What is squamous cell carcinoma?

Squamous cell carcinoma is a malignant tumour caused by the uncontrolled growth of squamous cells in the skin. This form of skin cancer usually develops on areas of skin that are often exposed to the sun, such as the face, ears, neck, scalp, hands and arms, but it can also occur on other parts of the body. Although SCC usually remains local, in some cases it can become invasive and spread to nearby lymph nodes and other organs, which makes it potentially more dangerous than other, more common forms of skin cancer such as basal cell carcinoma.

The diagnosis and treatment of squamous cell carcinoma fall under regular specialist medical care and take place in hospital. Early recognition and timely treatment are therefore very important for a good prognosis.

How does squamous cell carcinoma develop?

Squamous cell carcinoma is mainly caused by prolonged exposure to ultraviolet (UV) radiation from the sun or sunbeds. This radiation can damage the DNA in skin cells, leading to uncontrolled cell growth and eventually the formation of cancer. Other risk factors are:

Age and skin type: older people and people with fair skin, blue eyes, and blond or red hair are at higher risk.
Immunosuppression: people with a weakened immune system, such as patients taking immunosuppressants after an organ transplant, are at higher risk.
Actinic keratosis: these precursor lesions are rough, scaly patches on the skin that can develop into SCC if they are not treated.
Smoking: smoking increases the risk of squamous cell carcinoma, especially on the lips and in the mouth.
Exposure to harmful substances: prolonged exposure to certain chemicals, such as arsenic, can increase the risk.

What are the symptoms of squamous cell carcinoma?

Squamous cell carcinoma can appear as various skin lesions, which often vary depending on the location and stage of the cancer. Some common symptoms are:

Rough, scaly patch: a red, rough or scaly patch that does not heal and grows in size.
Raised lump: a firm, raised lump that sometimes has a rough or scaly surface and may ulcerate or form crusts in the centre.
Open sore: a sore that does not heal or comes back after it has healed.
Wart-like lesion: a lesion that resembles a wart, often with a central depression or a scaly crust.
Bleeding or crusting: the lesion may bleed easily or form crusts, especially with trauma or irritation.

How is squamous cell carcinoma treated?

The treatment of squamous cell carcinoma depends on the size, location and extent of spread of the tumour, as well as the patient's general health. The main treatment options are:

Surgical excision: the most common treatment, in which the tumour is cut out together with a margin of healthy tissue to ensure that all cancer cells are removed.
Mohs micrographic surgery: a specialised technique that is particularly effective for SCC in cosmetically sensitive areas such as the face. The tumour is removed layer by layer and examined under the microscope until no more cancer cells are found.
Cryotherapy: freezing the tumour with liquid nitrogen to destroy the cancer cells, usually used for small and superficial SCCs.
Radiotherapy: used in patients who cannot undergo surgery or when the cancer has spread to nearby lymph nodes or other tissues.
Photodynamic therapy (PDT): a light-sensitive substance is applied to the skin, followed by exposure to a special lamp to destroy the cancer cells.
Topical chemotherapy: creams or ointments containing chemotherapeutic agents can be used for superficial SCCs.
Systemic therapy: in rare cases of advanced or metastatic squamous cell carcinoma, systemic treatments such as chemotherapy or immunotherapy may be needed.

Prognosis and prevention

The prognosis for squamous cell carcinoma is generally good when the cancer is detected and treated early. In most cases the tumour can be removed completely and the chance of cure is high. However, because SCC has the potential to spread, it is important to have it treated quickly. Patients who have had SCC are at increased risk of developing new skin cancers, so regular skin checks are essential.

Preventive measures include:

Sun protection: using sunscreen with a high SPF, wearing protective clothing and avoiding direct sunlight, especially during peak hours.
Avoiding sunbeds: Avoid sunbeds, as they can emit significant amounts of harmful UV radiation.
Regular skin checks: self-examination of the skin and regular dermatological check-ups to detect early signs of skin cancer.
Treatment of actinic keratosis: timely treatment of actinic keratosis can prevent the development of SCC.

What is the difference between squamous cell carcinoma and other forms of skin cancer?

Squamous cell carcinoma differs from basal cell carcinoma and melanoma, both in behaviour and in severity. SCC is more aggressive than basal cell carcinoma and is more likely to spread, but it is less dangerous than melanoma, which tends to metastasise more quickly. While basal cell carcinoma is mainly locally destructive and rarely spreads, squamous cell carcinoma has the potential to spread, which makes prompt treatment important.

Squamous cell carcinoma is a common form of skin cancer which, although treatable, should be taken seriously because of the risk of spread. Early detection and treatment are crucial for a good prognosis and for maintaining healthy skin.

Want to know more? Read more about Removal of skin imperfections or having a mole removed at Kliniek het Bolwerk.