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Squamous cell carcinoma (SCC) is the second-most common form of skin cancer, behind basal cell carcinoma (BCC). Though SCCs are less common, they are more aggressive than BCCs. Risk factors include sun exposure, immunosuppression (e.g. organ transplant patients), human papillomavirus, radiation exposure. Occasionally, SCCs can develop in chronic, long-standing ulcers. SCC may also arise from pre-cancerous growths called actinic keratosis.
SCC occurs most commonly on sun-exposed areas including the head & neck, forearms, backs of the hands. SCCs present as flat or nodular growths on the skin that can ulcerate and bleed. They are occasionally painful.
Metastases:
SCCs metastasize at a rate of approximately 5%. The many risk factors for SCCs to metastasize include:
- Recurrence after previous treatment
- Location (temples, scalp, ear, lip)
- Larger size
- Increasing depth
- Presence of immunosuppression
When SCCs do metastasize, they carry a mortality rate of 18%.
Treatment and Prevention of SCC:
- Surgical methods
- Excision
- Mohs surgery (for head & neck, hands/feet locations and recurrent tumors)
- Electrodessication & Curettage (scrape & burn)
- Cryosurgery (freezing)
- Topical therapy for superficial SCCs
- 5-fluorouracil chemotherapy
- Imiquimod
- Photodynamic therapy (photosensitizer with light)
- When SCCs demonstrate involvement of nerves, adjunctive radiation therapy is usually recommended.
- For high-risk tumors, a special procedure called sentinel lymph node biopsy may be recommended to detect involvement of the lymph nodes.
- Individuals with immunosuppression may benefit from low-dose oral retinoids (e.g. acitretin).
- Sun protection and use of sunscreens are important preventative measures for all the major forms of skin cancer including SCCs.
Consult your dermatologist if you develop a new, bleeding, persistent, growing, and/or painful growth on sun-exposed areas.
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