Squamous cell carcinoma (skin cancer) symptoms, treatment & more

Squamous cell carcinoma is a slow-growing cancer that develops in the outer layer of skin. It’s usually found on areas of the body most often exposed to the sun:

• Scalp
• Face and lips
• Neck
• Chest
• Upper back
• Ears
• Arms
• Hands

But it can occur on any part of the body, including inside the mouth or on the genitals. Squamous cell carcinoma of the lip, vulva and penis are more likely to spread. Contact your doctor about any sore that does not heal after several weeks.

Risk factors and causes of squamous cell carcinoma

Squamous cell carcinoma is most often found in people 50 or older. Key risk factors include chronic exposure to sunlight over the years and frequent use of tanning beds. It's usually not life-threatening, but if left untreated it can spread to the bones and nearby lymph nodes, where it becomes more difficult to treat.

While survival rates generally decrease as cancer progresses, squamous cell carcinoma that’s already spread to nearby lymph nodes can still be effectively treated using a multifaceted approach.

Symptoms of squamous cell carcinoma

• A red, raised patch or wart-like sore on or inside the anus or on the genitals
• Hard, red bump or knot
• Flat sore or lesion with a scaly crust

Diagnosis of squamous cell carcinoma

Your doctor will perform a physical exam of your skin and ask about your symptoms. If any sores, bumps or lesions are found, your doctor may order a biopsy of the tissue to test it for cancerous cells.

Squamous cell carcinoma is most curable in the early stages before it spreads. If it’s diagnosed early, the five-year survival rate is approximately 99%. To protect yourself, get a professional skin cancer examination at least once a year and perform monthly self-examinations of your skin. Report any changes to your physician.

If you’re diagnosed with advanced squamous cell carcinoma, your doctor may recommend an evaluation by a multidisciplinary team to explore multiple treatment options. The team may include your dermatologist and your primary care physician as well as physicians and surgeons from other specialties.

Testing your skin for squamous cell carcinoma

Many doctors will order a PET or CT scan once a squamous cell carcinoma diagnosis has been reached to ensure the cancer is contained within the layers of the skin and has not spread to other parts of the body. Your doctor may also test your lymph nodes near the tumor site.

The newest diagnostic tool is genomic testing and genetic testing, which analyze your genes for the likelihood you’ll develop certain types of cancers. Results help doctors make more informed decisions to improve your health outcomes

What are the stages of squamous cell carcinoma?

Squamous cell carcinoma stages represent the size of a tumor and how far it has spread. However, squamous cell carcinoma usually spreads (metastasizes) slowly, and most cases are diagnosed while the cancer is confined to the upper layer of the skin. The doctor will assign one of the following squamous cell carcinoma stages to the tumor:

• Stage 0: Cancer is only present on the epidermis (the top layer of the skin).
• Stage 1: Cancer has grown deep into the skin but has not spread to nearby lymph nodes or healthy tissues.
• Stage 2: Cancer has grown deep into the skin and displays one or more high-risk features (such as metastasis to nerves or lower skin layers) but has not spread to nearby lymph nodes or healthy tissues.
• Stage 3: Cancer has grown into lymph nodes but has not spread to any other organs.
• Stage 4: Cancer has spread to one or more distant organs, such as the lungs, liver, brain or distant parts of the skin.

Treatment options for squamous cell carcinoma

There are many ways to treat squamous cell carcinoma. Options may include:

• Mohs surgery: The doctor removes the cancerous cells, as well as a very thin layer of tissue around the affected area, and then views the tissue under a microscope looking for cancer. If cancer cells remain at any of the margins, the surgeon removes another layer of tissue. The doctor repeats this process until no cancer cells remain.
• Excisional surgery: The tumor as well as a layer of healthy skin are cut out to ensure all cancerous cells are removed. For small, early cancers that have not spread, excisional surgery is frequently the only treatment required. For advanced cases, the doctor likely will recommend additional treatments such as chemotherapy or radiation after removing the tumor.
• Currettage and electrodesiccation: The tumor is scraped off with a curette (a spoon-shaped instrument). The area is then treated with a heated electric needle (electrode) to destroy any remaining cancer cells.
• Cryosurgery: The doctor applies liquid nitrogen to the tumor, which freezes it and kills the skin cells.
• Radiation therapy: Multiple narrow radiation beams (light energy) precisely target the tumor.

Prevention of squamous cell carcinoma

• Avoid ultraviolet (UV) exposure by remaining in the shade, wearing long sleeves and pants, a hat and sunglasses.
• Wear a broad-spectrum sunscreen offering both UVA and UVB protection when outdoors.
• Never use indoor tanning beds or other UV tanning lights.