Squamous Cell Carcinoma (SCC)

What is Squamous Cell Carcinoma?

Squamous cell carcinoma (SCC) is the second most common type of skin cancer and concerns the presence of irregular growths in the body’s squamous cells, which are located in the upper layers of the skin. SCC’s typically resemble red, scabrous patches, ulcers, growths or warts and will often bleed. Like BCC’s, Squamous cell carcinomas have the potential to cause disfiguration and even death, if left untreated. SCC is attributed to the collective damage caused by prolonged sun exposure.

In most cases, SCC will develop on areas of the body that receive the most sun exposure, such as the face, neck, arms, legs and hands. In rare incidences however, SCC can also develop in areas that don’t receive sun exposure. Generally, the carcinoma will spawn in areas of the body that exhibit strong visible signs of UV damage, such as freckles, wrinkles, age spots and abnormal pigmentation.

Warning Signs

Squamous cell carcinomas will generally have a rough, scabby appearance and will often bleed when physically damaged. They may also resemble a sore or ulcer and possess a crusted exterior. As a rule, it’s essential that you consult with a skin cancer specialist if you discover a newly formed skin lesion that refuses to heal.

Scabrous Red Patch

a rough textured, scab-like sore that may occasionally bleed or crust up

Skin Growth

skin growth that features a depressed centre that may sometimes bleed. This type of SCC is known to rapidly enlarge

Open Sore

an ominous looking skin sore that shows no signs of healing and will often bleed and crust

Wart-like Sore

this SCC resembles a wart that will crust and sometimes bleed

WHO’S AT RISK?

Literally anyone who has had a considerable amount of sun exposure throughout the course of their lives is at risk of developing SCC. However, those with fair skin and light eyes are at most risk. Additionally, those with outdoor occupations or who spend a considerable amount of recreational time outdoors, are at increased risk. Also, people who have been treated for Basal Cell Carcinoma (BCC) in the past, are at greater risk of developing SCC.

Squamous cell carcinoma is more than twice as prevalent in men than it is in women, which can explained by the greater amount time spent outdoors by men, either through outdoor work or recreational activities. Whilst it’s true that SCC is more common amongst older people, specifically those over the age of fifty, instances of patients in their twenties and thirties being treated for SCC has increased at an alarming rate in recent times.

There has been a significant increase in the number of women under the age of forty, developing SCC as well, which industry experts have blamed on tanning beds, as the large majority of tanning patients are female. Although SCC is most commonly caused by cumulative sun exposure over many years, it can also manifest in areas of the body that have been badly burned, scarred, or exposed to x-rays or harmful chemical substances, among other things. In incidences where SCC develops amongst seemingly healthy skin, some industry experts cite these as being caused by genetics.

TREATMENT

Almost all cases of SCC can be treated successfully and with minimal scarring, when diagnosed early. However, if the cancerous growth manages to go undetected or if a person wrongfully dismisses them as being insignificant, the SCC will begin to puncture the lower-lying layers of skin, resulting in a deeper wound and larger skin. In some cases, negligence can cause the SCC to spread to other parts of the body, resulting in severe complications, or even death. For this reason, any unusual skin sore is cause for concern and should be examined immediately by a doctor.

The form of treatment used to remove the SCC will depend on the size and depth of the cancer, the type of SCC and its location on the body. At Skin Clinic Robina, we offer the following treatment methods at our Skin Cancer Clinic:

• Surgical removal/excision – this involves numbing the skin tissue using a local anaesthetic. The cancerous and surrounding normal tissue is then removed using a surgical scalpel.
• Flap surgery – flap surgery is required when the size of the wound created by the skin cancer’s removal, is too large to stitch together. A skin flap made of healthy skin or tissue beneath the skin (subcutaneous) is removed from an area of the body, and transferred to the site of the wound where the skin cancer was extracted. This patches and covers the area of the wound.
• Graft surgery – this is similar to flap surgery, except the tissue extracted from the healthy donor site of the body, relies on the blood supply of the wound created by the skin cancer’s removal.
• Slow MOHS technique – while this treatment method concerns the surgical excision of the skin cancer, Slow Mohs surgery may require multiple treatment sessions. When the skin cancer has been removed, the extracted cancerous tissue is sent to a lab for analysis. If results indicate that the tissue contains cancer around the margins of the sample, then additional tissue will be removed, and the sample is sent to the lab once more. This is done until the margins around the sample are identified as non-cancerous.
• Curettage and cautery – the area to be treated is numbed with a local anaesthetic and the cancerous lesion is removed using a small surgical instrument known as a curette. The extracted tissue is sent to a lab for assessment. The resulting wound is then cauterised, which prevents bleeding, while eliminating any lingering cancer cells. This process is repeated twice if the cancerous lesion is malignant.
• Topical/cream treatments – skin cancer does not always require surgical intervention. Sometimes, topical treatments can be used to successfully treat the cancerous cells. This includes immunotherapy and chemotherapy creams.
• Photodynamic Therapy (PDT) – PDT is a nonsurgical method for the treatment of superficial skin cancers. Metvix (MLA) is applied to the cancerous tissue and covered for approximately 3 hours, after which the treated area is then exposed to red light to complete the treatment process. This is then followed by two additional treatments, spaced two weeks apart.
• Rhenium-SCT – a painless treatment solution that requires no anaesthesia, Rhenium-SCT is ideal for patients who are elderly, susceptible to allergies, have multiple diseases or who have a low pain threshold. In the majority of cases, Rhenium only requires a single treatment session and is non-surgical, ensuring little to no scarring. Treatment is highly precise, with no damage done to surrounding healthy tissue. Please note that we currently do not perform Rhenium-SCT at our clinic, but can provide a referral for those who wish to undergo this treatment.

RECURRENCE

Anyone who has been treated for SCC in the past has a greater chance of developing further instances of the cancer in the future, particularly in the exact same part of the skin or close by. This is because the skin has been irreparably damaged by past sun exposure. For this reason, it’s imperative that sites of previous SCC’s are monitored with extra caution and a critical element of the post-operative process involves regular visits to your skin cancer specialist. In cases where the SCC does return, they will most commonly do so within the first 2 years of the initial removal. For a recurring tumour, your doctor may elect to use a different treatment method.

PREVENTION

It’s a well-known fact that Australia is the driest continent on Earth, receiving high amounts of intense sunlight, all year round. For this reason, it’s extremely important that people implement a list of sun smart strategies when venturing outside. These include:

• Always try to minimise your sun exposure between the hottest hours of the day; 10 AM – 4 PM
• Wear a wide-brimmed hat and (ideally) sunglasses with UV-protective lenses
• Do not use tanning beds
• Use sunscreen with an SPF rating of at least 15 (50 is recommended)
• Always apply sun cream to your body, approximately half an hour before you head outside and again every 2 hours thereafter or immediately after you’ve been in the water
• Always keep infants out of direct sunlight
• Aim to see a skin specialist at least once a year, for a skin check. (your frequency of visits should be based on the amount of time you spend outdoors, your skin complexion and your past skin cancer history)

CONTACT SKIN CLINIC ROBINA

Squamous Cell Carcinoma can be treated successfully when detected early. If you have noticed the sudden appearance of an unusual mark or sore on your skin that refuses to heal, we strongly advise you to come in and have your skin examined by one of our trained professionals. Likewise, if it’s been a while since you last had a skin check – or if you haven’t ever had one at all, arrange for an appointment with us today.