SCCs or Squamous Cell Cancers are very common cancer frequently diagnosed at My Skin Cancer Centre in Brisbane. The high UV index in northern cities is a predisposing factor to the development of this type of skin cancer. SCCs are usually slow growing crusty skin cancers that are most frequently found on exposed areas of the ears, nose, face and arms. All SCCs should be treated as invasive cancers given their ability to spread (metastasize). Unlike Basal Cell Cancers, Photodynamic Therapy is NOT an option for SCCs.
Important facts on SCCs
Invasive SCCs are usually slowly-growing, tender, scaly or crusted lumps. The tumour may be soft and freely movable and may have a red, inflamed base.The lesions may develop sores or ulcers that fail to heal. SCC’soccurmost often on sun exposed sites such as the scalp in balding men, forehead, ears, lips, lower legs, forearms and backs of the hands.Tumors on the scalp, forehead, ears, nose, and lips are at higher risk of spreading (metastases).
SCCs typically grow slowly over months to years however can also develop rapidly. They vary in size from a few millimetres to several centimetres in diameter.
Most SCCs develop as a result of exposure to ultraviolet radiation, which damages the DNA of cells. Those with fair complexions, blue eyes and light hair are most at risk although SCC’s may develop in anyone.
Actinickeratosis (also known as sunspots) is the most common precursors of SCC. These lesions begin as pink, brown, rough patches that are more easily felt than seen. Another precursor to developing SCC isIntraepidermal Carcinoma (IEC) also known as Bowen’s disease, which presents as irregular, well defined, red, scaly patches on sun-exposed areas.
Other factors that may increase the likelihood of developing SCCsinclude a family history of SCC, smoking, prior burn injury, persistent ulcers, long-term use of immunosuppressant’s, and infection with a strain of human papillomavirus (which causes most genital SCCs). Any person previously diagnosed with or treated for SCC is at increased risk of recurrent disease.
SCC isusually diagnosed based on the appearance of the lesion. To confirm the diagnosis and rule out other conditions, your doctor or dermatologist will perform a biopsy of the lesion. In certain circumstances, when SCCs are invasive or have spread to other sites, additional tests such as ultrasound, CT or MRI may be performed.
SCC isa potentially invasive cancer and may be treated best by surgical removal of the lesion under local anaesthetic. The doctor will usually cut out the lesion along with an appropriate margin of normal skin surrounding the tumor.
Mohs micrographic surgery, a specialized form of surgery performed by a trained specialist, may be necessary for large, poorly defined, deep or recurrent tumours or those on delicate areas.
Where large excisions are necessary, a skin graft may be required.
Radiation treatment utilizes x-rays to destroy cancer cells. It is sometimes used for high risk primary skin cancers on the face and for metastatic disease (where the cancer has spread beyond the skin).
The larger these tumors grow, the more extensive the treatment needed.
Following diagnosis of SCC, treatment is usually curative. It is possible however, for an SCC to recur at the same site or for a new SCC to develop elsewhere. Should this occur, additional treatment with surgery or radiotherapy will be required.
If you have had an SCC you are at increased risk of developing further SCC as well as other skin cancers, particularly basal cell carcinoma and melanoma.
It is recommended that those who have had SCC undergo regular skin checks with a GP or My Skin Clinic doctor or dermatologist. The earlier a new lesion is detected, allows for easier and more effective treatment to be undertaken.
SCCs in general have an increased likelihood for recurrence and metastasis than BCCs and hence require more regular follow up. It is suggested that you see your doctor at regular intervals (every 3–6 months) for the first several years, depending on the location, size, aggressiveness, and spread of the initial cancer.