to seek medical advice as soon as you notice any suspicious growths or changes in your skin.
What causes cutaneous squamous cell carcinoma?
Cutaneous squamous cell carcinoma (SCC) is primarily caused by excessive exposure to ultraviolet (UV) radiation, either from the sun or from artificial sources like tanning beds. Squamous cell skin cancers, including SCC, develop from the flat cells of the epidermis and are commonly associated with sun exposure. Over time, this UV exposure damages the DNA in skin cells, leading to abnormal cell growth and the development of cancerous lesions. While anyone can develop SCC, people with fair skin, a history of frequent sunburns, or prolonged sun exposure are at higher risk. Other factors, like a weakened immune system, certain genetic conditions, or previous radiation therapy, can also increase the likelihood of developing squamous cell carcinoma. Taking proactive steps to protect your skin from UV rays, such as wearing sunscreen and avoiding tanning beds, is key to reducing your risk.
Symptoms and Identification of Squamous Cell Carcinomas
Squamous cell carcinoma can be identified by several symptoms:
A rough, scaly patch of skin that may crust or bleed.
A firm, red nodule or lump.
A sore that doesn’t heal or keeps coming back.
A wart-like growth.
Unlike some skin cancers, SCC may cause discomfort, itching, or pain when touched. If you notice any of these signs, it’s important to see a dermatologist for evaluation. Squamous cell carcinoma diagnosed through clinical features and a diagnostic biopsy is crucial for proper treatment, and staging investigations may be necessary for high-risk cases to assess the spread of the cancer.
Squamous cell carcinoma in situ (Bowen disease)
Squamous cell carcinoma in situ, also known as Bowen disease, is an early form of squamous cell skin cancer that affects only the top layer of the skin. It appears as a slow-growing, red, scaly patch that can be mistaken for other skin conditions like eczema or psoriasis. Unlike more advanced squamous cell carcinoma, Bowen disease hasn’t spread beyond the surface of the skin, which makes it easier to treat when caught early. It’s usually caused by long-term sun exposure or, in some cases, the human papillomavirus (HPV). Although it’s not life-threatening, Bowen disease can progress to invasive squamous cell carcinoma if left untreated. Early diagnosis and treatment, such as topical creams, cryotherapy, or minor surgery, can help prevent it from becoming more serious. Regular skin checks and sun protection are essential in reducing the risk of Bowen disease and other skin cancers.
Staging cutaneous squamous cell carcinoma
The differences between intraepidermal carcinoma (IEC), well-differentiated, moderately differentiated, and poorly differentiated squamous cell carcinoma (SCC) reflect the progression and aggressiveness of the cancer cells.
– Intraepidermal carcinoma (IEC), also known as Bowen disease, is the earliest form of SCC. The cancer is confined to the top layer of the skin (the epidermis) and hasn’t yet invaded deeper tissues. It’s considered non-invasive, and if caught early, is very treatable.
– Well-differentiated SCC is an early-stage invasive cancer. The cancer cells still closely resemble normal skin cells, which means they grow more slowly and are less aggressive. This form is often easier to treat and less likely to spread.
– Moderately differentiated SCC is a middle stage where the cancer cells show more abnormality and start to lose some of the features of normal skin cells. This type tends to grow faster and has a higher chance of spreading than well-differentiated SCC, requiring more aggressive treatment.
– Poorly differentiated SCC is the most aggressive type. The cancer cells have little to no resemblance to normal cells, which means they grow quickly and are more likely to invade deeper tissues and spread to other parts of the body. Poorly differentiated SCC often requires more extensive treatment to control its growth.
Staging cutaneous squamous cell carcinoma (SCC) is an important process that helps doctors understand how far the cancer has spread and guides the best treatment options. The stages range from Stage 0 (also called in situ, like Bowen disease) where the cancer is confined to the top layer of the skin, to Stage IV, where the cancer has spread to deeper tissues, lymph nodes, or even other organs. Early-stage SCC, such as Stage I or Stage II, typically stays within the skin or immediately surrounding areas and is often highly treatable with minor surgery or other localized therapies. However, as SCC progresses to more advanced stages, like Stage III or IV, it becomes more challenging to treat as the cancer may have spread deeper or to distant parts of the body. Knowing the stage of SCC helps your healthcare team provide personalized care, and early detection makes a big difference in treatment success and recovery.
The Different Types of Skin Cancer
The three most common types of skin cancer are:
Basal Cell Carcinoma (BCC): The most common and least dangerous type of skin cancer. BCC usually appears as a shiny, flesh-colored bump or nodule and grows slowly.
Squamous Cell Carcinoma (SCC): The second most common type of skin cancer, SCC can be more aggressive than BCC but is highly treatable when caught early.
Melanoma: The least common but most dangerous type of skin cancer. Melanoma can spread rapidly and is responsible for most skin cancer deaths. It often looks like a dark, irregularly shaped mole.
Less common types include Merkel cell carcinoma and Kaposi sarcoma, though these are rarer and generally more aggressive.
How Serious is Skin Cancer?
All types of skin cancer can become serious if left untreated. Squamous cell carcinoma can become invasive, and melanoma, the most dangerous type, can spread quickly to other organs. The good news is that when caught early, most skin cancers, including SCC and BCC, can be treated successfully with minimal long-term consequences.
How Does Skin Cancer Start and Spread?
Skin cancer starts when the DNA of skin cells is damaged, often by ultraviolet (UV) radiation from the sun or tanning beds. This causes cells to grow uncontrollably, forming tumors. Over time, these tumors can grow deeper into the skin and spread to other parts of the body through the bloodstream or lymphatic system. The earlier a cancer is treated, the less likely it is to spread.
