Medical & Surgical Dermatology

Squamous Cell Carcinoma (SCC)

Squamous cell carcinoma (SCC) is the second most common type of skin cancer. Together with basal cell carcinoma, the most common skin cancer, these two cancers are collectively referred to as nonmelanoma skin cancer.

Of the more than 1 million cases of skin cancer that will be diagnosed in the United States this year, about 20 percent will be SCC. Most cases of SCC will be caused by exposure to the sun's harmful ultraviolet (UV) rays. The risk of developing SCC increases when a person also has one or more of these risk factors:

  • Fair skin.
  • Blonde or red hair; blue or green eyes.
  • History of indoor tanning.
  • Diagnosed with actinic keratoses (AKs).
  • Family history of skin cancer.
  • Weakened immune system (immunosuppression).
  • Received radiation therapy.
  • History of exposure to coal tar products or arsenic.

The risk of developing SCC also increases with age because each exposure to harmful UV rays causes more damage to the skin. As this damage accumulates, the risk of developing skin cancer grows.

WHAT IT LOOKS LIKE

SCC usually looks like a red, crusted, or scaly patch on the skin, a non-healing ulcer, or a firm red nodule. Generally appearing on sun-exposed areas such as the head, neck, ears, trunk, and arms, SCC also can develop on other areas of the body. Some SCCs develop from small, sandpaper-like lesions called actinic keratoses, which also are caused by exposure to sun's UV rays.

SQUAMOUS CELL CARCINOMA IS SERIOUS

With early detection and proper treatment, SCC is curable. Allowed to progress, SCC can invade and destroy much of the tissue surrounding the cancerous tumor, which can be disfiguring.

Some SCCs, such as those that develop on a lip or an ear, can be particularly aggressive. Left untreated, aggressive SCCs have a greater risk for metastasis (spreading) to the lymph nodes and other internal organs. This makes early diagnosis and treatment of SCC essential.

A Water’s Edge Dermatology practitioner should examine any lesion that looks like a red, crusted or scaly patch, or a non-healing sore.

DIAGNOSIS AND TREATMENT

Before SCC can be treated, the diagnosis must be confirmed with a biopsy. This simple procedure can be performed in the office and involves removing a small amount of tissue so that it can be examined under a microscope. If the diagnosis is SCC, a variety of surgical and non-surgical skin cancer treatment options are available. The Water’s Edge Dermatology practitioner will choose an appropriate treatment after considering the location of the tumor, size, microscopic characteristics, health of the patient, and other factors. 

Most treatment options are relatively minor, office-based procedures that require only local anesthesia.
These include:


  • SIMPLE SURGICAL EXCISION.  Removes the cancer and some of the surrounding healthy tissue. The removed specimen is examined under a microscope to determine if all of the skin cancer has been removed.
  • MOHS MICROGRAPHIC SURGERY.  Performed by a specially trained dermatologic surgeon, Mohs allows the surgeon to spare as much normal skin as possible while simultaneously removing the cancer.
  • ELECTRODESICCATION AND CURETTAGE.  Removes the cancerous tumor by scraping (curetting) it off. The base of the tumor is burned (cauterized) with an electric needle (electrodesiccation).
  • CRYOSURGERY.  Removes the tumor by freezing it with liquid nitrogen.
  • RADIATION THERAPY.  Damages or kills the cancerous cells with high-energy x-rays, which also help to prevent continued growth.
  • TOPICAL THERAPY.  Medications such as imiquimod and 5-fluorouracil can be applied at home to treat the cancer.
  • FOLLOW UP

Most patients with localized SCC (cancer that is confined to the tumor and that has not spread) have an excellent prognosis. Cure rates range from 85 percent to 95 percent or greater.

Even so, follow-up appointments with a Water’s Edge Dermatology practitioner are essential. SCC can recur, and studies show that individuals who develop SCC have an increased risk of developing future skin cancers, including melanoma. The recommended follow-up may include a full-body skin examination at least once a year to check for abnormal moles or lesions. Patients also should perform regular skin self-examinations and should be alert to any non-healing sores and other changes that develop on the skin. If any of these are spotted, make an appointment to see a Water’s Edge Dermatology practitioner.

PREVENTION

Avoiding unprotected exposure to the sun's UV rays is the primary form of skin cancer prevention at any age, even if you've had a SCC removed. Here's how you can Be Sun SmartSM:


  • Gnerously apply a broad-spectrum, water-resistant sunscreen with a Sun Protection Factor (SPF) of 30 or more to all exposed skin. "Broad-spectrum" provides protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Reapply approximately about every two hours, even on cloudy days, and after swimming or sweating.
  • Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, where possible.
  • Seek shade when appropriate, remembering that the sun's rays are strongest between 10 a.m. and 4 p.m. If your shadow is shorter than you are, seek shade.
  • Protect children from sun exposure by playing in the shade, using protective clothing, and applying sunscreen.
  • Use extra caution near water, snow, and sand because they reflect the damaging rays of the sun, which can increase your chance of sunburn.
  • Get vitamin D safely through a healthy diet that may include vitamin supplements. Don't seek the sun.
  • Avoid tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look like you've been in the sun, consider using a sunless self-tanning product, but continue to use sunscreen with it.
  • Check your birthday suit on your birthday. If you notice anything changing, growing, or bleeding on your skin, see a Water’s Edge Dermatology practitioner. Skin cancer is very treatable when caught early.

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