Squamous Cell Carcinoma

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How Does The Sun Cause Cancer?

Sun exposure damages the DNA in the skin and can result in skin cancer. People with lighter skin color are more susceptible to skin cancer than people with darker skin color. The more you are out in the sun, the more damage you sustain. The damage is cumulative, so that 5 minutes here and 10 minutes there add up. There really isn’t a safe amount of time you can be exposed to the sun without causing damage. If you need Vitamin D you should obtain it from food and/or vitamin supplements rather than through sun exposure.

How Does Squamous Cell Carcinoma Develop?

Squamous cell cancers arise from the middle or squamous layers of the epidermis. Squamous cell cancers are abbreviated “SCCs”. Left untreated, SCCs grow larger in diameter and penetrate deeper and deeper into the skin and the structures beneath the skin. Some SCCs spread, or metastasize, to other parts of the body. The risk for spread depends on several factors. Some SCCs are more aggressive at baseline and have a higher propensity to spread. SCCs on the lip or ear are at higher risk for metastasis. People who have a compromised immune system also tend to have SCCs that can spread.

Treated SCCs can recur after treatment, which means that the cancer grows back in the same spot. If you get an SCC nearby, or in another location, it is most likely not the original SCC spreading, but the development of a new SCC at the new location. Once you have had one SCC, you have about a 15-30% chance of getting another one in the next 3 years. If you have had more than one SCC, that risk goes up.

What Types Of SCCs Are There?

There are several different types of SCCs. Some of these types include squamous cell carcinoma-in-situ (also called Bowen’s Disease), invasive, Keratoacanthoma, spindle cell, sclerosing, and Basosquamous Cell Carcinoma. SCCs can also be a combination of any of these types. SCCs can also arise within a scar, such as a burn scar, without having had much sun exposure to the area. SCCs arising in a scar tend to be more aggressive and have a higher chance of metastasizing. It is important for the provider to know the subtype of the SCC you have because some are more aggressive than others and the more aggressive ones need to be treated in a more aggressive fashion.

What Treatments Are Available?

There are various treatments available to treat SCCs. Some of these are outlined below.

    • Creams, gels or solutions that are applied to the skin cancer
      • Imiquimod- this cream is applied to the site daily to several times a week for weeks to months
      • 5-Fluorouracil (5-FU)- this cream is applied from twice a day to several times a week for several weeks
    • Cryotherapy: this technique refers to treatment with liquid nitrogen to kill the tumor. This procedure is usually done under local anesthesia (anesthetic injected into the area with a tiny needle to make the area numb so the freezing does not hurt). How long the area needs to remain frozen depends on its size, but it is frozen for at least several minutes.
    • Photodynamic therapy (PDT): A liquid that sensitizes the skin is applied to the skin cancer and left in place from minutes to hours depending on which liquid is needed. Then a specific wavelength of light is applied to the site for at least several minutes. The liquid and the light work together to kill the skin cancer.
    • Radiation therapy
      • Electron beam therapy in a hospital setting involves 5-7 treatments per week for 2-4 weeks
      • Superficial brachytherapy: This type of treatment is often done in an office setting rather than the hospital. It also involves multiple treatments per week for several weeks
    • Surgical treatments
      • Electrodessication and curettage (ED&C, also called C&D for curettage and desiccation): With this technique the visible tumor is scraped off (curettage) and what remains is treated with an electric current to destroy the tissue (electrodessication). This is usually repeated once or twice and is done under local anesthesia in the office.
      • Excision: The skin cancer is cut out with a margin of normal surrounding skin. The extra margin is taken out since SCCs can have microscopic extensions that cannot be seen with the naked eye. The remaining skin is then sewn back together. This is all done under local anesthesia in our office. The removed skin is sent to a pathology lab for processing. A pathologist determines if the cancer has been completely removed or if there is some SCC remaining in the patient. It usually takes about 1 week to get the results.
      • Mohs surgery: The skin cancer is cut out and the patient waits while the removed tissue is processed to ensure its complete removal. It may be removed completely on the first attempt or it may take several attempts. Once the skin cancer is completely removed then the hole, or defect, created by its removal is repaired. This procedure is all done under local anesthesia in our office by one of our Mohs surgeons.

If you have been diagnosed with a Squamous Cell Carcinoma, your provider will discuss the various options that are appropriate for your situation. You will then decide together how to proceed.

Contact Our Board-Certified Dermatologists

If you have or suspect you have squamous cell carcinoma, please contact our board-certified dermatologists by calling (818) 842-8000 or schedule an appointment online to get started on your skin cancer screening & removal. We have seven convenient offices in Burbank, Northridge, Glendale, West Hills, Santa Clarita, Verdugo Hills, and Pasadena. We look forward to meeting you!

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