| Squamous Cell
Carcinoma |
| Squamous Cell Carcinoma (SCC) is the second most
common cancer of the skin. Squamous cell carcinoma is a tumor that
arises in the outer layer of the skin (the epithelium). Squamous cell
carcinoma is also associated with exposure to the sun’s harmful
ultra violet rays. More than 250,000 new SCC’s are diagnosed
every year in the U.S. Middle aged and elderly persons, especially
those with fair complexions and frequent sun exposure are most likely
to be affected. Squamous cell carcinomas begin in the outer layer
of the skin and can arise from actinic or solar keratoses (small precancerous
scaley growths). If treated in a timely manner, it is uncommon for
skin squamous cell carcinoma to spread to lymph nodes or distant organs.
There is an increased risk for metastasis when the tumor is large,
recurrent, located on the scalp ears, lips, or has aggressive growth
characteristics. |
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| How do you get
squamous cell carcinoma? |
| Ultraviolet light exposure (through the sun or tanning parlors) greatly
increases the chance of developing skin cancer. Persons with light
skin who sunburn easily are at highest risk, although anyone can get
squamous cell carcinoma. With increasing age, the risk of developing
skin cancer grows. Heavy sun exposure and severe sunburns as a child
may especially increase the likelihood of skin cancer. |
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| What does squamous
cell carcinoma look like? |
| A squamous cell carcinoma appears as a crusted or scaly area of the
skin, with a red, inflamed base. Squamous cell carcinoma can present
as a growing tumor, a non-healing ulcer, ore just as a crust. Any
worrisome skin lesions, especially those that are not healing, are
growing, bleeding, or changing in appearance, should be evaluated
by a dermatologist. A skin biopsy for microscopic examination is usually
necessary to confirm the diagnosis.
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| Where does squamous
cell carcinoma appear? |
| Squamous cell carcinomas are common in sun-exposed areas like the face, neck,
and arms. The scalp, back of hands, and ears are especially common.
However, SCC can occur anywhere on the body, even on the lips, inside
the mouth, and on the genitalia.
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| How serious is
squamous cell carcinoma? |
| Usually these skin cancers are locally destructive. If left untreated,
squamous cell carcinoma can destroy the skin and may result in the
loss of a nose or ear. In certain aggressive types of squamous cell
carcinoma, especially those on the lips, ears, and scalp, or those
that are left untreated, the tumor can spread to the lymph nodes and
other organs, resulting in approximately 2,500 deaths each year in
the United States. |
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| How do dermatologists
treat squamous cell carcinoma?
|
| Dermatologist use a variety of different surgical treatment options
depending on location of the tumor, size of the tumor, microscopic
characteristics of the tumor, health of the patient, and other factors.
Most treatment options are relatively minor office-based procedures
that require only local anesthesia. Surgical excision to remove the
entire cancer is the most commonly used treatment option. In many instances, Mohs Micrographic Surgery will be recommended. |
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| I have been referred for Mohs Micrographic surgery. What does this mean? |
Mohs Microhraphic surgery was named after Dr.Frederick Mohs, a surgeon who invented the technique of examining the removed tissue in a very precise way prior to suturing the wound closed. It is recommended when it is imperitive to attain the highest cure rate, and/or to spare as much normal skin as possible. With Mohs surgery, the entire perimeter and undersurface of the removed tissue are examined while the patient waits, in order to ensure removal prior to reconstruction. Because 100% of the margin gets examined, the Mohs surgeon can minimize the amount of tissue removed, and maximize conservation of healthy/normal tissue.
Mohs micrographic surgery is performed by specially trained dermatologic surgeons who specialize in the removal of skin cancer, and in post operative reconstruction. The skin cancer is removed under local anesthesia in an office setting and microscopic sections are prepared on slides while you wait. Your Mohs surgeon examines the slides to determine if the cancer cells have been removed. If not, additional layers are taken until the cancer is completely excised. The advantage of this technique is that a minimum amount of tissue is removed and all the edges of the specimen are carefully studied. Mohs surgery results in the highest cure rate and in maximal tissue conservation, thus optimizing the cosmetic outcome.
Mohs micrographic surgery is indicated for tumors that are:
• Located on cosmetically sensitive areas (face)
• Located on structures where tissue conservation is imperative (eyes, ears, nose, lips)
• Aggressive in their growth characteristics
• Persistent or recurrent despite previous treatment
• Large in size |
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| Can squamous cell
carcinoma be prevented? |
| Ultraviolet light avoidance is the primary form of prevention and
is important at all ages. Outdoor activity should be avoided between
late morning and early afternoon, tanning parlors should be shunned,
and wide brimmed hats should be worn along with other protective clothing.
Sunscreens with SPF 15 or higher and UVA block should be applied regularly
even for a brief exposure to sunlight. |
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