What is squamous cell carcinoma?
SCC is the second most common type of skin cancer, accounting for 20% of skin cancer diagnoses. More than one million Americans are diagnosed with SCC every year. It can be disfiguring and even deadly if not diagnosed and treated early. More than 15,000 Americans die from SCC each year.
What causes SCC?
The main cause is intense, long-term exposure of unprotected skin to the damaging ultraviolet rays of the sun. SCC develops anywhere on skin sun-exposed but commonly affects the face, ears, neck, chest, lips, and backs of the hands, and legs. People who have ever used indoor tanning increase their risk of SCC by 67%. SCC can also develop on the genitals and in burns, scars, ulcers, ulcerated skin and areas exposed to x-rays and some chemicals.
Who is at risk for squamous cell carcinoma?
SCC is the most common type of skin cancer in African Americans, but also affects Latinos and fair-skinned people, and anyone with a history of long-term, substantial exposure to the sun’s ultraviolet (UV) rays and indoor tanning.
- Anyone who has had a basal cell carcinoma, or a prior SCC is at risk for new or second SCC.
- A family history of SCC and melanoma are at risk for SCC.
- People with a weak immune system, and organ transplant patients are 100x more likely to develop an SCC.
- Anyone with a chronic skin infection and inflammation.
- Actinic keratosis (a rough, scaly raised growth caused by the sun) is a precancerous growth that is associated with development of SCC.
- Men are more frequent victims, but women are catching up.
- Most diagnoses are made in people over the age of 50. However, women under 40 are diagnosed more often than in the past, likely due to the use of tanning beds.
What are the symptoms of SCC?
The appearance of a SCC varies and may look like firm, red bumps; scaly patches, or sores that won’t heal; raised growths with a lower center; and wart like growths, but they can also be flat with only minor skin changes.
Dr. Sedrak will review your medical history and conduct a physical exam. Suspicious lesions will be biopsied. A small amount of tissue will be removed and sent to a lab for microscopic evaluation. When the entire lesion can be removed, it may be a cure. Metastases are uncommon except in advanced stages or when they originate in scars, when it can spread to your lymph nodes. So, they will be examined and biopsied if they are too large or firm.
Choice of treatment depends on the size, location, and depth of the tumor, as well as your age and health, and how likely treatment will affect your appearance. Because SCC develops on the face, eyes, lips and nose standard excision can be disfiguring. Consequently, microscopic surgery called Mohs surgery can spare healthy tissues and reduces the risk of recurrence.
Recurrences will be treated aggressively with Mohs Surgery. Prognosis is excellent unless SCC has metastasized.
Excision is reserved for low risk tumors that are located in areas where tissue sparing is not critical. Excision involves the removal of the entire lesion and a margin of healthy skin around the lesion. The excised tissue is sent to a lab for microscopic analysis and confirmation of diagnosis. The cure rate is 92% but drops to 77% for recurrent SCCs.
Mohs Micrographic Surgery
Mohs surgery requires specialized training. The procedure involves the removal of thin layers of the tumor, which are examined under a microscope to see if any cancer cells remain. This is repeated until the sample is free of cancer cells. While Mohs surgery takes several hours, the result is the preservation of healthy skin and an almost invisible scar.
There are a variety of topical treatments including topical drugs and photodynamic therapy (PDT). Topical chemotherapy drugs are used to kill cancer cells. Topical therapies are reserved for low-risk superficial tumors that doesn’t extend deep into the skin. If the BCC is superficial topical medications can provide an 80-90% cure rate.
Dr. Sedrak is a board-certified, fellowship trained dermatologist and MOHs surgeon. At the Texas Skin Cancer Center with offices in Houston, Kingwood and Sugarland, Texas you will always receive private, respectful and compassionate care in a state-of-the-art facility. Contact Texas Skin Cancer Center to schedule a consultation today. Don’t wait. Early diagnosis and treatment can save you from disfigurement and suffering.