Squamous Cell Carcinoma
If you’ve been diagnosed with squamous cell carcinoma (SCC), you are not alone. SCC is the second most common form of skin cancer. When detected early and treated properly, SCC is highly curable.
Most SCCs develop on skin that gets sun exposure, such as the face, ears, lips, back of the hands, arms, and legs. SCC also can develop on areas of the body that do not get sun, such as inside the mouth or on the genitals.
People of all skin colors get SCC although it is more common in Caucasians.
Your everyday activities expose you to ultraviolet (UV) rays, which damage your skin. You receive this exposure every time you go outdoors during the day, when you drive your car or sit near your office window.
People who use tanning beds have a much higher risk of getting SCC. They also tend to get SCC earlier in life. Your risk of developing SCC increases if you have any of the following factors:
- Your physical traits
- Pale or light-colored skin
- Blue, green, or gray eyes
- Blond or red hair
- An inability to tan
- Your life experiences
- Spent a lot of time outdoors, for work or leisure, without using sunscreen or covering up with clothing
- Used tanning beds or sunlamps
- Been exposed to cancer-causing chemicals (e.g., arsenic in drinking water, coal tar, worked with some insecticides or herbicides)
- Smoked tobacco
- Spent lots of time near heat, such as a fire
- Your medical history
- Diagnosed with actinic keratoses (AKs)
- Badly burned your skin
- Have an ulcer or sore on your skin that has been there for many months or years
- Taking medicine that suppresses your immune system
- Received an organ transplant
- Infected with human papillomavirus (HPV)
- Had many PUVA light treatments
- Have one of these medical conditions: xeroderma pigmentosum, epidermolysis bullous, or albinism
SCC appears on the skin in many shapes. You may see a:
- Bump that feels crusty or rough
- Flat patch that is red and rough
- Dome-shaped bump that grows and may bleed
- Sore that does not heal, or heals and returns
Some SCCs begin as a precancerous growth called an actinic keratosis or AK. Most AKs share common qualities such as being dry, scaly, and rough-textured. A single AK may range from the size of a pinhead to larger than a quarter.
To diagnose SCC, a dermatologist performs a skin biopsy. This is the only way to diagnose skin cancer. Your dermatologist can perform a biopsy using local anesthesia during an office visit.
To perform a biopsy, your dermatologist will remove the entire growth (or a part of it) that might be a SCC. Your dermatologist may send this to a laboratory or look at it under a microscope. The findings will be communicated in a biopsy report.
If the diagnosis is SCC, your dermatologist will consider many factors to determine the best treatment for you, including where the SCC appears on your body, if the SCC has spread to another part of your body, and your overall health.
- Keep all appointments with your dermatologist. When found early, skin cancer can often be cured.
- Perform skin self-examinations. Examine your skin as often as your dermatologist recommends. Be sure to check your scalp, ears, genitals, and buttocks.
- If you notice anything on your skin that is changing, itching, or bleeding, immediately make an appointment to see your dermatologist.
- Protect your skin every day by:
- Seeking shade. Shade helps protect your skin from the sun’s harmful UV rays. Shade is especially important between 10 a.m. and 2 p.m. when the sun’s rays are strongest. But any time your shadow is shorter than you are, seek shade.
- Wearing protective clothing. This means wearing a long-sleeved shirt, pants, a wide-brimmed hat, and sunglasses, when possible.
- Generously applying sunscreen that offers broad-spectrum (UVA and UVB) protection, water-resistance, and a Sun Protection Factor (SPF) of 30 or more. Be sure to apply the sunscreen 15 minutes before going outside. Apply it to all skin that clothing will not cover. You should reapply sunscreen every two hours, even on cloudy days. After swimming or sweating, you also need to reapply your sunscreen.
- Protect your skin when around water, snow, and sand. These reflect and intensify the damaging rays of the sun.
- Never use a tanning bed. UV light from tanning beds can cause skin cancer and wrinkling. If you want to look tan, consider using a self-tanning product or spray. Even when using one of these products, you need to use sunscreen.
- Use condoms. This can prevent an HPV infection, which reduces the risk for getting SCC on the genitals.
- Limit the amount of alcohol you drink and do not smoke. Smoking tobacco and drinking alcohol can increase your risk of getting SCC in your mouth.
When detected early and treated properly, SCC is highly curable. Left untreated, SCC can spread to other parts of the body, making treatment difficult.
Treatment for SCC involves having one or more of the following:
- Excision: This is a surgical procedure. Your dermatologist can perform this during an office visit, using local anesthesia. Excision involves removing the SCC and some normal-looking skin. You may require stitches to repair the wound. What your dermatologist removes will be examined under a microscope. If the normal-looking skin contains cancer cells, you will need more treatment.
- Mohs Surgery: Mohs surgery is usually performed in a medical office under local anesthesia while you remain awake. Your dermatologist may be a Mohs surgeon or may refer you to a dermatology colleague who has received the specialized training to become a Mohs surgeon. During the surgery, the Mohs surgeon first removes the BCC and some normal-looking surrounding skin around and below it.
While you wait, the surgeon uses a microscope to look at what was removed. If the surgeon sees cancer cells, he or she will continue to remove layers of skin and examining them under the microscope. This process continues until cancer cells are no longer seen. You may require stitches to repair the wound.
- Radiation: When a patient cannot undergo surgery to remove the cancer, radiation therapy may be recommended. A series of radiation treatments are used to destroy the cancer cells.
- Photodynamic therapy (PDT): This treatment uses light to remove some very early skin cancers and actinic keratoses. PDT is a two-step process. First, a chemical is applied to the skin. The chemical remains on the skin for some time so that it can be absorbed. Then the skin is exposed to a special light to kill the cancer cells.
- Laser treatment: Lasers can be used to remove an SCC that sits on the surface of the skin. This treatment is only recommended for early SCCs.
- Chemotherapy or Immunotherapy cream: When SCC is caught early, a dermatologist may prescribe medicine that you apply to your skin at home to destroy the cancer cells.
- Chemoprevention: If you have a condition that causes you to develop many SCCs, an oral medicine may be prescribed that can reduce the likelihood of developing future SCCs.
If I have SCC, am I at greater risk of developing other skin cancers?
Yes. Studies show that people who have one skin cancer are at greater risk of developing another skin cancer. Perform regular skin self-examinations, and protect your skin every day. Be sure to keep all appointments with your dermatologist, and make an immediate appointment of you notice anything changing, itching, or bleeding on your skin.
Are tanning beds ever safe?
No. Never use a tanning bed. UV light from tanning beds can cause skin cancer and wrinkling. If you want to look tan, consider using a self-tanning product. Remember that even when using one of these products, you need to use sunscreen.