Squamous Cell Cancer: Pictures, Symptoms, Treatment, and More

Squamous cell cancer (SCC) is a type of cancer that is also called squamous cell carcinoma. It starts in the thin, flat cells called squamous cells that make up the top layer of your skin. You also have squamous cells in your lungs, mucous membranes, digestive tract, and urinary tract, among other places.

cutaneous SCC is the name for SCC that forms on your skin (cSCC). Changes in the DNA of squamous cells cause them to grow and divide out of control, which is how cSCC starts. It usually appears on parts of your skin that get a lot of sun, such as your face, neck, or arms.

Read on to learn more about this type of skin cancer, including what it looks like, what causes it, and how it’s diagnosed and treated.

What is squamous cell skin cancer?

Cutaneous SCC, or cSCC, is a type of cancer that starts in your skin’s squamous cells. The Skin Cancer Foundation says that cSCC is found in about 1.8 million people in the United States every year. It is the second most common type of cancer of the skin.

Even though cSCC doesn’t cause death, it can become dangerous if it isn’t treated. If you don’t get treatment right away, the growths can get bigger and spread to other parts of your body, which can cause serious problems.

People with cSCC often get rough, red patches, open sores, or growths that look like warts on their skin. These abnormal growths can happen anywhere, but they usually happen in places that get the most ultraviolet (UV) radiation from the sun, tanning beds, or lamps.

More than 90 percent of all mouth cancers are also oral SCC. About 30 percent of lung cancers called “non-small cell lung cancer” are lung SCC, and about 25 percent of all lung cancers are lung SCC.

Types of skin cancer

Your skin is made up of many layers. The epidermis is the layer of skin that is on the outside and protects the body. There are three main types of cells in the epidermis: keratinocytes (skin cells, also called squamous cells)

• melanocytes (pigment-producing cells)
• Langerhans cells (immune cells)

The cells of the epidermis are always shedding so that fresh, new cells can take their place.

But skin cancer can happen when certain changes happen to the DNA of any of these cells. These are the main kinds of skin cancer:

• squamous cell carcinoma
• basal cell carcinoma
• malignant melanoma

Squamous cell cancer

The cells that are closest to the surface of your skin are called squamous cells. Their job is to line your skin. cSCC usually forms in places on the body that get a lot of UV radiation, like the face, hands, and ears.

Basal cell cancer

The basal cells are the ones that are below the squamous cells. They are always dividing to make new cells. The American Cancer Society says that about 80 percent of all skin cancers are caused by basal cell carcinoma.

Like cSCC, basal cell cancer usually happens in places that get a lot of sun, like your face and neck. This kind of cancer usually grows slowly and doesn’t spread to other parts of the body very often.

But if you don’t treat basal cell cancer, it can spread to your bones and other parts of your body.

Melanoma

Melanocytes and basal cells are both found in the deepest part of your epidermis. The colour of skin comes from a pigment called melanin, which is made by these cells. Malignant melanoma is what happens when cancer starts to grow in melanocytes.

Malignant melanoma is less common than squamous cell and basal cell cancers, but if it’s not treated, it’s more likely to grow and spread.

What are the symptoms of squamous cell cancer?

cSCC usually happens in places that get a lot of UV light, like your face, ears, and hands. But it can also show up in your mouth, on your genitalia, and around your anus.

Some of the signs of cSCC are:

• a wound that is open and can have raised edges
• a red, scaly spot on the skin;
• a brown spot that looks like an age spot.
• a new growth on an old scar, birthmark, or mole that looks like a wart.
• a growth with a horn shape
• firm growth that looks like a dome

The American Academy of Dermatology says that most cSCC is either red or pink. It could also:

• brown
• black
• yellowish
• white

This type of cancer can lead to:

• lip or mouth sores that don’t heal
• sore or rough patches in your mouth
• a loose tooth
• white or reddish patches
• painful swallowing
• a growth inside your mouth

Make an appointment with your doctor or a dermatologist right away if you have any signs of cSCC or a sore or growth that won’t heal. Complications can be avoided by getting a diagnosis and treatment as soon as possible.

What are the causes and risk factors for squamous cell cancer?

cSCC is caused by changes that happen in the DNA of squamous cells. Because of these changes, abnormal cells start to multiply too quickly.

Most DNA changes that lead to cSCC and other skin cancers are caused by UV radiation.

Causes of squamous cell cancer

Most cases of cSCC are caused by exposure to UV radiation, either from the sun or from tanning lamps and beds used indoors. Some other possible causes are:

• Genetics. Genetic factors seem to have something to do with the growth of cSCC. A study from 2015 found that people with a history of cSCC in their family are about four times more likely to get it themselves.
• Smoking. cSCC is more likely to happen to people who smoke, especially on their lips. Smoking is the main reason why people get lung cSCC and other types of lung cancer that aren’t small cell lung cancer
• Chemical exposure. Some chemicals, like coal tar, paraffin, some petroleum products, and arsenic, may make cSCC more likely to happen.
• Radiation exposure. When you get radiation therapy, your risk of getting skin cancer in the area that was treated goes up a little bit.
• Immunosuppression. Immunosuppression makes cSCC more likely to happen. For example, people who get organ transplants are 65 to 250 times more likely to get cSCC than the rest of the population.
• Burns that left deep scars and sores. cSCC can grow in sores, ulcers, or burn scars that have been on your body for a long time.

