Squamous Cell Carcinoma

What is It?

Squamous cell carcinoma is the second most common form of skin cancer after basal cell carcinoma.

It affects more than 100,000 Americans each year. It arises from cells (squamous cells) that make up the upper layers of skin and can occur anywhere on the body but are most common in sun-exposed areas. Although these tumors originate in the superficial layers of skin, they eventually penetrate deeper tissue if not treated — in a small percentage of cases, they spread (metastasize) to distant tissues and can be fatal.

What causes it?

Chronic exposure to sunlight (most cases. This is why tumors appear most frequently on sun-exposed areas: face, neck, bald scalp, hands, shoulders, arms, and back. The rim of the ear and lower lip are especially vulnerable areas. It may occur in areas of previous injury: burns, scars, long-standing sores, sites exposed to x-rays or chemicals. It can also occur with conditions that suppress the immune system or cause chronic skin inflammation

Occasionally it can arise spontaneously on what appears to be normal, healthy, undamaged skin; researchers believe inheritance may play a role.

Who gets it?

Anyone with a long history of sun exposure

Fair skin, light hair blue/ green eyes are at highest risk. African Americans are far less likely to develop any form of skin cancer.

Anyone with an outdoor occupation or who spends the majority of their leisure time outdoors.

What to look for?

A persistent, scaly-red patch with irregular borders that sometimes crusts or bleeds

An elevated growth with a central depression that occasionally bleeds

Rapid growth and increase in size

A wart-like growth that crusts and occasionally bleeds

An open sore that bleeds, crusts, and persist for weeks.

Regardless of appearance, any change in a pre-existing skin growth, or the development of a new growth or open sore that fails to heal, needs to be evaluated by a physician.


After a physician’s examination, a biopsy will be performed to confirm the diagnosis. This involves removing a piece of the affected tissue and examining it under a microscope. If tumor is presents, treatment (usually surgery) is required. Treatment can almost always be performed on an outpatient basis in a physician’s office or clinic. A local anesthetic is used and pain/discomfort is usually minimal.

Types of Treatment

Excisional surgery: the entire growth is removed by a scalpel and sent to the laboratory where it is examined microscopically to ensure all tumor cells have been removed.

Curettage and Electrodesiccation: the growth is scraped away, then burned until no tumor remains.

Cryosurgery: liquid nitrogen freezes the tumor. No cutting is included in this bloodless procedure.

Moh’s surgery: (microscopically controlled surgery) successive thin layers of tumor are removed and examined under the microscope. This is repeated until the site is tumor-free. This procedure saves the greatest amount of healthy tissue and reduces recurrence.

Radiation: x-ray beams are directed to the tumor. Total tumor destruction requires a series of treatments, usually several times a week for one to four weeks.

Laser surgery: A laser beam is used to excise or vaporize the tumor.

Follow Up

Anyone who has had a squamous cell carcinoma has an increased chance of developing another because of excessive previous sun exposure which cannot be reversed or undone.

Although the tumor has been carefully removed, another may arise in the same place or nearby.

Squamous cell carcinomas on the nose, ears, and lips are especially prone to recurrence.

It is important to periodically examine the entire body for warning signs of squamous cell carcinoma, paying particular attention to any previously treated site.

Any changes should be reported to a physician


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