The squamous cells of the body are found in the middle to the top portion of the very thin layer of the skin known as the epidermis. The entire depth of this part of the skin is approximately 0.2 millimeters but it is a very active cell production and cell evolution region.1 Cells in this area and the layer directly below, the basal layer, can become cancerous and lead to the two most common forms of cancer, squamous and basal cell carcinomas. Of basal and squamous cell cancers the most common is basal, resulting in this diagnosis for about 90% of all types of skin cancers.
For those diagnosed with squamous cell carcinoma it is important to keep in mind that, like basal cell carcinoma, this is a type of skin cancer that is not often associated with spreading. However, it does spread more aggressively than basal cell carcinoma and should be treated as early as possible. As with other types of nonmelanoma skin cancers the most common risk factor for squamous cell carcinoma is repeated or intense sun exposure or exposure to UV radiation. This can become more pronounced as a risk if the individual also has fair skin, burns easily and has light colored hair and eyes, particularly if the individual is over the age of 50.2
Early Signs To Watch For
Squamous cell carcinoma is not a hidden type of cancer. There are typically signs and symptoms that are evident on the skin. However, because of the nature of these symptoms they can easily be mistaken for other skin conditions or even dismissed as part of the aging process until the cancer has advanced. The most obvious signs of skin cancer are bumps that develop under the skin and turn into sores that do not heal. Often the surface of the bump is described as looking red and inflamed with a dry or scaly surface. There may also be large, irregular shaped red patches on the skin that are flat and develop slowly.
In most individuals squamous cell carcinoma is commonly found on sun exposed areas of the body. This includes the face, neck, hands or arms but also the ears, back and legs may be affected depending on tanning or sun exposure. Areas that have been sunburned multiple times anywhere on the body are also at greater risk for developing skin cancer as the individual ages.3
Actinic Keratosis
An early sign of the possibility of developing squamous cell skin may be the presence of skin patches on the body that are known as actinic keratosis. Not all people that have this condition will develop skin cancer, but it can occur. It is very slow to develop and has all the same risk factors as squamous and basal cell carcinomas. The most common sign is small, raised and very rough areas of skin, typically reddish to brownish in color that develop on sun exposed areas of the skin.
Since actinic keratosis and skin cancer can appear the same, a biopsy by a dermatologist may be required to rule out the chance of squamous cell carcinoma. Actinic keratosis can be treated by simple surgical procedures including cryotherapy or freezing as well as chemical peels, laser treatments and topical applications of creams.4
Stages of Skin Cancers And Treatments
Squamous cell carcinoma and basal cell carcinoma share the same stages or the extent to which the cancer has developed. This is determined by a biopsy which allows the dermatologist or oncologist to study the cancerous cells and the layers to tissue that have been damaged. The earlier stages provide greater options for non-surgical types of treatments while the more advanced stages may require significant types of treatments such as chemotherapy and radiation therapies.
Stage 0 indicates that the cancerous cells have only invaded the top layer of the skin. It is usually treated with freezing, topical applications of drug therapies or a scraping procedure that removes the cancer cells completely.
Stage 1 the cancerous growth is clearly visible and is up to ¾ of an inch in width. Depending on the location of the body this cancer may be removed using any of the methods listed above as well as by a minor surgery. The cancer has not invaded lower tissues layers or other surrounding tissues at this stage. The next stage, Stage ll, is the same in that it is not a deep cancer but it is now larger on the skin’s surface than ¾ of an inch or 2 centimeters.
Stage lll skin cancers have moved to other surrounding tissues which may include muscles, bone, cartilage or even into a lymph node that is proximal to the squamous cell carcinoma. Removal of the tumor typically includes surgical procedures, including Mohs surgery, laser treatments or more extensive radiation or chemotherapy treatments.
Stage lV squamous cell carcinomas are not common but they can occur. They include the invasion of the lymph nodes by the cancer and the spread of the cancer to other parts of the body. This is the most serious stage of cancer and requires much more significant and comprehensive treatment.5
Prevention and early detection of any type of basal or squamous cell carcinoma or melanoma begins with monthly skin self-exams and talking to your doctor about any abnormal areas or patches of skin that you note.
References
1 Skin Cancer: Basal and Squamous Cell. (n.d.). Retrieved from American Cancer Society: www.cancer.org/Cancer/SkinCancer-BasalandSquamousCell/DetailedGuide/skin-cancer-basal-and-squamous-cell-diagnosis
2 Basal Cell and Squamous Cell Carcinoma. (n.d.). Retrieved from Univesity of California San Francisco Health: www.ucsfhealth.org/conditions/basal_cell_and_squamous_cell_carcinoma/
3 Squamous Cell Skin Cancer. (n.d.). Retrieved from PubMed Health: www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001832/
4 Actinic keratosis. (n.d.). Retrieved from PubMed Health: www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001830/
5 Staging. (n.d.). Retrieved from National Cancer Institute: www.cancer.gov/cancertopics/wyntk/skin/page9
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