SQUAMOUS CELL CARCINOMA
Common and often easier to recognize.
Squamous cell carcinoma (SCC) is the second most common form of skin cancer. It develops in the squamous cells that make up the outer and middle layers of the skin. When detected early, most SCCs can be treated effectively.
While SCC isn’t usually life-threatening, it can be aggressive. If left untreated, it may grow and, in some cases, spread to other parts of the body.
What is squamous cell carcinoma?
Squamous cell carcinoma is a type of skin cancer that begins in the squamous cells, which are the flat cells located near the surface of the skin. These cells normally shed and renew themselves, but when their DNA becomes damaged from ultraviolet (UV) radiation or other causes, they can start to grow abnormally and form cancer.
How to spot squamous cell carcinoma.
Squamous cell carcinoma can appear in different ways. It often develops on sun-exposed areas of the skin, but it can also occur on other parts of the body, including the lips, mouth, and genitals. Lesions may itch, crust, or bleed, and may resemble sores that do not heal.
Signs & Symptoms
- A red, firm nodule
- A flat sore with a scaly crust
- A new sore or raised area that forms within an old scar or ulcer
- A scaly or rough patch on the lips that may become an open sore
- A reddish, rough patch inside the mouth
- A red, raised patch or wart-like growth on the genitals or in the anal area.
Features of Each Subtype
SCC in Situ (Bowen’s Disease)
These lesions often have an irregular border and may appear red, pink, or reddish-brown. They are usually scaly or crusted. Many are asymptomatic, but some may itch or bleed.
Dermoscopy Features: A common pattern is a structureless brown area. Other patterns may include an asymmetric mix of brown or grey dots and lighter structureless areas. Colours can range from brown to grey. Dermoscopic clues may include dots arranged in lines and coiled vessels.
Well-differentiated SCC
Appearance: Lesions can range from a few millimetres to several centimetres. They are typically domed, rough, and raised, and often appear pink. While commonly found on sun-exposed areas like the head, neck, and arms, they can occur anywhere on the body, including the mouth, anus, and genitals. They may be tender or painful, and can sometimes cause altered sensation.
Dermoscopy Features: Patterns may include multiple vessel types (including coiled and occasionally branched vessels). Whitish structureless areas may be present. Dermoscopic clues may include surface keratin, white circles, and white structureless areas.
Poorly differentiated SCC
Appearance: These lesions also range from small to several centimetres. They may appear as papules or nodules, or as patches or plaques that are rough and raised. Pink areas are often central and unevenly distributed. They usually occur on sun-exposed skin and may be tender or painful.
Dermoscopy Features: Common clues include perifollicular white circles and multiple vessel types (coiled, linear, and occasionally branched vessels). Vessels may cover a large portion of the lesion. Pink colouring is often seen. White circles and white structureless areas may also be present.
Who is most at risk?
Anyone can develop squamous cell carcinoma, but several factors are associated with a higher risk, including:
- Fair skin or skin that burns easily
- Significant or long-term sun exposure
- A history of frequent sunburns
- Use of tanning beds
- A history of precancerous skin lesions (such as actinic keratosis)
- A personal history of skin cancer
- A weakened immune system (from medical conditions or certain treatments)
Preventing squamous cell carcinoma.
Full body protection
Where possible, protect the skin with UV-protective clothing. For exposed areas, use a broad-spectrum UVA/UVB sunscreen with an SPF of 30-45 and reapply as directed.
Develop sun-safe habits
Try to avoid strong UV exposure by seeking shade between 10 am and 4 pm.
Avoid tanning
Tanning beds and prolonged UV exposure can damage the skin and increase the risk of several types of skin cancer. There is no such thing as a “safe” or “base” tan before travelling to a sunny destination.
Check your skin regularly
Watch for new or changing spots, freckles, moles, or growths. If something looks different or is otherwise concerning, consider booking an assessment at the Kelowna Skin Cancer Clinic.
Get to know your treatment options.
Squamous cell carcinoma treatments available through our clinic include curettage and electrodesiccation, cryosurgery, and photodynamic therapy. Your clinician will discuss which approaches may be appropriate based on the type and location of the cancer.
If the cancer is more advanced or has spread, additional treatments (such as surgery or chemotherapy) may be recommended by your care team.
Talk to a physician.
If you’re concerned about a new spot or skin change, consider booking an assessment at the Kelowna Skin Cancer Clinic. A clinician can examine the area, provide guidance, and help you understand your options.