Squamous Cell Carcinoma (SCC)

Squamous cell carcinoma, or SCC, is a type of cancer that develops in the squamous cells, which are thin, flat cells that make up most of the outermost layer of the skin. It is characterized by an overproduction of squamous cells in your epidermis, which may or may not spread to other areas of your body. Prolonged sun exposure is believed to result in abnormal genetic mutation that may cause squamous cell carcinoma. Though anyone can develop this skin cancer, certain risk factors can increase the likelihood of it. Early cancer detection and treatment can lead to a positive prognosis. 

Keep reading to learn more about this type of skin cancer, what it looks like, how it is staged, what causes it, and how it's diagnosed and treated. 

What is Squamous Cell Carcinoma?

Squamous cell carcinoma, or SCC, is the second most common type of skin cancer that develops from chronic sun-exposed areas of your body. It is characterized by an uncontrolled growth of squamous cells in the epidermis. Although it is far less aggressive than melanoma. Untreated cases of SCC can be debilitating, disfiguring, and sometimes deadly. Squamous cell carcinoma is twice as common in men than women and is most often seen individually in their 70s. 

SCC commonly occurs on your skin in areas with the most sun exposure, such as your face, head, arms, and legs. However, it can also develop in areas of your body where you have mucus membranes (these are the inner lining of your organ and body cavities like in your mouth, lungs, and anus). 

There are two different types of squamous cell carcinoma, namely: 

• Cutaneous: Cancer affecting only the epidermal layer of your skin
• Metastatic: Cancer that spreads to other parts of your body beyond your skin.

What Are the Stages of Squamous Cell Carcinoma? 

Squamous cell carcinoma is classified into stages that help design an appropriate treatment plan for you. There are five stages of SCC, namely:

Stage 0

• The cancer is confined only to your skin's top or superficial (epidermis) layer. 
• This stage is also known as squamous cell carcinoma in situ. 

Stage I

• The cancer develops in the top and middle layers of your skin, namely the epidermis and dermis. 

Stage II

• Cancer is present in the top and middle layers of your skin. 
• The tumor targets the nerves or deeper layers of your skin.

Stage III

• The cancer has spread beyond your skin and affected the nearby lymph nodes.

Stage IV

• Cancer has spread beyond your skin, invading your lymph nodes.
• The tumor spreads to other parts of your body and organs, like the liver, lungs, or brain. 

Where on Your Body Can You Get Squamous Cell Carcinoma?

You may develop squamous cell carcinoma on any part of your body, but it is most common on your:

• Skin
• Oral cavity (mouth, tongue, and throat)
• Face including your lips, nose, ears, eyelids, and scalp
• Stomach 
• Hands, arms, and legs 
• Anal cavity 

What Causes Squamous Cell Carcinoma?

Several research studies suggest squamous cell carcinoma is caused by an abnormal genetic mutation involving the p53 gene. The most common way this gene mutates is through UV (ultraviolet) exposure and indoor tanning beds. 

p53 gene: This gene instructs your cells to divide and replicate to replace cells when they reach the end of their lifespan. It is a tumor suppressor, meaning it can control how much and how often your cells should create new cells. Too many cells create tumors that can be cancerous. 

What Are the Significant Risk Factors For Squamous Cell Carcinoma?

Anyone can get squamous cell carcinoma, but you may be more at risk if you:

• Have long-term sun exposure
• Have sun damage to your skin at a young age 
• Have a pale complexion
• Have blue or green eyes 
• Have blonde or red hair 
• Are 70 years of age or older 
• Are a women
• Have a weak immune system
• Have undergone an organ transplant
• Have chemical exposure
• Have a history of other skin cancers 
• Have chronic inflammatory skin conditions or infections 

What Are the Signs of Squamous Cell Carcinoma?

You can notice the presence of cancerous bumps, marks, or lesions that form on your skin and can be a classical sign of SCC, including:

• Actinic keratosis: A bump or lump that feels dry, itchy, and scaly and varies in color from the surrounding skin. 
• Cheilitis: A lesion in your lower lip where the tissue becomes pale, dry, and cracked. 
• Leukoplakia: White or pale spots in your mouth, tongue, gums, and cheeks. 

What Are the Symptoms of Squamous Cell Carcinoma?

There may be a cascade of symptoms associated with squamous cell carcinoma. These include the following:

• A rough feeling bump or growth on the skin
• This may be flat, scaly, and red that is larger (about 1 inch) 
• An open sore with raised borders 
• A brown spot resembling an age spot
• The growth may crust or bleed 
• The growth may also appear elevated with a central depression 
• New growth on an old scar or birthmark
• Lip or mouth sores that do not heal 
• Loose teeth 
• Sore patches in the mouth 
• Painful swallowing 

How is Squamous Cell Carcinoma Diagnosed?

Your doctor will evaluate your symptoms and record your medical history to learn about the presence of any debilitating disease. They will then physically examine the lump to assess its size, color, and texture. To confirm the diagnosis, they would recommend the following diagnostic tests:

• Skin biopsy: A small tissue sample is collected from the lump and studied under a microscope to rule out other skin cancers. 
• Imaging tests: A CT scan or MRI is done to check the size and extent of the cancerous tumor and determine if it has spread to the lymph nodes. 

How is Squamous Cell Carcinoma Treated?

Treatment of SCC depends on the type, stage, and severity of the cancer. Treatment options may include:

Mohs Micrographic Surgery         

• The procedure involves the removal of the lump and some of the surrounding tissues and skin. 

Excisional Surgery         

• Your doctor removes the cancer cells and a thin layer of healthy skin in the surrounding area. 

Electrosurgery          

• This is also known as electrodesiccation and curettage.
• It involves scraping off the cancer and burning the skin to kill cancer cells.

Cryosurgery          

• During this procedure, your doctor uses liquid nitrogen to freeze and destroy the cancer tissues. 

Radiation      

• Here, high-energy X-rays are used to kill the cancer cells. 
• This is performed multiple times for several weeks. 

Photodynamic Therapy

• This involves the application of a photosensitizing substance to the cancerous areas.
• These areas are exposed to strong light for several minutes after a few hours. 
• This activates the medicated substance to kill the cancer cells.

Systemic Chemotherapy         

• Your doctor uses powerful drugs to target and destroy the cancer cells. 

Can You Prevent Squamous Cell Carcinoma?

You cannot completely prevent all types of SCC, but you can adopt a few preventive tips to reduce risk. These include:

• Avoiding excess sun exposure
• Using broad-spectrum sunscreen when outdoors
• Avoiding tanning beds 
• Stopping smoking 
• Wearing protective clothing to prevent direct sun exposure
• Avoiding exposing yourself to chemicals without protective gear 

Conclusion

It can be daunting to notice any skin changes that lead to a cancer diagnosis. Squamous cell carcinoma is an aggressive type of skin cancer, commonly affecting men over 60 to 70 years of age. Early detection and treatment are the key to a successful outcome and prognosis in patients, especially with cutaneous SCC. Seek medical help immediately if you notice any new lumps or bumps on your skin. Get them examined and treated immediately for an improved quality of life.