Squamous Cell Carcinoma

What is squamous cell carcinoma?

• Squamous (SKWAY-mus) cell carcinoma or "SCC" is a slow growing type of skin cancer. Skin cancer occurs when cancer cells are found in the layers of the skin. Normal cells split in a planned way, making more cells only when needed. Cancer cells grow and divide without order, often making a lump or bump. This lump or bump is called a tumor.
  
  
• Some cancers spread to other parts of the body, but squamous skin cancer cells usually do not. Most people get SCC after the age of 60. SCC is found more often in fair skinned, light-haired people who have been in the sun a lot.

What causes SCC?

The main cause of skin cancer is being out in the sun too much and too often. Sun lamps and tanning booths using man-made ultraviolet (UVA UVB) rays can also cause skin cancer.

Skin cancer may also be caused by:

• Being around certain chemicals a lot. These chemicals include coal tars, arsenic, or radium.
  
  
• Having certain skin diseases that may lead to skin cancer. These skin diseases may include actinic keratosis and radiation dermatitis. Burn scars that you have had for a long time may also turn into SCC.

What are the signs and symptoms of SCC?

The most common warning sign is a sore on the skin that does not heal. You may have a small, scaly bump that crusts and damages the skin. These bumps, called tumors, are often found in skin that has been sunburned before. This tumor does not usually hurt or itch. Most of these tumors are found on the face, ears, hands, or arms. These are also found in areas that have not been in the sun.

Later in the disease, you may have skin ulcers that are itchy or painful. These ulcers may easily bleed when touched or poked, and do not heal.

How is SCC diagnosed?

You may need a biopsy which means having a piece of the tumor or sore removed. The tissue is sent to a lab for tests to see if cancer cells are present. Once cancer cells are found, tests are done to find out what type of cancer it is and how much it has grown. Your test results help caregivers decide what treatment is best for you.

How is SCC treated?

You may be treated with one or more of the following:

• Cryosurgery: During cryosurgery, a chemical called liquid nitrogen is put on the area to be removed. This freezes and kills the tissue. The dead tissue later falls off. Once the tissue thaws, the area may hurt and swell for a short time. You may need cryosurgery more than once.
  
  
• Excision surgery: This is a surgery to remove all or part of a tumor from the skin.
  
  
• Electrodesiccation and curettage: The skin tumor is scraped and then heated with an electric probe to kill the cancer cells. This is often done in the doctor's office.
  
  
• Laser therapy: A narrow beam of light is used to kill the cancer cells.
  
  
• Mohs' surgery: This surgery removes only skin with cancer cells and as little healthy tissue as possible. Thin layers of the tumor are scraped off one at a time.
  
  
• Radiation: X-rays or gamma rays are used to treat cancer. Radiation kills cancer and keeps the cancer from spreading. It also keeps cancer cells from dividing into new cells, which is one way cancer spreads. Hard-to-treat areas, such as the eyelids, tip of the nose, or the ear may be treated with radiation.
  
  
• Skin grafting: This procedure is done to remove a thin piece of healthy skin from one part of the body. The healthy piece of skin is then put onto the injured part of the body. When a large or deep tumor is removed from the skin, a large wound and scar may occur. A skin graft can help close the wound or decrease the amount of scarring.
  
  
• Topical chemotherapy: Chemotherapy is often called "chemo". The word topical means it is put on the skin as a lotion or cream. This medicine is used to treat cancer that is in the outer layers of the skin. Topical chemotherapy is put on to kill cancer cells. While being treated, your skin may hurt and look very red.

How should I take care of my skin?

• Protect your skin from the sun's ultraviolet (UVA UVB) rays.
  
  
  • Wear sunscreen that has an SPF (sun protectant factor) of 15 or higher. The sunscreen should also have UVA and UVB protection. Follow the directions on the label when using sunscreen. Put on more sunscreen if you are in the sun for more than an hour. Also reapply sunscreen often if you go swimming or are sweating a lot.
    
    
  • Stay out of the sun between 10 AM and 4 PM. The sun is strongest and most damaging to your skin between these times.
    
    
  • Protect your lips by using lipsticks and lip balms that have sunscreen in them.
    
    
  • Wear long-sleeved shirts and pants to protect your arms and legs when you are out in the sun. Wear a hat with a wide brim to protect both your face and neck.
  
  
• Do not use tanning booths. These can damage your skin as much as the sun.
  
  
• Look for new bumps on your skin once a month. A mole is a small, dark bump on the skin. Know what your regular birthmarks and moles look like. A new mole that appears on your skin after 30 years of age should be watched closely for changes.

For support and information:

• Accepting that you have skin cancer is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings and let them help you. Encourage those close to you to talk to your caregiver about how things are at home. Your caregiver can help your family better understand how to support a person with skin cancer.
  
  
• You may also want to join a support group of other people who also have skin cancer. Ask your caregiver for contact information of support groups. Contact the following for more information:
  • American Cancer Society
    250 Williams Street
    Atlanta , GA 30303
    Phone: 1- 800 - 227-2345
    Web Address: http://www.cancer.org
    
  • National Cancer Institute
    6116 Executive Boulevard, Room 3036A
    Bethesda , MD 20892-8322
    Phone: 1- 800 - 422-6237
    Web Address: http://www.cancer.gov
    
  • The Skin Cancer Foundation
    245 5th Avenue, Suite 1403
    New York , NY 10016
    Phone: 1- 800 - 754-6490
    Web Address: www.skincancer.org
    

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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