Squamous Cell Carcinoma (SCC)

Most squamous cell carcinoma is caused by ultraviolet radiation from the sun or tanning beds that damages the DNA of skin cells causing mutations that instruct the cells to grow uncontrollably. DNA mutations combined with risk factors such as these increase the chance of developing SCC. Risk factors include:

• Being fair skinned
• Excessive sun exposure
• A history of sun burns
• A history of precancerous lesions
• A personal history of previous skin cancer
• A weakened immune system, particularly organ transplant recipients

SCC often appears as a scaly, red or pink patch of skin that may itch, bleed, or form a crust. It can appear as a firm, red bump or nodule on the skin that may have a rough, scaly or crusty surface. Other signs and symptoms of SCC include:

• A sore that does not heal or heals and then returns
• A wart-like growth that crusts or bleeds
• A raised growth with a depression in the center
• A growth with a hard or horny surface
• Swelling or redness in the affected area
• Persistent tenderness or pain

It’s important to have any suspicious skin lesions evaluated by Dr. Marc Stees, a board-certified dermatologist, especially if they are new, changing, or persist for more than 4 weeks. Early detection and treatment of SCC can prevent it from growing larger and spreading to other parts of the body.

Squamous cell carcinoma is usually diagnosed by a skin exam. Dr. Stees may use a dermatoscope, a handheld device that allows him to see the skin lesion in more detail.

If he suspects a SCC, he will perform a biopsy. The biopsy can be performed with a local anesthetic and a small, sharp blade or a biopsy punch. He will take a small sample of the tissue and send it to a laboratory for diagnosis. When the diagnosis is SCC he will recommend treatment based on the size, location, and type of SCC.

The treatment options for squamous cell carcinoma (SCC) depend on several factors, including the location, size, and stage of the cancer, as well as the overall health of the patient. The most common treatment options for SCC include:

1. Mohs surgery: This is a specialized form of surgery that involves removing the cancerous tissue layer by layer until only healthy tissue remains. This method yields the highest cure rate of all treatment options for SCC. This procedure is often used for SCC that is located in areas where preservation of surrounding tissue is critical.
2. Surgical excision: This involves removing the cancerous tissue along with a margin of healthy tissue around it to ensure that all the cancer cells are removed.
3. Radiation therapy: This treatment involves using high-energy radiation to kill cancer cells. Radiation therapy may be used as the primary treatment for SCC. It also may be used after surgical removal of the SCC for large and aggressive tumors and those that were found to be tracking along nerves microscopically (perineural invasion).
4. Topical chemotherapy: This involves applying a cream or lotion containing drugs that kill cancer cells directly to the affected area. This is only used in lesions that are confined to the epidermis, or the outermost layer of the skin.
5. Immunotherapy: This involves using drugs that stimulate the immune system to attack cancer cells. This type of treatment is typically reserved for SCCs that have spread (metastasized) or cannot be removed surgically.

The choice of treatment will depend on the specific characteristics of the SCC, as well as the patient’s overall health and preferences. It’s important to discuss all treatment options with Dr. Stees to determine the best course of action.