Squamous Cell Cancer

Squamous cell carcinoma (SCC) is the second most common type of skin cancer in the United States. Clinically, it presents as a pink, scaly, crusted lesion on sun exposed areas such as the head, face, neck and extremities. However, SCC can also affect mouth, genital skin as well as non-exposed areas of the body. SCC has a higher risk of spreading to lymph nodes and other internal organs. 

Risk factors for squamous cell carcinoma include:

  • light complexion

  • excessive sun exposure

  • weakened immune system

  • increased age (> 50)

  • tobacco use (smoking, chewing)

  • UV radiation exposure as from tanning beds

  • infection from oncogenic strains of Human Papilloma Virus (HPV)
     

A skin biopsy can confirm the diagnosis. The size, biological behavior of cancer, location, duration, as well as presence of any metastasis can help in treatment options as well as risk stratification for patient.  Generally, the larger the lesion and the longer it has been present, the higher the risk of metastasis. Treatment options include:

  • Curettage & Electrodessication: Also known as "scrape and burn" technique, in this method,the cancer is scraped with a tool, and burned with an electrical needle called hyfrecator. This wound heals on its own in a few weeks. There are not sutures required so there is no post-op visit to have sutures removed.

  • Surgical Excision: the lesion is surgically excised with appropriate margins. Resulting skin defect is then sutured in layers. The internal layers dissolves on its own in a few weeks to a few months, and the top layer is left in skin for 5-14 days, depending on the type of repair, location of surgery on the body and types of sutures used.

  • Mohs Micrographic Surgery: This is a tissue-sparing procedure in which the cancer is excised in layers to confirm negative margins, by processing tissue on the same day, while patient waits for the confirmation. Once all cancer is removed, the defect is closed with sutures, repaired with a skin graft or flap or allowed to heal on its own, through second intent. This is the preferred method of treatment for large cancers or tumors on cosmetically sensitive areas like face, ears, scalp, fingers, toes and sometimes neck.

  • Topical Chemotherapy: This is a non-surgical treatment option which can be used for superficial SCCs (squamous cell carcinoma in-situ). This treatment requires precise application of cream or solution on top of cancer for several days to several weeks. 

  • Radiation Therapy: This is an option for difficult to treat tumors, very large tumors spanning over multiple cosmetic units on face and ears, or for patients, usually elderly, who are not candidates for surgical excision.

 

Patients who develop any suspicious lesions that are changing, growing, bleeding or not healing, should consult a dermatologist for evaluation. Patients with a history of sun damage, precancerous lesions, or skin cancers may need routine skin examinations. Our physician can help determine the right treatment course for you.