Squamous Cell Carcinoma

 

Overview

Squamous cell carcinoma is one of the most common types of skin cancer. It accounts for about 20 percent of all skin cancers. Squamous cell carcinoma develops on the surface of the epidermis, one of three layers of the skin. It commonly appears on sun-exposed areas of the body, such as the face, ears, nose, lips, and back of the hands. It can also develop within scars or skin ulcers elsewhere. Squamous cell carcinoma is more aggressive than basal cell carcinoma, another common type of skin cancer. It is more likely to invade tissues beneath the skin and slightly more likely to spread to lymph nodes and/or distant parts of the body.

The best way to prevent squamous cell carcinoma and other skin cancers is to limit unprotected exposure to the sun. When you are out in the sun, remember to wear a wide-brimmed hat, use sunblock, and limit your time in the sun to before 10 a.m. and after 3 p.m.

If you are diagnosed with squamous cell carcinoma, the good news is that it is highly curable. Dermatologists and other skin cancer experts at The Cancer Center at Hackensack University Medical Center are highly skilled in providing several treatment options. The Cancer Center features:

  • board-certified dermatologists and surgeons skilled in Mohs surgery, laser surgery, cryosurgery, and other surgical options
  • clinical research studies that are investigating new treatments for skin cancer
  • a full range of support services

 

Risk Factors

Exposure to ultraviolet radiation present in sunlight and artificial sources, such as tanning booths and sun lamps, puts you at risk for squamous cell carcinoma. Other risk factors include:
  • fair skin (The rate of skin cancer is 10 times higher for Caucasians than dark-skinned African-Americans.)
  • being male
  • chemical exposure (especially arsenic)
  • long-term or severe skin inflammation or injury
  • treatment for psoriasis
  • a weakened immune system

 

Symptoms

Symptoms of squamous cell carcinoma include:
  • any change on the skin, especially in the size or color of a mole or other darkly pigmented growth or spot
  • scaliness, oozing, bleeding, or a change in the appearance of a bump or nodule
  • the spread of pigmentation beyond its border
  • a change in sensation, itchiness, tenderness, or pain

 

Treatment Services

Most squamous cell carcinomas can be cured completely with fairly minor surgery. For some squamous cell carcinomas with a high risk of spreading, surgery may be followed by radiation therapy or chemotherapy.

Surgery

The type of surgery depends on how large the squamous cell carcinoma is and where it is found on the body. Your doctor may recommend one of the following types of surgery:

  • simple excision: removal of the tumor and some surrounding normal skin
  • curettage and electrodesiccation: scraping out the tumor with a long, thin instrument then using electrodes to destroy any remaining cancerous cells
  • cryosurgery: using liquid nitrogen to freeze and kill abnormal cells
  • Mohs surgery: a highly specialized technique during which a surgeon or dermatologist removes a layer of skin and then maps the cancer's location. After the sample is checked, more skin is removed if the tissue is malignant. The physician continues to remove more skin and examine it until no more cancerous cells are found. Mohs surgery creates a better appearance after surgery.
  • laser surgery: a beam of laser light is used to vaporize cancer cells
  • lymph node removal surgery: may be used if the skin cancer is suspected to have spread into nearby lymph nodes
  • skin grafting and reconstructive surgery: may be used if a very large tumor has been removed, to help the wound heal and replace tissue

Radiation Therapy

External beam radiation is the most common type of radiation therapy used to treat squamous cell carcinoma. It may be used as the primary treatment if the tumor is large, is located on an area of the skin that makes surgery difficult, or if a patient cannot tolerate surgery. Radiation therapy may also be used as an adjuvant (additional) treatment after surgery to kill any cancerous cells that may not be visible during surgery.

Chemotherapy

Chemotherapy may be used at the time of radiation therapy or before surgery to help shrink tumors. It may be given topically (placed directly onto the tumor) or intravenously. Chemotherapy does not cure metastatic squamous cell carcinoma, but it may be used to temporarily delay the further spread of cancer and to relieve symptoms.