Skin Cancer Overview

The American Cancer Society estimates there will be nearly 2 million new cancer cases diagnosed in 2022 alone, and skin cancer continues to be the most common form of cancer in the United States. Prevailing wisdom for lowering skin cancer risk continues to advise reducing your amount of sun exposure and avoiding indoor tanning. But even so, skin cancer can still develop over time, and early diagnosis is one of the most important keys to successful carcinoma treatment. In this article, we’ll focus on squamous cell carcinoma.


Squamous Cells, Basal Cells, and Melanocytes

Most skin cancers begin in the epidermis, which is the topmost layer of skin. The epidermis includes three main types of cells:


• Squamous cells

These flat cells are located in the upper epidermis, and are constantly being shed as new cells form. If these cells begin to grow out of control, they can turn into squamous cell carcinoma (skin cancer).

• Basal cells

Basal cells are found in the lower section (or “base”) of the epidermis. Cells in this layer constantly divide to form new cells to replace the squamous cells which are continuously shed from the skin’s surface. Skin cancers which form in the basal cell layer are known as basal cell skin cancers or carcinomas.

• Melanocytes

Melanocytes produce the pigment melanin, which gives skin its shade of tan or brown. Melanin acts as a natural sunscreen, serving to help protect the skin’s deeper layers from solar radiation impacts. Melanoma (melanocyte skin cancer) can form in these cells.


A Closer Look at Squamous Cell Carcinoma

Squamous cell carcinoma is the most common skin cancer found in African Americans and Asian Indians, and is the second most common skin cancer to be diagnosed among Caucasians, Hispanics, and those of non-Indian Asian descent. Squamous cell skin cancer usually isn’t life-threatening by itself, but it can be aggressive and can metastasize to other areas. If left untreated, squamous cell carcinoma of the skin can grow large, and can also spread to the lungs and lymph nodes, resulting in serious complications.

Squamous cell carcinomas can be found on any area of the body that typically receives a significant amount of sunlight exposure, and they frequently occur on the face, ears, neck, lips, scalp, and backs of the hands. Some especially aggressive squamous cell carcinomas can also be found in scars, previous burn sites or radiation burns, or other chronically inflamed, ulcerated skin sites. Arsenic exposure and HPV can also increase the risk for squamous cell carcinoma development.


How Dangerous Is Squamous Cell Carcinoma?

Most squamous cell carcinomas (or SCCs) can be easily treated and cured by a licensed skin care professional like Winston-Salem Dermatology. But if allowed to grow unchecked, these lesions can become disfiguring, dangerous, and even downright deadly. SCCs can become invasive, expanding into deeper layers of the skin and eventually spreading to other parts of your body. The cure rate for SCCs is quite high in comparison to some other types of skin cancer, as long as you pursue early diagnosis and treatment.


Symptoms of Squamous Cell Carcinoma

While SCC most frequently develops on sun-exposed areas, it can also appear in some areas of the skin that you might not suspect. These may include the inside of the mouth, the genital area, and the bottoms of the feet. Here are some common signs and symptoms of SCC:

  • Firm, red nodules
  • Flat sores with a scaly crust
  • A new sore or raised area on an old scar or ulcer
  • Rough, scaly patches on the lips that can turn into open sores
  • Red sores or patches which appear on the inside of the mouth
  • Raised, red patches or wartlike sores which appear around the anus or genital area


Some Causes and Risk Factors for Squamous Cell Carcinomas

SCCs on the skin occurs when the squamous cells in the middle and outer layers of the epidermis develop DNA mutations. When a mutation occurs, skin cells can begin to grow out of control and then replace normal, healthy cells. Most DNA mutations in skin cells are caused by exposure to ultraviolet (UV) radiation that comes from natural sunlight, and is also found in tanning lamps and tanning beds. But this exposure doesn’t explain the SCCs that develop on areas of the skin which aren’t ordinarily exposed to sunlight or UV radiation. Here are a few of the factors which can contribute to increased risk for SCCs and skin cancer:

