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  You are at: Procedure info > Skin cancer > Squamous cell carcinoma

Squamous Cell Carcinoma
















What is squamous cell carcinoma?

Squamous cell carcinoma (SCC) is a malignant skin cancer and affects approximately 200,000 people per year. It tends to affect people of older ages, and occurs most commonly on sun-exposed areas of the body.


What do squamous cell carcinomas look like?

SCCs can vary from small, scaly growths, to larger 'scabbed' areas, to dome-shaped red growths a few centimetres in size. As they grow, they can ulcerate and bleed or even become infected.

They do not always show these features though, and can sometimes look and act very much like innocent growths. For this reason, if you have any concerns about a skin growth, seek medical advice immediately.

To see pictures of skin cancers, please click here


Can SCCs spread?

As well as growing wider and deeper, SCCs have the ability to spread to nearby lymph glands. This risk is approximately 2-5%, although some SCCs, such as those that arise from longstanding inflamed areas, have a 50% risk of spreading.

SCCs can then potentially spread elsewhere, to areas such as the lung or bone.



What causes squamous cell carcinoma?

There are a number of risk factors, the most prominent being:

  • Sun exposure - this seems to be the most important risk factor. The sunlightSunburn increases the risk of skin cancer risk looks set to worsen with a depletion of the protective ozone layer.

  • Skin type - skin that burns easily and tans poorly is more at risk of SCC

  • Immunosuppression - people that have certain cancers such as lymphoma or those that are taking immunosuppression drugs (eg transplant patients) have a higher risk of SCC

  • Actinic keratosis - about 5-20% of patients with actinic keratosis can develop SCCs.



How are SCCs treated?

Often, a specialist can diagnose an SCC with relative confidence and proceed with treatment. Occasionally, the diagnosis is not obvious and a biopsy is needed - a small sample is taken and sent to a lab, and treatment decided according to the results. There are a number of treatment options, including:

  • Surgery - this is probably one of the most common treatment methods. The tumour is removed, often under local anaesthetic, and sent to the lab for confirmation of diagnosis. An extra margin of normal-looking skin is also taken at the same time to try and ensure that all the tumour is removed. If the area is relatively small, the defect can usually be closed with stitches. Larger areas may need a skin graft or other procedure to provide skin cover.

  • Curettage - small growths may be 'scraped away' under local anaesthetic, leaving a barely noticeable scar. The disadvantage is that there will be no sample to send to the lab, and recurrence rates may be higher

  • Radiotherapy - some SCCs may be treated with radiotherapy, which is generally painless. Radiation treatment can affect the skin, however, with ulceration and scarring occurring over the following years - for this reason, younger people are usually not suitable for radiotherapy. Older people that are unfit for surgery, or those with very large SCCs tend to benefit the most.

  • Moh's surgery - this is a form of surgery whereby small samples of the tumour are removed and examined. The process is continued until all the tumour has been removed. This can sometimes result in less normal tissue being removed than in standard surgery, but does often need multiple visits to the operating theatre. For this reason, Moh's is often reserved for areas such as the nose, where spare skin is in short supply


The final treatment option will often depend on the body area, tumour size and of course patient preference. Your specialist will be able to discuss treatment options with you.



Are any other tests needed?

Blood tests and scans are usually not required unless if a general anaesthetic is needed, or if the specialist suspects the SCC has spread or invaded into deeper areas such as the skull.


What happens after SCC treatment?

As SCCs have the potential to spread to nearby glands, follow-up in clinic is recommended after treatment, often for up to 5 years. The specialist will be looking for any firm lumps or changes in the scar area, marble-like lumps in the nearby glands or any SCCs starting elsewhere.

Having had one SCC, there are increased risks of getting another. A medical opinion should therefore be sought for any future suspicious growths.


What are the overall risks to life?

If the SCC has spread to nearby glands or elsewhere, then this can pose a serious risk to life. For this reason, it is very important to seek medical advice as soon as any suspicious growths are found, to hopefully remove them before they get a chance to spread.


How can SCCs be avoided?

Whilst the risks can never be zero, you can reduce your risks greatly with some simple steps:

  • Stay out of the sun, especially between 11am and 3pm, when it is most strong

  • Wear high factor sun cream if you need to go out in the sun (eg sports)

  • Reapply sun cream regularly and especially after swimming

  • Wear sun-protective clothing such as long-sleeved shirts and hats

  • Never get sunburnt, and keep children out of the sun


To see pictures of skin cancers, please click here

Other SurgeryWise articles

You may also be interested to read our articles on actinic keratosis, melanoma, basal cell carcinoma or moles.



The information provided is as a guide only and you should discuss matters fully with your specialist before deciding on the right procedure for you. If you have any concerns about a skin growth, seek medical advice immediately. Please also read our disclaimer



Read our guide on skin grafts after squamous cell carcinoma surgery



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