Cutaneous squamous cell carcinoma is a type of skin cancer that originates in the skin’s squamous cells. The second most common form of skin cancer, this type of cancer is diagnosed in millions of Americans each year.
Squamous cells are flat cells located in the epidermis, which is the top layer of skin. These cells shed continuously, but malignant squamous cell carcinoma occurs when the squamous cells begin to grow abnormally. This abnormal cell growth is triggered by damage to your skin’s DNA, often because of ultraviolet (UV) radiation.
Because of its association with excessive exposure to the sun, the incidence of squamous cell carcinoma has increased by up to 200 percent since the 1990s. While this type of skin cancer has become more common, it remains quite treatable, especially in its earliest stages.
What causes squamous cell carcinoma?
Exposure to UV rays is the leading cause of squamous cell carcinoma. When unprotected skin is exposed to the sun, the UV radiation damages DNA in the skin, which then triggers the growth of abnormal squamous cells.
Certain risk factors can increase the risk of developing squamous cell carcinoma:
- Advanced age
- Blond or red hair
- Blue or green eyes
- Exposure to certain chemicals, including arsenic
- Pale complexion
- Tanning bed use
- Use of certain medications after an organ transplant
- Weakened immune system
In addition to those who have the risk factors identified above, men are also at a higher risk—they’re two times more likely to develop squamous cell carcinoma than women.
What are the signs and symptoms of squamous cell carcinoma?
Recognizing the signs of squamous cell carcinoma can help you get a prompt diagnosis and treatment. Squamous cell carcinoma symptoms include:
- A lesion on the lower lip that may burn when exposed to the sun
- A lingering open sore that bleeds or crusts
- An elevated growth that indents in the middle and may rapidly increase in size
- A persistent scaly red patch that may crust or bleed
- A wart-like growth that crusts and bleeds
- White or pale spots on the mouth, tongue, gums, or cheeks
Actinic keratosis can also be a sign of squamous cell carcinoma. This skin disorder causes areas of skin that are rough or bumpy and may feel dry, itchy, or even scaly. While these patches aren’t cancerous, they can develop into cancer, so are usually removed as a precaution.
How is squamous cell carcinoma diagnosed?
If you have signs or symptoms of squamous cell carcinoma, your dermatologist or another medical provider will first do a thorough physical exam, looking carefully at your skin using a dermatoscope. Other tools may also be used to confirm a diagnosis:
- Biopsy of cells in the skin
- Imaging, such as CT scans, ultrasound, or PET scans, to identify the size of the squamous cell carcinoma and determine if it has spread
If tests find that you have squamous cell carcinoma, your provider will determine the staging of the disease to help define a treatment plan.
Squamous cell carcinoma treatment at NGMC
Most squamous cell carcinomas can be successfully treated, but the earlier they are detected, the better. Treatment usually includes surgery but may also include other therapies along with or in place of surgery.
Surgery for squamous cell carcinoma
In many cases, squamous cell carcinomas can be removed surgically during an office visit with a dermatologist. There are three types of surgical removal:
- Curettage and electrodesiccation uses two types of treatment to remove cancer by first scraping off the squamous cell carcinoma and then using an electrode to kill off remaining cancer cells. This treatment is typically used for small, low-risk squamous cell carcinomas.
- Excision involves cutting out the skin cancer and a section of normal-looking skin around it. The skin removed during an excision is examined under a microscope. If there are no cancer cells in the normal-looking skin, the excision is complete.
- Mohs surgery removes skin in thin layers, preserving as much normal-looking skin as possible. The skin that was removed is examined under a microscope. If the margins are clear, meaning no cancerous cells were found in the normal skin, the procedure is complete.
If excision is recommended but cancerous cells are detected in the normal skin, you may need more excision or another procedure such as Mohs surgery.
Cryosurgery for cutaneous squamous cell carcinoma
Less commonly, squamous cell carcinomas may be frozen off. During cryosurgery, liquid nitrogen is applied to the affected area, freezing that area of the skin.
Radiation therapy for cutaneous squamous cell carcinoma
Radiation therapy may be used as a standalone treatment for squamous cell carcinoma or along with surgical removal. Several types of radiotherapy may be used:
- Brachytherapy involves placing radioactive implants in or near the cancer.
- External beam radiation uses high-energy beams of radiation sent from outside the body into the tumor.
- Superficial radiation therapy directs beams of radiation just beneath the skin to directly target the tumor.
Radiotherapy may be given if there is a high risk of recurrence or in cases of invasive squamous cell carcinoma where the cancer has spread or penetrated deep into the skin.
Immunotherapy for squamous cell carcinoma
Metastasized squamous cell carcinoma may be treated using immunotherapy. This treatment option uses powerful medications to train your immune system to destroy cancer cells.
Squamous cell carcinoma research
At NGMC, our patients benefit from both current treatment options as well as access to innovative new therapies through clinical trials. When an appropriate clinical trial is available, we help patients enroll. Learn more about the current clinical trials we are participating in.
Cancer Rehabilitation
Squamous cell carcinoma treatment can cause a number of side effects, including skin irritation, fatigue, and weakness. At NGMC, we offer specialized cancer rehabilitation services designed to help you cope with side effects and maintain quality of life.
Patient navigation
A cancer diagnosis can be overwhelming, frustrating, and sometimes scary. When you’re feeling uncertain about what’s ahead, our team of cancer care navigators is here to walk by your side. Reach out to our patient navigation program today to connect with a navigator.
Schedule an Appointment with a Dermatologist
Our board-certified dermatologists provide expert services for a variety of skin cancer conditions. From diagnostic procedures to specialized skin cancer treatment, our dedicated team can help guide you through your skin cancer journey. Choose your dermatologist below to get started.