Squamous Cell Carcinoma
Squamous Cell Carcinomas (SCC) account for at least 20% of all non-melanocytic skin cancers. They develop mostly on sun exposed areas of your skin - face, ears, hands and lower legs and are most commonly seen in people over 50. They very occasionally can spread to either nearby lymph nodes or internal organs.
Generally SCCs are removed by standard surgical excision and reconstruction. The margins around the lesion are slightly larger than those used for BCCs, which reflects the slightly higher risk of problems from these lesions. Occasionally radiotherapy may be required after any surgery to try and reduce the risk if the SCC recurring. Mr Peach can discuss this with you if appropriate.
Over time ultraviolet (UV) rays from the sun cause damage to the skin. The skin can repair this damage, but eventually with increasing exposure and persistent UV penetration the structure of the skin changes and skin cancers develop. Pre-cancerous lesions such as actinic keratoses or Bowen’s disease can develop first.
Excess UV exposure accounts for many SCC, however there are other factors which may be relevant:
Immunosuppression often due to organ transplants
Longstanding ulcers, burns or wounds
Frequent use of tanning beds increases the risk x2.5 for developing an SCC
Familial or genetic reasons - Xeroderma Pigmentosum
The appearance of an SCC can vary, but generally they will have a crusty scale like raised area of skin and is commonly an inflamed (red) lesion. The central part of the lesion could either be a horn like projection or have a crater like middle.
The diagnosis is commonly made from the history and a clinical examination. However a biopsy of the area is often used to distinguish these lesions from other types of skin cancers or benign (non-cancerous) skin conditions.
Most SCCs are fully treated by surgery. The lesions should be sent for pathology to confirm the diagnosis and that an adequate margin (cuff of normal tissue) has been achieved with the surgery.
Occasionally an SCC may spread to adjacent (nearby) lymph nodes. If this is the only area of spread then removal of those lymph nodes (lymph node dissection) would be recommended. The pathology report of these nodes would determine whether additional radiotherapy would be required. If the skin cancer has spread to internal organs then chemotherapy may be recommended.
Mr Peach has many years of experience in discussing these issues with patients and would be able to talk with you about the options.
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Based in Leeds
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