  • Fair skin
  • Blue, green, or gray eyes
  • Blonde or red hair
  • Males are generally more susceptible than females
  • Excessive sun exposure
  • Use of tanning beds
  • Exposure to other forms of radiation
  • A personal history of sunburns
  • A personal history of precancerous skin lesions
  • A personal history of skin cancer
  • Long-term exposure to water-borne toxins like arsenic
  • A weakened immune system
  • The presence of an autoimmune disorder
  • Other rare genetic disorders


Prevention is the Best Cure

Many SCCs are completely preventable with proper skincare. One of the best preventative measures you can take is by practicing proper sun safety. Use sunscreen year-round, and wear protective clothing. If you know you’re going to be outside for an extended period of time, you could put on a large-brimmed hat, and might consider wearing pants and long sleeves as well. It’s best to avoid tanning beds, tanning lamps, and any unnecessary UV exposure, too. Check your skin regularly, too. Keep an eye out for any new or changing lesions that are growing, are prone to bleed, or simply aren’t healing properly. If you notice anything unusual, you should report those changes to your doctor immediately.


Squamous Cell Carcinoma Treatment Options

Most squamous skin cell cancers can be treated with great success, as long as they’re caught early one. Smaller squamous cell cancers are usually pretty simple to treat, but larger squamous cell cancers can be much more difficult to treat. In the rare case that this type of cancer spreads to your lymph nodes or other parts of the body, treatment options like radiation therapy, immunotherapy, and sometimes chemotherapy may be necessary.

Squamous Cell Carcinoma


Surgical Treatment for SCCs

  • Excision – This involves cutting out the tumor itself, as well as a small margin of the surrounding skin.
  • Curettage and Electrodesiccation – This type of treatment option is best suited for smaller cancerous cells, not larger growths.
  • Mohs Surgery – Mohs surgery is especially targeted for SCCs that pose a higher risk of coming back, including larger tumors, cancers that spread along the nerves, and those that occur on the face or in the genital area. This method may also be used following an excision procedure where all the cancer wasn’t able to be removed. 
  • Radiation Therapy – Radiation therapy is a good treatment option for patients with larger size cancers, especially if they’re located in areas such as the eyelids, ears, nose, or other areas where surgery is more difficult.
  • Cryotherapy – Also known as Cryosurgery, this method is typically reserved for early squamous cancer cells, as well as for people who can’t have surgery. Cryotherapy isn’t recommended for larger tumors or invasive cancers, and isn’t as well-suited for certain areas like the eyelids, scalp, legs, nose, and ears. 


Treatment of Advanced Squamous Cell Cancers

  • Lymph Node Dissection – If your squamous cell carcinomas are large or have grown deeper into the skin, removing any nearby lymph nodes is highly recommended. The lymph nodes will then be examined under a microscope to discern whether there are any remaining cancerous cells.
  • Immunotherapy – If your cancer is advanced and can’t be cured with surgery or radiation therapy, administration of an immunotherapy drug may be recommended. These medications may include Cemiplimab (Libtayo) or Pembrolizumab (Keytruda); just be aware that the effects of certain drugs haven’t yet been studied in patients with weakened immune systems.
  • Systemic Chemotherapy or Targeted Therapy – Chemotherapy or targeted therapy drugs, also known as EGFR inhibitors, might be another option for patients whose cancer has spread to lymph nodes or distant organs. These two treatments can be used separately, or in combination with each other if the situation warrants it.


Partner with Winston-Salem Dermatology for Skin Cancer Treatment and Better Skin Care

There are certainly steps you can take to reduce your personal risk for SCCs, and you should certainly be keeping tabs on any unusual skin lesion developments. But for any areas of concern, the best solution is to consult with a local dermatologist for a professional consultation. Winston Salem Dermatology is here to help! We’re equipped and experienced in the treatment of all major skin conditions, including squamous cell cancers. If you’re ready to get some peace of mind about any skin abnormalities or are ready to pursue a proven course of treatment, reach out to us today! You can connect with us online, or for a faster response, simply give us a call at (336) 774-8636!

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