SQUAMOUS CELL CARCINOMA

Squamous cell carcinoma (SCC) is an uncontrolled growth of abnormal cells arising in the squamous cells, which compose most of the skin’s upper layers (the epidermis). SCCs often look like scaly red patches, open sores, raised growths with a central depression. They sometimes crust or bleed. The areas affected are those frequently exposed to the sun, areas with most sun damage (wrinkling, changes in pigmentation, and loss of elasticity) such as the rim of the ear, lower lip, face, bald scalp, neck, hands, arms and legs. It may also occur on the mucous membranes and genitals.

Squamous cell cancer may occur in normal skin or in skin that has been injured or inflamed. Often it develops in a previously scarred area of skin, around a burn, for example.


Causes
SCC is mainly caused by too much sun exposure over the course of a lifetime. It can become disfiguring and sometimes deadly if allowed to grow, since it can spread (metastasize) to other parts of the body. Patients who have had basal carcinoma are at a higher risk of developing SCC, as are people who work or spend a lot of their leisure time outdoors. People with fair skin, light hair and blue, green or grey eyes are at highest risk. Individuals who have had needed a large number of X-rays or who have been exposed to certain toxic chemicals also have an increased risk.

Men are affected more than women, with SCCs usually appearing from the age of 50 and are most frequently seen in people in their 70s.

A sore that does not heal can be a sign of squamous cell cancer. Any change in an existing  wartmole, or other skin lesion could be a sign of skin cancer.

What You Can Do

Avoiding sun exposure is the best way to lower the risk for all types of skin cancer. We recommend that you:

  • Seek shade, especially during midday hours.
  • Wear clothing to protect exposed skin.
  • Wear a hat with a wide brim to shade the face, head, ears, and neck.
  • Wear sunglasses that wrap around and block as close to 100% of both UVA and UVB rays as possible.
  • Use sunscreen with sun protective factor (SPF) of 15 or higher, that offers both UVA and UVB protection.
  • Avoid indoor tanning.

Regularly checking your skin, both by self-examination and by our dermatologist, is also a good idea if you have fair skin and/or a family history that suggests you could be high risk.

What We Can Do For You

A biopsy is needed to confirm the diagnosis of SCC. This is a minor procedure that can be done in a sterile treatment area. The skin will be injected first with local anaesthesic so that you feel no pain. A piece of tissue is then removed and sent to a laboratory to be examined under a microscope. If the diagnosis is confirmed, further treatment will be needed.
Numerous treatment options are available for squamous cell carcinoma. Your therapy will depend upon the type of skin cancer you have and the stage it is at.

  • Surgery — many skin cancers can be cut from the skin quickly and easily. In fact, the cancer is sometimes completely removed at the time of the biopsy, and no further treatment is needed.
  • Mohs’ Surgery – a special technique used for skin cancer. This method is used to remove large tumours, cancer in hard-to-treat places and growths that have recurred. This surgery is performed to remove all of the cancerous tissue.
    After local anaesthesia, the cancer is shaved off, one thin layer at a time, and checked under microscope until it is completely removed.
  • Curettage and Electrodesiccation – Doctors commonly use a type of surgery called curettage. After a local anaesthetic numbs the area, the cancer is scooped out with a curette – an instrument with a sharp, spoon-shaped end. The area is also treated by electrodesiccation. An electric current is applied to control bleeding and kill any cancer cells remaining around the edge of the wound. Most patients develop a flat, white scar.
  • Cryotherapy liquid nitrogen is applied to the growth to freeze and kill abnormal cells. After the area thaws, dead tissue falls off. More than one freezing may be needed to remove the growth completely. Cryosurgery doesn’t usually hurt, but you may have pain and swelling after the area thaws. A white scar may form in the treated area.
  • Laser Therapy – a narrow beam of light is used to remove or destroy cancer cells. This approach is sometimes used for cancers that involve only the outer layer of skin.
  • Topical Chemotherapy – anti-cancer drugs (a cream or lotion) are applied to the tumour directly. This is a useful treatment for cancers on the top layer of the skin. The cream is applied daily for several weeks. Intense inflammation is common, but no scarring.
  • Radiation Therapy – high-energy rays are used to damage cancer cells and stop them from growing. This therapy is used for areas that are difficult to treat with surgery, such as the eyelid, tip of nose or ear.  Several treatments may be needed to destroy all cancerous cells. Possible complications include a rash or dry skin. Following treatment, most patients notice changes in the colour or texture of the treated skin.
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