Download Squamous cell carcinoma

PATIENT INFORMATION
Squamous cell carcinoma
Bald scalp in men
excision lines
Method of excision of BCC
the spot if it appears to be an obvious SCC.
What is squamous cell
carcinoma (SCC)?
Squamous cell carcinoma is the
second-most common form of skin
cancer
It is a serious form of skin
cancer in which cells in the epithelial layer (skin surface) of the skin
develop into a malignant tumour.
What is the cause of SCC?
The two main factors in causation are sun exposure and skin type
(fair skin that tans poorly and
burns easily). As with other types
of skin cancer, years of exposure to
the UV rays of the sun is the main
cause. Long-term damage to these
surface cells triggers the growth of
abnormal cells.
The causes can be summarised
as follows:
l Excessive exposure to sunlight
(most cases).
l Skin damage by radiation.
l Exposure to coal tar and various
industrial tar products (uncommon).
l Exposure to chemicals such as
arsenic and polycyclic hydrocarbons.
Queensland has the highest rate
of skin cancer in the world.
Who gets SCCs?
Any person can get an SCC but
it is more common with increasing age and in men, which may
reflect more exposure to sunlight.
The risk increases with:
l Age older than 60.
l Fair complexion.
* Common sites of
squamous cell
carcinoma
Outdoor occupation.
Development of sunspots (solar
keratoses).
The problem is rare in people
with dark skin. Sunspots (solar
keratoses) are dry, rough, persisting spots on the skin which can
change into an SCC and need to
be watched and treated if they alter
appearance.
l
l
Where do SCCs usually
occur?
They usually develop in skin
exposed to the sun, particularly the
face (especially the lower lip),
ears, neck, forearms, back of the
hands and lower legs. In older men
they can occur on the scalp. A
whitish thick patch on the lip
(especially lower lip) may be the
forerunner of an SCC.
What are the symptoms and
signs?
The first sign is a thick fleshy
lump with crusting that appears on
the skin and grows steadily. It may
look like a wart or small ulcer at
first. It becomes crusty and may
bleed. The lump is not usually
painful or itchy, although it may
be tender to gentle squeezing.
What are the risks?
This cancer has to be treated
with considerable respect. If it is
allowed to grow unchecked, it may
spread to other parts of the body
by “seeding” through blood vessels or lymphatic channels. If this
metastatic effect occurs, the outlook is very poor. However, if the
problem is detected early, treatment is simple and effective and
the outlook is excellent.
What should be done?
It is important to visit your local
doctor without delay if you
develop a suspicious skin spot for
no apparent reason. If considered
suspicious, the doctor may want to
remove a small sample for laboratory microscopic analysis (a
biopsy) or may completely excise
How can SCCs be prevented?
Protect yourself from the sun:
l Try to avoid direct sunlight when
the sun is strongest (eg, 10am to
2pm standard time).
l Wear a broadbrimmed hat, T-shirt
and baggy shorts in the sun.
l Use a factor 15+ or more sunscreen on exposed skin.
l Wear a shirt or dress with
sleeves.
l Be wary of reflected sun on
cloudy days.
l Don’t be fooled by a cooling
breeze — you may still be
exposed to UV rays.
What is the treatment?
Most SCCs are easily removed
by a minor surgical operation in
which the total spot is removed
along with a small margin of about
3-5mm of skin to ensure all the
malignant cells are removed.
When the tumour is large, a skin
graft will be needed to cover the
remaining defect.
Other treatments are radiotherapy, laser therapy and cryosurgery
(freezing of the tumour). More
than 99% of patients are completely cured by this treatment.
Regular check-ups are recommended during the next few years
to detect if any of the cancer
remains. If this is the case, the
treatment is repeated.
Acknowledgment to Professor
Robin Marks.
AUTHOR: PROFESSOR JOHN MURTAGH
Copyright of Professor John Murtagh and Australian Doctor. This patient handout may be photocopied or printed out by a doctor free of charge for patient information purposes.