Risk factors for squamous cell cancer

Some things that can cause cSCC are:

• having fair skin
• having light hair and blue, green, or grey eyes having long-term exposure to UV radiation living in sunny areas or at a high altitude having a history of multiple severe sunburns, especially if they happened early in life having a history of being exposed to chemicals like arsenic
• having a history of lowering the immune system
• history of severe burn scars, ulcers, or sores

How is squamous cell cancer treated?

There are many ways to treat cSCC. The treatment depends on:

• the extent and severity of your cancer
• your age
• your overall health
• the location of the cancer

If cSCC is caught early, it is usually possible to treat it successfully. Once it has spread, it is harder to treat. Many treatments can be done in the doctor’s office. Some possible treatments are:

• Mohs micrographic surgery. In Mohs surgery, your doctor uses a scalpel to cut away the abnormal skin and some of the tissue around it. The sample is looked at right away with a microscope. If there are any cancer cells in the sample, the process is done again and again until there are no more cancer cells.
• Surgery to remove a part. During excisional surgery, your doctor cuts out the cancer cells and a thin layer of healthy skin around them. Wounds are closed with stitches. The sample is then sent to a lab to make sure that all of the cancerous tissue has been taken away.Electrosurgery. Electrosurgery is also called
• electrodesiccation and curettage. To kill cancer cells, it scrapes off the cancer and burns the skin. Most of the time, this process is done more than once to make sure the cancer is completely treated and gone.
• Cryosurgery. During cryosurgery, your doctor freezes the cancerous tissue with liquid nitrogen, which kills it. This treatment is done more than once, just like electrosurgery, to make sure that all cancerous tissue has been removed.
• Radiation. X-rays with a lot of energy are used to kill cancer cells. This treatment is done on the outside with the help of a machine that sends rays to the affected area. Radiation is often done several times a week over the course of a few weeks.
• Photodynamic therapy. Also known as PDT, photodynamic therapy involves putting a substance on the cancerous areas that makes them more sensitive to light. After 1 to 3 hours or longer, the treated areas are put under bright light for a few minutes. This makes the medicine that was put on work and kills the wrong cells.
• Systemic drugs. Several types of systemic drugs are FDA approved cemiplimab-rwlc (Libtayo) and pembrolizumab are used to treat cSCC (Keytruda). Systemic drugs affect your whole body and are often used to treat cSCC that is spreading quickly.

Non-FDA-approved methods for treating squamous cell carcinoma

Some doctors may also treat cSCC with laser surgery and medications that are put on the skin. But these ways to treat cSCC have not been approved by the Food and Drug Administration:

• The use of lasers. During laser surgery, your doctor uses a focused beam of light to remove abnormal patches of skin.
• Drugs that go on the skin. Some medicines that are put on the skin to treat other types of skin cancer, like 5-fluorouracil and imiquimod, may also help treat cSCC.

Once you’ve been treated for cSCC, it’s very important to go to all of your follow-up appointments with your doctor. cSCC can come back, so it’s important to check your skin at least once a month for spots that look like they might turn into cancer.

How is squamous cell cancer diagnosed?

Your doctor will first do a physical exam and look for signs of cSCC in any unusual spots. They will also ask about your past health. If your doctor thinks you have cSCC, he or she may do a biopsy to be sure.

A small piece of the affected skin is usually taken off during a biopsy. The sample of skin is then sent to a lab where it will be tested.

In some cases, your doctor may need to take out more of the abnormal growth or even all of it to test it. Talk to your doctor about any worries you have about scarring or a biopsy.

After treatment for cSCC, you should go to all of your follow-up appointments with your doctor. Cancer can come back, so it’s important to check your skin at least once a month for any signs of cancer or precancer.

Can squamous cell cancer be prevented?

Follow these tips when you can to help lower your risk of cSCC:

• Limit your sun exposure.
• Don’t go out in the sun between 10 a.m. and 4 p.m., when it’s the hottest.
• When you go out in the sun, wear sunscreen with an SPF of at least 30.
• Wear sunglasses that block UV rays.
• When you work outside, wear a hat and cover your skin.
• Try to stay away from tanning beds and lamps.
• Protect your skin even in the winter, when UV rays can be even more harmful.
• Every month, check your skin for any new or strange growths.
• See a dermatologist once a year to check the skin on your whole body.

Takeaway

The best way to treat cSCC is to find it early. If cSCC isn’t treated in its early stages, the cancer may spread to other parts of the body, like the lymph nodes and organs. When this happens, the condition can be dangerous to life.

People whose immune systems aren’t as strong because they have HIV, AIDS, or leukemia are more likely to get more serious forms of cSCC.

If you think you might have skin cancer, you should see a doctor right away.