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The 5-year survival rate of squamous cell carcinoma (SCC) is between 95%-99% when detected early and appropriate treatment is sought
Squamous cell carcinoma (SCC) is a type of skin cancer that arises from the squamous cells that make up the outer layer of the skin.
SCC of the skin is typically not life-threatening, with the 5-year survival rate ranging between 95%-99% when detected early and appropriate treatment is sought.
Each year in the United States, over 700,000 individuals are affected by SCC, which accounts for roughly 2,500 deaths every year. SCC is the second most common type of skin cancer in the country.
What is squamous cell carcinoma?
Squamous cell carcinoma is an aggressive but relatively slow-growing cancer that occurs when the DNA in the squamous cells mutates, causing cells to become abnormal and start multiplying uncontrollably.
Characteristic features of SCC include:
- Rough patch on the skin that appears red and scaly and may be itchy
- Open sores on the skin, which may be tender and often have raised borders
- Brown mark that looks like an age spot
- Excess growth of skin becomes firm and develops into a dome
- Growth or expansion of a pre-existing scar or birthmark
- Wart-like development
- Old scar that becomes sore
- Small rhinoceros-shaped horn emerges from the skin
SCC may develop from a precancerous condition called actinic keratosis caused by skin exposure to UV rays from sunlight for many years. SCC is usually seen on the:
- Lips
- Head
- Scalp
- Face
- Ears
- Neck
- Chest
- Upper back
- Hands
- Legs
SCC may also be seen inside the mouth, nails, nail beds, and genitals.
What are risk factors for squamous cell carcinoma of the skin?
Risk factors for squamous cell carcinoma include:
- Caucasians
- Light-colored hair
- Green, gray, or blue eyes
- Exposure to ultraviolet radiation
- Excessive use of indoor tanning beds
- Living in very sunny regions or high altitudes
- History or family history of skin cancer
- Use of immunosuppressants
- Highly compromised immune system due to conditions such as HIV or AIDS
- Prolonged exposure to pollutants such as industrial oils, tar, or arsenic
- Cigarette smoking
- Xeroderma pigmentosum (a rare disorder in which the skin is highly sensitive to sunlight and gets damaged)
How is squamous cell carcinoma of the skin diagnosed?
Early detection of SCC is critical because it is easier to remove and treat the tumor when it is smaller. Factors that can aid in the early detection and diagnosis of SCC include the following:
Self-examination
Inspect your skin regularly for abnormal changes or growths that suggest early stages of SCC. It is important to understand patterns of skin markings such as moles, blemishes, and freckles to detect when changes occur.
People who are at a risk of SCC should be able to detect abnormal changes on the skin and seek medical attention if they find any. A mole or freckle that bleeds, itches, or appears to spread must be investigated.
Professional examination
If you are at a high risk of SCC, seek professional help to inspect the skin for abnormal changes. Checking for enlarged lymph nodes may be important, especially if there are suspicious patches on the skin that may be caused by SCC. This aids in determining the spread of cancer and guiding future treatment selections.
Skin biopsy
If you develop suspicious lesions on the skin, you may be subjected to a skin biopsy, which involves collecting a small sample of skin to analyze it for malignant development and confirm a diagnosis.
However, based on the size, location, and specific characteristics of the lesion, it should be removed and treated even before confirmation of malignancy. Some treatment options include surgical removal of the tumor, also called a full biopsy.
5 stages of squamous cell carcinoma of the skin
Staging of SCC depends on how far the cancer has spread, and prognosis depends on the stage. When SCC spreads outside the epidermis, the 5-year survival rate falls below 50%. Fortunately, however, metastasis of SCC is uncommon. Furthermore, SCC normally progresses slowly and is detected early in most cases even before the disease has progressed past the epidermis.
The stages of SCC of the skin are as follows:
- Stage 0: SCC is detected on the skin but has not progressed past the epidermis.
- Stage I: SCC has progressed further into thes skin but has not reached healthy tissue or lymph nodes.
- Stage II: Although SCC has not migrated to any lymph nodes or healthy tissues, it exhibits at least one high-risk trait that includes spreading into the skin's lower layers or nerves.
- Stage III: SCC has progressed to the lymph nodes but has not migrated to other organs or tissues.
- Stage IV: Cancer has spread to at least one distant organ such as the lungs, brain, or any other area of the skin. At this stage, the cancer cannot be cured, but treatment can be given to manage symptoms.
What are the treatment options for squamous cell carcinoma of the skin?
SCC is curable if treated in the early stages. Therapy is determined by the size and location of cancer, age, recurrence, and overall health.
- Surgery: Surgery is usually the treatment of choice for SCC:
- Mohs surgery: Cancerous tissue is removed and examined at the same time.
- Excisional surgery: Malignant part of the skin is removed along with a portion of healthy tissue. Healthy tissue is examined to determine whether there has been a complete removal of malignant cells.
- Electrosurgery: Lesion is scraped with the use of a curette and burned with an electrocautery needle to kill any leftover malignant cells and to reduce bleeding. This is usually performed on small lesions.
- Chemotherapy: Drugs are applied directly on the lesions or injected into the tumorous growth to destroy the abnormal cells. If cancer advances and spreads, intravenous injections of chemo drugs such as cisplatin are given. Immunotherapy drugs may be given to increase the activity of immune cells and help fight cancer cells.
- Radiation therapy: Radiation therapy has been found to be highly effective in treating SCC. The lesions or tumors are subjected to radiation to destroy the cancer cells.
- Cryotherapy: In cryotherapy, liquid nitrogen is used to freeze the cancer cells. This therapy is often used for extremely small tumors or a patch of skin that seems odd but is not malignant.
- Laser therapy: Laser therapy is done for small and superficial lesions of SCC and involves using intense, narrow laser beams to destroy the growth or cancer cells. There is a low risk of side effects such as damage to the surrounding tissue, bleeding, or scarring of the skin.
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How to prevent squamous cell carcinoma of the skin
Avoiding prolonged sun exposure is the best way to prevent skin cancer. Early identification of cancer is critical for the best potential outcome.
- Avoid sun exposure during peak hours such as 10 a.m. to 4 p.m.
- Apply sunscreen with an SPF of 30 or higher every day before going out. Sunscreen should be used in all seasons such as winter, irrespective of the intensity of sunlight. It is recommended to use sunscreen even if you stay indoors. Sunscreens should be waterproof to be effective and should be applied to all exposed skin regions and reapplied every 2 hours or after swimming.
Other means of prevention include:
- Monthly examination of your skin for possible skin changes
- Dermatologist visit once a year
- Avoiding tanning beds
- Wearing protective clothes, especially in the sun
