This information is intended to provide a general overview of Squamous Cell Carcinoma of the Skin. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider for any health concerns or before making any decisions related to your health.
Squamous cells form the outermost layer of the skin, and they are also found in the inner lining of hollow organs such as the throat and digestive tract. This information focuses exclusively on squamous cell carcinoma (SCC) of the skin.
The primary cause is prolonged exposure to ultraviolet (UV) light, which accumulates over an individual's lifetime. This UV light is typically from sunlight or the use of tanning beds.
Other risk factors include chronic skin wounds and previous radiation therapy for another cancer, with tumours often forming at the radiation site.
Organ transplant recipients face a significantly higher risk than the general population. This is believed to be due to immunosuppressive medications taken to prevent organ rejection, making the patient more susceptible to this type of cancer.
SCC may develop from, or be associated with, actinic keratoses. These are scaly, damaged patches of skin frequently found on sun-exposed areas such as the face, scalp, and the back of the hands.
Overall, SCC of the skin spreads, or metastasises, in only about 5% of cases. However, the risk of spread is higher for larger tumours and those located around the head and neck, including the ears, eyelids, and lips.
In general, any new or changing spot on your skin that persists for two weeks or more warrants a doctor's attention. While skin cancer often has no symptoms in its early stages, signs can appear at any point.
Skin cancer may not present clear physical signs initially, which can delay detection. However, some types may cause sensations like itching, tenderness, pain, or a burning feeling. You might notice a spot that bleeds, crusts over, or does not heal. While basal cell carcinoma can feel like a pearly bump, squamous cell carcinoma may be rough or scaly.
Signs of SCC, which often develops in areas of high sun exposure, include:
We recommend consulting a doctor if you notice any of the following:
Early evaluation and diagnosis are critical for significantly improving treatment outcomes.
Any persistent changes to the skin should be evaluated by a doctor. The diagnostic process typically involves a physical examination of the suspected area. To obtain a definitive diagnosis, the suspicious tissue must be examined under a microscope—a process known as a biopsy.
The specific biopsy procedure recommended depends on the size, shape, and location of the growth. A local anaesthetic is typically administered before the procedure.
All or part of the suspicious area is removed with a scalpel. If the growth is small enough to be completely removed, this procedure serves as both a diagnostic and a treatment method.
The doctor uses a special tool to remove a round cylinder of tissue from the suspicious area. Stitches may be needed to close the wound.
A piece of the growth is shaved off using a scalpel, surgical scissors, or other special tools. Stitches are typically not required.
After the biopsy, the skin sample is sent to a pathologist—a doctor who specialises in diagnosing disease—for examination under a microscope. The pathologist will determine if the results are abnormal, identifying benign (non-cancerous) growths or confirming the presence of cancer (basal cell carcinoma, squamous cell carcinoma, or melanoma).
Basal cell cancer usually remains localised. However, for melanoma or SCC that covers large areas of skin, additional tests may be required to determine if the cancer has spread (metastasised). This includes checking if the cancer has invaded deeper layers of skin, surrounding nerves, or lymph nodes. Patients may undergo medical imaging or have their lymph nodes biopsied if the doctor suspects the cancer has spread.
The pathologists at SSCHRC are highly specialised in diagnosing both common and rare skin cancers, and we welcome the opportunity to provide second opinions.
Your skin cancer treatment at SSCHRC includes a plan customised to your specific type of cancer. Basal and squamous cell skin cancers are typically removed using one of the procedures detailed below.
A doctor numbs the diseased area with a local anaesthetic and then cuts it out entirely, including a small margin of healthy tissue.
A dermatologic surgeon removes a very thin layer of cancer tissue at a time, immediately examining it under a microscope. This process continues until no cancer cells are found in the layer. This procedure has a very high cure rate and generally results in less scarring than traditional excisions. SSCHRC has a dedicated Mohs and Dermasurgery Centre for this procedure.
This less invasive procedure uses liquid nitrogen to freeze and destroy diseased tissue. It is often used for precancerous conditions (actinic keratosis) and occasionally for small, newly developed skin cancers, as it allows the doctor to focus treatment on a limited area, avoiding destruction of nearby healthy tissue.
Chemotherapy drugs are delivered as a topical ointment applied directly to the affected skin. This treatment is used for actinic keratosis and superficial skin cancers, and unlike cryosurgery, it can cover large sections of skin, such as a patient's entire face.
An intense, focused beam of light is used to destroy precancerous conditions and early, superficial skin cancers. The laser is precisely set to remove the skin in controlled layers based on the cancer's depth.
This procedure uses a scraping instrument (curette) and electrical currents to destroy and remove small, superficial skin cancers.
When a patient's skin cancer has spread or is at high risk of spreading, the treatment plan becomes more complex. At SSCHRC, these plans are developed by a team of doctors from multiple specialities, including dermatology, radiation oncology, and various surgical specialities. For instance, high-risk skin cancer on the head or neck may be managed by a head and neck surgeon. Treatments may involve surgery, radiation therapy, and chemotherapy.
Skin cancer screening is recommended for people at an increased risk of developing the disease. If you have one or more risk factors, we encourage you to discuss them with your healthcare provider and get regular skin cancer screenings. Behavioural and lifestyle changes can also play a vital role in prevention.