Squamous cell carcinoma usually happens on skin that gets a lot of sun, like the neck, hands, arms, face and ears. It can also appear on the bottoms of feet or genitals, or inside of the mouth.
It starts when squamous cells develop changes in their DNA from too much UV radiation, which can come from sunlight or tanning beds. These changes cause cancerous growths that can grow, break apart and spread to other parts of the body.
Diagnosis
Squamous cell carcinoma (SCC) of the skin usually happens on sun-exposed skin such as the face, neck, lips, earlobes, hands or scalp. It can also happen in scars, sores and scaly patches on the body or inside the mouth or genital area. It is rare for this type of cancer to spread to other parts of the body. Almost all SCC of the skin can be treated if it is caught early. It is important to look for and call a doctor right away if you notice any new, changing or unusual lumps or bumps on your body.
SCC often looks like a rough-feeling bump or growth, which may crust over and bleed. It might resemble a wart or a blister. It can grow over time, becoming larger and more uncomfortable. It can also look red, pink or black, depending on your skin color. SCC that has spread to other parts of the body is more serious and can be harder to treat.
Having certain risk factors increases your chance of getting this cancer. These include: Having light skin and blue or green eyes. Having a history of precancerous skin lesions, such as actinic keratosis or Bowen disease. Having a weakened immune system, which can happen when you have leukemia or lymphoma or take medicines to help treat those diseases. Having had a severe sunburn earlier in life.
Your doctor will do a physical exam and ask you about your health history. Then they will take a small sample of the sore or patch to test in the lab, which is called a biopsy.
A biopsy is a quick procedure. Your doctor will use a tool to cut, shave or punch out some of the tissue and then send it to a laboratory to check for cancer cells. If the biopsy shows you have SCC, your doctor will talk with you about treatment options.
If your SCC has spread, your doctor will need to do other tests to see how far the cancer has gone and what stage it is in. These may include a CT scan or PET scan of your body to look for other cancers or for signs that the cancer has spread. They will also do a special exam of the lymph nodes near the site of your cancer to see if it has spread there.
Treatment
The good news is that squamous cell carcinoma is highly treatable, especially when caught early. It is more likely to spread deeper into the skin if it goes untreated, but this can be prevented with regular visits to your doctor and taking steps to protect your skin from UV damage.
A squamous cell carcinoma is a cancer that starts in the cells that form the outer layer of the skin (epidermis). It usually occurs on areas of your body that receive a lot of sun exposure, such as your face, ears, neck, arms and legs. It can appear as a firm red bump, scaly patch or open sore that bleeds easily.
SCC is typically treated by removing the tumor along with some of the surrounding healthy skin. Your doctor may recommend Mohs micrographic surgery, a type of excision that allows them to save as much normal tissue as possible while still removing the tumor. Your doctor will examine the removed tissue under a microscope to ensure that all of the cancer cells have been eliminated.
If your squamous cell carcinoma has reached the deeper layers of your skin, your doctor will use chemotherapy or radiation therapy to help prevent it from coming back and spreading to other parts of your body. Your doctor will also test your lymph nodes to see if the cancer has spread to them.
Immunotherapy is a type of treatment that uses medicine to encourage your body’s natural defenses to attack the cancer cells. It is usually used when other treatments aren’t possible or effective.
The survival rates listed below are based on the averages from large groups of people with different types of cancer. These numbers should only be used as general guidelines and not to compare your own situation with other people’s. Everyone’s cancer is different, and the outcome for any given person cannot be predicted with certainty.
Prevention
Squamous cell carcinoma is most curable when it’s found and treated in the early stages before it spreads. This skin cancer can cause disfigurement, serious health problems and death if it’s not treated promptly. It occurs most often on sun-exposed areas of the body, especially the scalp, ears, lips, backs of hands and genitals. It also can occur in other parts of the body that have squamous cells, such as inside the mouth and on the mucus membranes.
UV radiation (from the sun and tanning beds) damages DNA in the top layer of skin cells. This can cause these cells to grow and shed uncontrollably, forming a lesion that may become cancerous. It most commonly affects sun-exposed areas, but it can appear anywhere on the body.
The 5-year survival rate for squamous cell carcinoma that’s detected and treated in the early stage is about 99%. It can be treated by surgical removal (excision) with a margin of healthy skin, which is typically done by a dermatologist. A technique called Mohs micrographic surgery can minimize scarring, if needed.
Using sunscreen and doing monthly self-exams for unusual bumps and changes in existing moles is the best way to help prevent squamous cell carcinoma. People who have had previous skin cancer or who have a family history of it are at greater risk for developing this type of cancer.
Other things that can increase your risk for squamous cell carcinoma include a history of other skin cancers, certain diseases or health conditions that weaken your immune system and your use of medications like corticosteroids. If you’re at high risk for this skin cancer, your doctor may suggest regular check-ups by a dermatologist and more frequent skin biopsies. They might also recommend taking a vitamin B3 supplement, such as nicotinamide, which has been shown to reduce the rate of new squamous cell carcinomas by 23% compared to placebo. This is a relatively common disease, but it can be prevented by practicing good sun safety and getting regular head-to-toe skin exams. If a spot or sore looks suspicious, contact your doctor right away.
Symptoms
A squamous cell carcinoma tumor is typically larger than a basal cell cancer, and it might spread to the lymph nodes or other parts of the body. It might also grow into or over a nerve, which can cause it to hurt and itch. It might also become infected with fungus or bacteria. If squamous cell carcinoma spreads (metastasizes) to your internal organs, it can be fatal.
The earliest warning signs of squamous cell carcinoma are changes to existing skin growths or new ones that develop. They usually appear on areas of the body that receive the most UV radiation, such as the face, lips and hands. They can also form in scars, wounds or abrasions, or on areas that have been injured by heat, such as burns. They can also develop in the mouth or on the genitals.
Squamous cell carcinoma of the skin is less common than melanoma, but it can be just as dangerous. Symptoms include an abnormal bump or growth that crusts over, bleeds or becomes infected. It might be red or pink, tan or brown, and may have a rough surface. It might also look like a wart, and it might feel tender or hard.
You’re more likely to get squamous cell carcinoma if you have had precancerous skin sores called actinic keratoses or Bowen’s disease. You’re also more likely to get it if you have a weakened immune system due to illness or taking medicines that suppress your immune system, such as leukemia and lymphoma drugs or those used after organ transplantation.
The most common way to treat squamous cell carcinoma is to remove it surgically or by using a special cream. But if the cancer is too large or has spread, you might need other treatment. Some people need chemotherapy, which kills cancer cells and can help prevent them from growing or spreading. Another option is immunotherapy, which helps your own immune system fight cancer. It works by disrupting the proteins that some cancer cells use to evade your immune system. It might be used alone or with other treatments, including surgery and radiation therapy.
