SCC or squamous cell carcinoma (also called cutaneous squamous cell carcinoma or CSCC) is the second most prevalent form of skin malignancy next to basal cell carcinoma. Most often, squamous cancer tumors develop in the areas of the skin that get the most sun exposure, such as the legs, head, and arms. This malignancy may also form in other body areas with mucous membranes. These are the body cavities and the inner lining of organs, such as the mouth, anus, and lungs. 

As some of the best general surgeons in Wellington, FL, we believe that our patients and readers should learn more about why some procedures are performed. Therefore, Dr. Eldredge and Dr. Shapiro, with their expert team, have created this comprehensive article to discuss the characteristics of squamous cells and how the mutations in these cells can be addressed with the help of surgery. 

And if you still have any concerns or questions after reading the article, please contact Advanced Surgical Physicians and schedule a consultation. 

Squamous Cell Carcinoma Types

Based on where the tumor originates from and how much cancer is in the patient’s body, experts differentiate the following types of squamous cell carcinoma: 

  • Metastatic, in which the cancerous cells spread to other body parts beyond the skin. 
  • Cutaneous, or squamous cell carcinoma in situ, where mutated cells haven’t spread beyond the skin’s top layer yet. 

Who Is at Risk of Squamous Cell Carcinoma?

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Generally speaking, this malignancy can affect anyone, but there’s an increased risk of developing these malignancies if you: 

  • Experience long-term sun exposure or severe sun damage to your skin at a younger age.
  • Have a pale complexion, red or blonde hair, and green or blue eyes. 
  • Are 65 years old or older.
  • Have been exposed to chemicals such as arsenic or other materials (even found in cigarettes).
  • Underwent an organ transplant.
  • Have a weak immune system.

Statistically speaking, men are twice as likely to develop squamous cancer than women, and people older than 50 are the age group with the highest risk. 

Squamous Cell Carcinoma Causes and Symptoms 

For the most part, symptoms of these malignancies will include skin changes such as: 

  • A rough growth or bump on the skin may bleed and crust over like scabs.
  • A sore or wound that won’t heal or heal but will recur.
  • A growth that’s higher than the surrounding skin but sinks in the middle.
  • A flat, scaly, red skin area that’s larger than an inch.
  • The bump can feel itchy, scaly, and dry and will often have a different color than the rest of the surrounding area.
  • Lesions on the lower lips that are cracked, dry, and pale causing a burning sensation when experiencing sun exposure.
  • Pale or white spots in the gums, mouth, tongue, or cheeks.

As mentioned above, this malignancy may develop on any part of the body, but they usually occur in the following areas:

  • The skin
  • Threat, tongue, mouth
  • Stomach (epidermoid or esophageal carcinoma)
  • Lips, nose, eyelids, scalp, face
  • Anal cavity
  • Legs, hands, and arms

The medical community agrees that the leading cause of the malignancy is the p53 gene mutation, which most often happens from UV exposure to the sun or indoor tanning beds.

More specifically, the p53 gene regulates cell replication and division to replace other healthy cells when they near the end of their lifespan. In other words, the p53 gene acts as a tumor suppressor, and if the gene fails to give the correct instruction to the cells, squamous cells may start to divide and replicate too frequently, causing lesions, bumps, and limps in and on the body.

For the most part, squamous cell carcinoma is in situ, meaning that it rarely metastasizes to other body parts, and even if it does, the process happens rather slowly. Needless to say, this can be life-threatening, and the tumor must be addressed by a medical professional as soon as possible. 

Diagnosing Squamous Cell Carcinoma,

If your provider suspects that a malignancy may be present, they will first perform a physical examination, observing the area where you are experiencing the symptoms and assessing the growth’s size, shape, color, and so on.

The doctor may also ask questions about your medical history and your lifestyle habits and may ask more specific questions about your symptoms. 

After a physical exam, the provider may recommend further tests to confirm the diagnosis, such as:

  • Imaging tests like an MRI or CT scan
  • Skin biopsy removes a small sample of the tissue in question for further examination. 

Squamous Cell Carcinoma Stages 

After establishing a diagnosis, healthcare providers usually assign a stage to the malignancy, which aims to signal how much cancer is in the body. Staging is crucial for creating a proper and effective treatment plan for the patient. In the case of squamous cell malignancies, experts usually differentiate five stages, which are the following:

  • Stage 0: The cancer is only in the epidermis. This is also referred to as squamous cell carcinoma in situ.
  • Stage I: The tumor is present both in the epidermis and the dermis, or the middle layer of the skin.
  • Sage II: The malignancy has spread to the deeper layers of the skin (subcutis) or may move to target the nerves.
  • Stage III: The cancerous cells have spread to the lymph nodes.
  • Stage IV: The cells have moved to other organs like the brain, liver, or lungs. 

Treatment

Patient Explaining Her Painful to Doctor in the Office

Treatment will mainly revolve around removing the cancerous cells from the body. Based on the shape, location, and size of the tumor, the treatment may include the following:

  • PDT, or photodynamic therapy, which uses light-sensitive agents and blue lights to remove cancerous cells from the skin.
  • Mohs surgery, which removes the skin layers that are affected by the malignancy. This is the most prevalent option for treating facial cancers. 
  • Cryosurgery, which freezes the cancer cells, destroying them in the process.
  • Excision, which cuts cancer out of the affected area. Later, the skin is stitched back together. 
  • Cutterage and electrodesiccation involve scratching off the lump with a curette and then burning the affected area with the help of an electric needle. 
  • Systemic chemotherapy, which uses powerful drugs to destroy all cancerous cells in the body. 

On the other hand, some other medications may also be helpful in the treatment process. More specifically, in some instances, healthcare providers may offer the following treatment methods: 

  • Immunotherapy to treat advanced cancers or other cases of squamous cell carcinoma that can’t be treated with surgery
  • Skin creams with 5-fluorouracil or imiquimod to treat tumors on the epidermis. 

Outlook

Fortunately, most squamous cell carcinoma cases will have a positive outcome with an outstanding survival rate, especially in the case of early diagnosis and treatment. Catching the disease early can prevent the tumor from growing and spreading to other bodily organs.

Still, patients must not forget that there’s a slight chance that cancer will return in the future. As such, scheduling regular follow-ups with your healthcare provider is essential to ensure everything’s all right. Also, proper UV protection and other strategies are necessary to lower the risk of recurrence.  

Learn More

Schedule an appointment with us today to learn more about each treatment process, its possible benefits, and complications, and learn the strategies that may help minimize the risk of developing squamous cell malignancies. 

Please remember that this blog is for informational purposes only. If symptoms do not resolve or if they return, seek medical attention as soon as possible at your primary care physician or with our office.