Squamous Cell Carcinoma
(Nonmelanoma Skin Cancer)
Definition
Squamous cell carcinoma of the skin is the second most common form of skin cancer. Basal cell carcinoma is the most common form. However, squamous cell carcinoma is more common in African Americans.
The name “squamous” comes from the cells where the cancer grows. These cells are in the uppermost layer of skin cells. Squamous cell carcinoma usually grows slowly. In some cases it can grow fast and spread to other tissues in the body, usually initially through lymph nodes. It is rarely fatal if treated early, but can be lethal if it spreads beyond the skin.
Squamous Cell Carcinoma
Causes
Exposure to ultraviolet (UV) light through time spent in the sun is known as the primary cause of squamous cell carcinoma. However, the growth results from a combination of sun exposure and genes that make developing the cancers more likely. Squamous cell carcinoma can also grow where the skin has been damaged by a burn, a long-standing wound, been exposed to certain chemicals, or been exposed to radiation.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
The following factors increase your chance of developing squamous cell carcinoma:
- Increasing age
- Childhood sunburns , freckling, or long periods of sun exposure
- Fair skin that rarely tans
- Blue or green eyes
- Blonde or red hair
- A family history of skin cancer
- A personal history of skin cancer
- Treatment that suppresses the immune system, such as that prescribed for people who have had an organ transplant
- Swallowing arsenic
- History of radiation or ultraviolet light treatment
- Frequent use of tanning beds
Symptoms
Symptoms include:
- A raised red patch that is scaly or rough
- A raised patch of skin that may appear to have horn-like rough edges
- In color, the patch may be reddish, pink, flesh-colored, or reddish-brown
- Poorly defined outline, with some satellite growths
- A long-standing sore that will not heal with simple at-home treatment
Diagnosis
The diagnosis will probably be made by a doctor who specializes in skin care, called a dermatologist. The dermatologist will look at the skin growth and take a sample, called a biopsy , to test for cancerous cells. The doctor will then decide on a treatment plan based on the size, growth, subtype, and location of the tumor.
Treatment
Treatment includes:
- Mohs micrographic surgery—microscopically controlled surgery that offers the best cure rate for squamous cell carcinoma
- Removing the growth with simple surgery
- Freezing the growth off with liquid nitrogen
- Radiotherapy, also known as radiation therapy
- Photodynamic therapy in which the cells absorb an acid that causes them to die when exposed to light
- Creams, especially fluorouracil (5-FU) or imiquimod
- Plastic surgery to repair any cosmetic problems that occur after treatment
Prevention
The following are ways to decrease your chance of developing squamous cell carcinoma:
- Reduce sun exposure by wearing sunscreen, long sleeves and slacks, and hats.
- Stay out of the sun during the midday hours.
- People who ski and enjoy other winter sports should be aware that UV light is stronger at higher elevations, and should take precautions (eg, wearing sunscreen).
- At-risk adults should examine themselves monthly and get an annual full-body exam by a dermatologist to check for moles, freckles, and other growths.
- Limit sun exposure/tanning for children and teens.
- Learn to recognize early squamous cell carcinoma and seek treatment.
RESOURCES:
American Academy of Dermatology
http://www.aad.org
American College of Mohs Micrographic Surgery
http://www.mohscollege.org/AboutMMS.html
The Skin Cancer Foundation
http://www.skincancer.org
CANADIAN RESOURCES:
Canadian Dermatology Association
http://www.dermatology.ca
The Canadian Skin Cancer Foundation
http://www.canadianskincancer.com/home.html
References:
Jerant A, Johnson J, Sheridan CD, Caffrey T. Early detection and treatment of skin cancer. Am Fam Physician . 2000 Jul 15;62(2):357. Available at: http://www.aafp.org/afp/20000715/357.html . Accessed June 20, 2007.
Saraiya M, et al. Preventing skin cancer. MMWR . 2003 Oct 17;52(RR15):1-12. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5215a1.htm . Accessed June 20, 2007.
Squamous cell carcinoma. DynaMed website. Available at: http://dynamed102.ebscohost.com/Detail.aspx?id=116909 . Accessed June 20, 2007.
Last reviewed November 2008 by Ross Zeltser, MD, FAAD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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