The Main Causes of Skin Cancer
The primary cause of skin cancer in America is excessive exposure to UV radiation, either from sunlight or artificial sources like tanning beds. Other factors include a history of sunburns, fair skin, a weakened immune system, and a family history of skin cancer.
Treatments for Squamous Cell Carcinoma and Skin Cancer
Squamous cell carcinoma diagnosed through clinical features and diagnostic biopsy is crucial in determining the appropriate treatment options. There are several effective treatments for squamous cell carcinoma, depending on the size, location, and depth of the cancer:
Mohs Surgery: A highly effective procedure where the cancer is removed layer by layer while preserving as much healthy tissue as possible. This is commonly used for aggressive SCC in sensitive areas like the face.
Excision: The cancerous tissue is cut out, along with a margin of healthy tissue to ensure all cancer cells are removed.
Cryotherapy: In some cases, IEC can be treated by freezing the cancer cells with liquid nitrogen.
Radiation Therapy: This may be used if the cancer is in a hard-to-treat area or for patients who are not candidates for surgery.
Topical Medications: In some early cases, medications can be applied directly to the skin to treat cancer.
The length of time required to remove skin cancer varies by the treatment method but is typically quick, with most procedures taking under an hour. Recovery may take a few weeks, depending on the depth and size of the cancer.
Complications and Outlook for Basal Cell Carcinoma and Squamous Cell Carcinoma
Both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are types of skin cancer that can have serious complications if left untreated. BCC is generally less aggressive than SCC, but it can still cause significant damage to the surrounding tissue and bone if it grows large enough.
SCC, on the other hand, is more likely to spread to other parts of the body, such as the lymph nodes, if it is not treated promptly. This can lead to more serious complications, including organ damage and even death.
The outlook for both BCC and SCC is generally good if they are caught and treated early. However, if they are left untreated, the prognosis can be poor. It is essential to seek medical attention if you notice any unusual skin changes or growths.
Benign Skin Tumors vs. Malignant Skin Tumors
Benign skin tumors are non-cancerous growths that do not invade surrounding tissue or spread to other parts of the body. Examples of benign skin tumors include moles, cysts, and lipomas.
Malignant skin tumors, on the other hand, are cancerous growths that can invade surrounding tissue and spread to other parts of the body. Examples of malignant skin tumors include basal cell carcinoma, squamous cell carcinoma, and melanoma.
It is essential to seek medical attention if you notice any unusual skin changes or growths, as early detection and treatment can significantly improve the outlook for skin cancer.
Epidemiology and Statistics of Skin Cancer
Skin cancer is one of the most common types of cancer worldwide, with over 9,500 people diagnosed every day in the United States alone. According to the American Cancer Society, there were over 9.5 million new cases of skin cancer diagnosed in the United States in 2020.
Basal cell carcinoma is the most common type of skin cancer, accounting for about 80% of all skin cancer cases. Squamous cell carcinoma is the second most common type, accounting for about 20% of all skin cancer cases.
The risk of developing skin cancer increases with age, with most cases occurring in people over the age of 50. However, skin cancer can occur at any age, and it is essential to practice sun protection and skin self-examination to reduce the risk of developing skin cancer.
Pathophysiology and Histopathology of Squamous Cell Carcinoma
Squamous cell carcinoma (SCC) is a type of skin cancer that originates in the squamous cells, which are the flat, thin cells that make up the outer layer of the skin. The pathophysiology of SCC involves a series of genetic mutations that lead to uncontrolled cell growth and tumor formation.
The histopathology of SCC involves the examination of tissue samples under a microscope to diagnose the presence of cancer cells. SCC is characterized by the presence of abnormal squamous cells that have invaded the surrounding tissue.
The diagnosis of SCC is typically made based on a combination of clinical examination, imaging studies, and histopathological examination of tissue samples. Treatment options for SCC include surgical excision, radiation therapy, and chemotherapy, depending on the stage and severity of the disease.
Preventing Squamous Cell Carcinoma
While skin cancer isn’t entirely preventable, you can significantly reduce your risk by:
Wearing sunscreen with broad-spectrum protection and an SPF of 30 or higher.
Avoiding tanning beds and prolonged sun exposure, especially during peak hours.
Wearing protective clothing, hats, and sunglasses when outdoors.
Regularly examining your skin for new or changing lesions and visiting a dermatologist for annual skin checks.
Are There Breakthroughs in Skin Cancer Treatment?
The latest breakthroughs in skin cancer treatment include immunotherapy and targeted therapy, which harness the body’s immune system to fight cancer or target specific cancer cells. These treatments are particularly promising for melanoma but may also be used for advanced cases of SCC or BCC.
Is Skin Cancer Deadly?
While most cases of skin cancer are curable when detected early, untreated skin cancer can become life-threatening, especially melanoma. Squamous cell carcinoma, if ignored, can also spread and become dangerous. The key to survival is early detection and treatment.
Conclusion: The Importance of Early Detection
Squamous cell carcinoma and other forms of skin cancer can often be treated successfully when caught early. Regular skin checks, both self-exams and professional screenings, are crucial for early detection. If you notice any unusual changes in your skin, such as new growths, sores that don’t heal, or changes in moles, see a doctor right away. Protecting your skin from UV damage and staying vigilant can go a long way in preventing skin cancer and keeping your skin healthy.
Skin cancer is a serious condition, but with the right knowledge, prevention strategies, and treatment options, it’s manageable. Always prioritise your skin health, use sun protection, and never hesitate to seek professional advice for any concerns.