Squamous Cell Skin Cancer

Lowering Your Risk

• Always wear a wide-brimmed hat and long sleeves and pants if you are going to be outdoors.
• Avoid the sun between 10 a.m. and 4 p.m., which is the peak time for UV rays. If outdoors, seek the shade.
• Always wear sunscreen on exposed skin. This is important for people of all skin colors. Make sure to use a broad-spectrum sunscreen that has a sun protection factor (SPF) of 30 or higher. Use it every day, even when it is cloudy.
• Use lip balm or cream that has sun SPF to protect your lips from getting sunburned.
• Wear sunglasses that block UV rays.
• Do not use tanning booths or sunlamps.
• Don't smoke or use tobacco products. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.

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Symptoms

Squamous cell skin cancer often affects the head, neck, trunk, arms, and legs. But it can be anywhere on the body where there is skin. This includes inside the mouth, on the genitals, and near the anus.

Signs of squamous cell skin cancer include:

• Any firm bump that doesn't go away. It is often on sun-exposed skin. But it can be on any part of the body.
• Any patch of skin that feels scaly, bleeds, or develops a crust. The patch may get bigger over a period of months and form a sore.
• Any skin growth that looks like a wart.
• Any sore that does not heal. It may occur in a scar or on skin that has ongoing problems.
• Any area of thickened skin on the lower lip. This is more likely if you smoke or use chewing tobacco, or your lips are often exposed to the sun and wind.

What Happens

Squamous cell skin cancer usually develops slowly. Because of this slow growth, it can often be detected and treated early, increasing the chance for a cure.

Squamous cell carcinoma may grow from a small rough spot in sun-damaged skin (actinic keratosis). Or it may develop from an early form of skin cancer called Bowen's disease. If a squamous cell skin cancer is not treated, or if the initial treatment doesn't work, it may spread (metastasize) to the nearby lymph nodes. From there it can spread to other parts of the body, such as the lungs, liver, or brain.

After you have one skin cancer, you are more likely to have another one develop in a new place.

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When to Call a Doctor

Watch closely for changes in your health, and be sure to contact your doctor if:

• You see a change in your skin, such as a spot, growth or mole that:
  • Grows bigger. This may happen slowly.
  • Changes color.
  • Changes shape.
  • Starts to bleed easily or crusts.
• You have a wound that does not heal.

Treatment Overview

Your doctor will want to remove all of the cancer. There are several ways to remove it. It depends on how big it is, where it is on your body, and your age and overall health. Options include:

• Surgery. The doctor numbs the skin and cuts out the cancer. This almost always cures the cancer.
• Mohs micrographic surgery. The doctor removes the skin cancer one layer at a time, checking each layer for cancer cells right after it is removed.
• Curettage and electrosurgery. Curettage uses a spoon-shaped tool (curette) to scrape off the skin cancer. Electrosurgery controls the bleeding.
• Cryosurgery. This destroys the cancer by freezing it.
• Photodynamic therapy. This uses a medicine that is activated with light.

Radiation therapy may be done if surgery isn't an option. Other treatment options include medicine applied to the skin (topical therapy). Treatment for advanced cases may include immunotherapy and chemotherapy.

After treatment, you'll need regular checkups.

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Self-Care

Protect your skin from ultraviolet (UV) rays. For example, stay out of the sun during midday hours, use a broad-spectrum sunscreen, and wear protective clothing. Get skin exams as advised by your doctor, and check all of your own skin for changes. Avoid medicines that can make your skin more sensitive to UV rays.

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