Squamous Cell Carcinoma

Skin cancers are the most common type of cancers, and there are three main types, which are divided into non-melanoma skin cancers, and melanoma;

Non-melanoma: o Basal cell carcinoma (BCC) o Squamous cell carcinoma (SCC)
Malignant melanomas

Overview

The term ‘non-melanoma’ means cancers that develop slowly in the upper layers of the skin. These cancers are the more common types (basal and squamous cell carcinomas), whereas melanomas are rarer and can be more serious. Non-melanoma skin cancers (BCCs and SCCs) are still serious and require specialist medical attention and treatment, and this is why suspected pre-cancerous lesions should always be checked by a medical expert.

Non-melanoma skin cancers typically present in the outermost layers of the skin (also called the epidermis) and are frequently named after the type of skin cell from which they develop. The term ‘squamous’ does not always refer to skin cancer. Squamous cells are present throughout the body, and are constantly dividing and forming new cells to replace the ones that have been naturally shed.

In the case of squamous cell carcinoma, the cancer forms in the squamous cells that line the top of the epidermis - the thin, flat cells that make up the outermost layer of the skin.

SCCs may also be referred to as cutaneous squamous cell carcinoma – this is usually abbreviated as ‘CSCC.’ The addition of the word “cutaneous” means that it develops externally. Clinicians and many online resources sometimes add the word to differentiate the disease from SCCs that develop inside the body – for example, in the mouth, throat or lungs.

According to NHS data, around 150,000 of new cases of non-melanoma skin cancer are diagnosed in the UK each year. Non-melanoma skin cancer is more likely to affect men than women, and it tends to affect older people with the rates being highest in those over the age of 75.



Squamous cell carcinomas (SCCs) are the second most common type of skin cancer, accounting for about 20% of all skin cancers.



Symptoms of Squamous Cell Carcinomas (SCC)

As non-melanoma skin cancer develops as a result of exposure to ultraviolet (UV) light, it most often presents in skin that has been regularly exposed to the sun – on the face, ears, hands, shoulders, upper chest and back. However, the popularity of unhealthy exposure to UV light – whether sunbathing on holiday, or the use of harmful tanning beds – means cancer may develop in other areas.

The first sign of a non-melanoma skin cancer is typically a lump or bump that appears on the skin, and doesn’t resolve itself after 4 weeks of monitoring. This is known as a suspicious growth, which needs to be investigated by a doctor.

In the majority of SCC cases;

  • They present as red, firm lumps, and may develop into ulcers, whereas pre-cancerous patches are more often flat and ‘scaly.’
  • A firm pink lump with a rough or crusted surface.
  • Lumps can be tender to the touch, and bleed easily.
  • Some SCC presents with a spiky ‘horn’ that sticks up from the surface.

If non-melanoma skin cancers are not treated, it is possible that they will cause significantly worse damage, so time is of the essence if you think you have a suspicious growth. There's a slight risk (up to 5%) that SCCs can spread to other parts of the body – typically the lymph nodes (small glands found throughout your body) – so do take any suspicious growths seriously as a possible skin cancer.

It is important that you visit your GP if you are worried about a lesion and they will refer you to a dermatologist for treatment if they feel this is appropriate. It is important to self-monitor for any changes, and follow up with your GP if you have been asked to keep an eye on a lesion and have any concerns.

If non-melanoma skin cancers are not treated, it is possible that they will cause significantly worse damage, so time is of the essence if you think you have a suspicious growth.

Causes of Squamous Cell Carcinoma

The primary cause of squamous cell carcinoma is overexposure to ultraviolet (UV) light, either from the sun, or from harmful artificial tanning practices, such as sunbeds or sunlamps.

The exposure to ultraviolet radiation can cause the DNA of skin cells (keratinocytes) in the outer layer of the skin to change, and this allows the skin cells to grow out of control, developing into SCCs.

UV light damage can cause SCCs directly, but it may also sometimes cause a scaly area to develop, which may be a pre-cancerous lesion called an actinic keratosis or Bowen’s disease, which if left untreated can develop into an SCC.

Squamous cell carcinomas can also evolve in skin that has been damaged by other forms of radiation (for example in burns), persistent wounds, viral warts and in old scars.

Factors that increase susceptibility include;

  • Previous skin cancer
  • A family history of skin cancer
  • Fair, or pale skin that burns easily
  • Working outdoors
  • Immunosuppression due to diseases that affect the immune system, such as HIV or leukaemia
  • Immunosuppressive medication, such as methotrexate, ciclosporin and azathioprine
  • Skin conditions, such as albinism and xeroderma pigmentosum

Treatment at Derma for Squamous Cell Carcinoma

Your appointment with the dermatologist will begin with analysis of the affected area, and together you will discuss your medical history, before a course of treatment is recommended.

Many non-melanoma skin cancers can be treated by excision, which is a relatively painless procedure that can be performed efficiently and effectively. Depending on insurance, treatment can be carried out the same day as the consultation.

Please note that further tests – such as a biopsy – may be necessary. Follow-up appointments will be required to ensure that the SCC is properly treated, and your skin monitored for any changes, as having skin cancer is likely to increase susceptibility.

We see and treat more skin cancer patients than any other doctors in Reading, so you can be assured that Derma will provide the very best care, the latest research and the most effective treatments.

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For more information, or to book an appointment with Derma, please call the clinic or contact us.

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