Squamous Cell Carcinoma

Exposure to UV rays, especially over a long period of time, is the biggest risk factor for squamous cell carcinoma. This includes UV rays from the sun or a tanning bed.

You are also at higher risk of developing squamous cell carcinoma if you:

• Have light skin or a fair complexion.
• Are older, especially over age 50.
• Are male.
• Are a smoker.
• Have a history of skin cancer.
• Have had radiation treatment.
• Received an organ transplant.
• Have xeroderma pigmentosum (XP), an inherited health condition that makes people sensitive to UV rays.
• Are human papilloma virus (HPV) positive, a sexually transmitted virus that may cause changes to genes that control how skin cells grow.
• Have a weakened immune system.
• Have a history of inflammatory skin disease.
• Work with certain chemicals, such as arsenic.

Early detection is crucial in the treatment of skin cancer. How often your doctor screens you will depend on your risk factors.

Protecting yourself from UV rays is the best way to help prevent squamous cell carcinoma.

You can do this by:

• Staying in shade
• Wearing sunscreen with a SPF of 30 or more.
• Wearing a hat and sunglasses
• Covering skin with clothing
• Avoiding tanning beds and artificial sunlight

If you've had skin cancer before or have a weakened immune system, talk to your doctor about these risk factors.

It's important to check your skin often for changes. Look at the front and sides of your body, and use a mirror or ask someone else to check your back.

Don't forget to check parts of your body you might not usually see, including your:

• Underarms.
• Buttocks.
• Scalp and where your hair parts.

Squamous cell carcinoma symptoms include:

• Small lumps or raised skin.
• Scaly or rough patches of skin.
• Areas that look like scars where you don't normally have a scar.
• Sores that aren't healing.

Sometimes these areas may look red or brown, and they may bleed, itch, or feel numb. They might appear raised and crusty, or they might be smooth and shiny.

Certain skin changes are precancerous conditions. Some of these conditions are more likely to turn into squamous cell carcinoma.

These include:

• Actinic keratosis, a skin change caused by too much sun. These are usually smooth or raised patches that might look red, tan, pink, or several colors at once.
• Bowen disease, a skin change that is the beginning of squamous cell carcinoma. Larger red patches that might be crusty, scaly, itchy, or sore form on the skin.

It's important to schedule an exam with your doctor when you notice new growths, patches, or sores that don't heal. Be sure to mention moles or spots you've had for a while, but now look or feel different.

To diagnose squamous cell carcinoma, your doctor will:

• Ask you about your medical history, including past skin cancers.
• Examine your skin for any changes or areas of concern.
• Biopsy the growth if needed.

Your doctor might remove the entire growth or area of concern, known as an excisional biopsy. Another biopsy type, called an incisional biopsy, removes only part of the growth. Other biopsy types are shave biopsy and punch biopsy.

If your squamous cell carcinoma appears to have spread, your doctor may order the following imaging tests:

• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI)

Squamous cell carcinoma treatment depends on your overall health, the location of your cancer, its size, and its stage. Your doctor will recommend the best treatment option after considering these factors.

An excisional biopsy may remove the entire growth or area of concern. You might have Moh's surgery, in which the doctor removes thin layers of cancerous tissue until healthy skin without cancer appears.

Other surgery types include:

• Laser surgery, which uses focused light to remove cancer.
• Curettage and electrodessication, in which a curette, a special sharp instrument, removes the cancerous tissue. Heat or a special chemical is then applied to the skin.

Sometimes, your doctor will recommend non-surgical squamous cell carcinoma treatments.

These can include:

• Immune response modifiers, which are creams or injected medicines that help your body's immune system destroy the cancer.
• Chemotherapy creams applied to the skin, known as topical chemotherapy.
• Cryotherapy, which uses liquid nitrogen to freeze and remove cancer.
• Photodynamic therapy (PDT), which combines medication and a special light to destroy cancerous tissue.
• Chemical peeling, in which chemicals applied to the skin shrink and kill cancer.

Dermatologists, pathologists, radiologists, medical oncologists, and surgical oncologists are part of the UPMC Hillman Cancer Center team. They work together to diagnose and treat squamous cell carcinoma.

Contact UPMC Hillman Cancer Center.

Learn more about squamous cell carcinoma and its treatment

Squamous cell carcinoma prognosis is usually good if treatment begins early. SCC recurs in less than 5% of cases.

A thin layer of tissue, called the basement membrane, separates the epidermis from the skin's other layers. Left untreated, squamous cell carcinoma can push through this membrane and spread to the other layers. It can also spread beyond the skin to lymph nodes or other organs, and become harder to treat.

Pay attention to any skin changes and see your doctor for an exam. Finding squamous cell carcinoma early makes it more likely that your doctor can remove the cancer completely.

UPMC Hillman Cancer Center offers free skin cancer screenings on the third Friday of every month at UPMC Hillman Cancer Center in Shadyside. To make an appointment, call 412-692-4724.