Introduction
Squamous cell carcinoma (SCC) is a common skin cancer with roughly 700,000 new cases being diagnosed in the United States each year. SCC may develop on the skin as a result of long-term sun exposure, especially on more sun-prone areas of the body. Such areas include: face, ears, lips, neck, and back of the hands; however, it is very possible to get SCC on any part of the body, including the inside of the mouth, lips, genitals, and frequently on the legs in women. Women as well as those who are fair skinned, have light hair, and light eyes are at a higher risk for developing SCC. Also, people with a medical condition; for example, xeroderma pigmentosum, epidermolysis bullous, or albinism are at an increased risk of acquiring SCC. Squamous cell carcinoma has a high development rate for those 50 years old and older and is common in people who are 70 years old and older. If SCC spreads, or rather becomes metastatic, it can grow deeper into the skin consequently destroying tissue and even bone. In some cases, SCC can spread to the lymph nodes and other parts of the body causing serious medical complications. Fortunately, with treatment early stages of squamous cell carcinoma are highly curable.
Causes
As mentioned above, most cases of squamous cell carcinoma are caused by ultraviolet (UV) light from long-term sun or tanning bed exposure. Other causes include: long-term exposure to carcinogens such as tobacco; tar; insecticides or herbicides; water containing trace amount of arsenic; a serious burn; ulcers or sores on the epidermis; and in some cases caused by certain strains of the human papillomavirus (HPV).
Symptoms
Common symptoms associated with squamous cell carcinoma include, but are not limited to: rigid-like, dome-shaped, or crusty bumps that may bleed; skin lesions that do not heal; and slow growing scaly-reddish patches (i.e. Bowen’s disease). For those over 40 years old who have developed SCC, it is estimated that up to 60% of cases developed as a pre-cancerous growth known as an actinic keratosis. This pre-cancerous growth typically has the following appearances: small, pink, rough, dry, itchy, painful, scaly patch or growth on skin.
Diagnosis
We will ask for your complete medical history; for example, whether you are on any medications, recent injuries or illnesses, mental health, and family members with any history of squamous cell carcinoma. Next, we may complete a physical examination assessing your skin. We may then complete a skin biopsy where a portion of a lesion is extracted and sent to the laboratory. The laboratory will determine whether SCC is present where the findings will be communicated to us in a biopsy report. If the biopsy report states that SCC is present, we will consider many factors to determine which treatment will be best for you.
Treatment
The type of treatment a patient receives will depend on how deep the cancer has grown and whether it has metastasized. Some cases of squamous cell carcinoma in its early stages may be treated with topical medications; for example, creams containing 5-fluorouracil (5-FU). The surgical procedures most often utilized are: surgical excision, Mohs surgery (most frequently utilized), and electrodessication & curettage. Other common treatments include: radiotherapy, radiation therapy, photodynamic therapy, and laser treatments for cases of early SCC. It is worth mentioning that most squamous cell carcinomas can only be removed through surgery.