If you or a loved one has been diagnosed with squamous cell skin cancer, it’s normal to worry about the cancer diagnosis. However, this is a treatable form of skin cancer. Please continue reading to learn more about the treatment options for squamous cell carcinoma and other similar skin conditions.

What are the different types of skin cancer?

Squamous cell carcinomas and basal cell carcinomas are the most common types of skin cancer. They are called non-melanoma skin cancers. Actinic keratosis is a rough, scaly patch of precancerous cells that can progress to squamous cell carcinoma. Other skin cancers, such as melanoma, are less common but are more invasive and more likely to spread to other parts of the body. 

Why does squamous cell carcinoma occur?

Cancer cells are abnormal cells that grow uncontrollably due to mistakes in the DNA (genetic material). Skin cancer is a condition in which cancer cells form in the skin due to excessive sun exposure or exposure to ultraviolet (UV) rays from tanning beds or sun lamps. 

Squamous cell carcinoma arises in specific cells called squamous cells, which are found in the upper layer of skin and mucous membranes (moist tissues that line cavities in the body such as the nose, mouth, throat, airways, intestines, urethra, rectum, and vagina).

Basal and squamous cell carcinoma tends to occur in areas of the skin that are exposed to the sun, such as the face, neck, and hands. These skin cancers can form in areas that have been sun damaged, sunburned, or exposed to radiation or chemicals. 

What does squamous cell carcinoma look like?

A squamous cell carcinoma typically appears as a firm, red bump in the skin. The area of skin cancer can become rough and scaly, and it may bleed and form a crust. You should make an appointment to see your healthcare provider if you have: 

• A sore that does not heal with continued scaling, bleeding, or crusting
• A raised red or brown area surrounded by normal skin
• A raised, shiny, smooth, or pearly-looking area of skin
• A white, yellow, or waxy-appearing area that feels firm, like a scar

How quickly does squamous cell skin cancer spread?

Squamous cell carcinomas spread slowly. These skin cancers may spread to nearby lymph nodes. However, they rarely metastasize (spread to other parts of the body). When they do spread, it occurs slowly. Most squamous cell carcinomas are diagnosed before they have spread beyond the skin. Squamous cell carcinomas that have not spread and are treated early are usually curable.

How serious is a squamous cell carcinoma diagnosis?

As mentioned, most squamous cell cancers are curable. The prognosis (outcome) varies from person to person and depends on the stage of cancer and other factors such as immune system health, smoking history, and medical history.

What are the stages of squamous cell carcinoma?

Staging of squamous cell cancer is important to plan treatment. The stages of squamous cell carcinoma are as follows:

• Stage 0 or carcinoma in situ or Bowen disease: The abnormal cells are limited to the squamous cell layer of the epidermis (the upper layer of skin). These abnormal cells may become tumor cells and spread to surrounding normal tissue. 
• Stage I: Skin cancer cells are found, and the size of the lesion is 2 cm or less.
• Stage II: The tumor is between 2 cm and 4 cm in size.
• Stage III: The tumor is larger than 4 cm, or the squamous cells have spread, with cancerous tissue found in the deeper layers of the skin or nearby lymph nodes. 
• Stage IV: The tumor cells have spread to the bone, the nerves deep in the skin, the lymph nodes, or other parts of the body.

Note: The staging for squamous cell carcinoma of the eyelid is different. 

Healthcare providers stage squamous cell carcinoma of the skin by performing imaging tests such as CT scan, chest X-ray, PET scan, ultrasound examination, eye examination, and lymph node biopsy.

How treatable is squamous cell skin cancer?

Squamous cell carcinoma can usually be treated and cured. However, early diagnosis and proper treatment are key. Many treatment options are available and most of these treatments can be performed in a doctor’s office without the need for a hospital stay. 

What are the options to treat squamous cell carcinoma?

• Radiation therapy: This involves using high-energy X-rays (radiation) to kill cancer cells or prevent them from multiplying. 
• Chemotherapy: These are drugs that stop cancer cells from growing. Topical medications (local treatments applied to the skin) are usually prescribed for skin cancer.
• Photodynamic therapy: This cancer treatment uses certain types of light to activate an injected drug that collects in the skin cancer cells. The activated drug kills the cancer cells while sparing healthy tissue. 
• Immunotherapy: This treatment boosts the immune system cells’ ability to fight cancer. 
• Targeted therapy: This skin cancer treatment targets and attacks the cells in a squamous cell carcinoma.
• Other treatments: Retinoids (drugs from the vitamin A family) are sometimes used to treat squamous cell carcinoma.

How do they remove squamous cell skin cancer?

Different types of surgical removal can be done to treat basal cell carcinoma and squamous cell carcinoma, leaving you cured and cancer free. These include:

• Simple excision: This involves cutting out the entire tumor along with some normal skin.
• Mohs surgery: This common treatment involves removing a thin layer of cancerous cells and checking the edges of the tumor under a microscope. Further layers are removed until no more cancer cells are seen in the surrounding tissue, leaving behind only normal cells and healthy skin. This allows the removal of as little normal skin tissue as possible. 
• Curettage and electrodesiccation (electrosurgery): A curette (sharp, spoon-like instrument) is used to cut the tumor out. Then an electric needle is used to apply an electric current to stop the bleeding and destroy the cancer cells at the wound’s edge. The process is repeated up to three times to remove all the cancer. 
• Cryosurgery or cryotherapy: Liquid nitrogen is used to freeze and treat cancer.
• Laser surgery: A laser beam is used to cut out abnormal tissue without any blood loss.

Additionally, procedures such as shave excision and dermabrasion may be used to treat actinic keratosis.

What is the most effective treatment for squamous cell carcinoma?

Treatment of squamous cell carcinoma and basal cell carcinoma depends on the stage. Localized squamous cell skin cancers are usually treated with simple excision, Mohs surgery, radiation therapy, cryosurgery, and curettage and electrodesiccation. Photodynamic therapy may be used to treat stage 0 carcinoma in situ. Treatment for squamous cell carcinoma that has spread may include immunotherapy with drugs such as cemiplimab and pembrolizumab or clinical trials of new treatments.

References: 

1. https://www.cancer.gov/types/skin/patient/skin-treatment-pdq