What is Squamous Cell Carcinoma?
Mutations in skin cells accumulate to cause pre-cancers and skin cancers which include squamous cell carcinoma. It is the second most common type of skin cancer and mainly related to excessive sun damage and sun exposure. Some are superficial and some can grow very fast and become invasive. They are scaly, red, and do not go away on their own. They may bleed and some may be painful, although most just stick around without causing pain.
Who is at risk?
Basically anyone who has been in the sun- which means all of us. However, some of us are more susceptible. Light-skinned individuals with blonde hair and colored eyes are at the most risk since they don’t have much in terms of pigment protection. This means their cell’s DNA is more at risk of damage from the sun than others. A tanning history whether in the tanning bed or outside puts you at a higher risk as well. The damage to the skin is cumulative, I like to liken it to a huge tank filling up with water drop-by-drop. At first there is barely any water but as time goes on- after years the tank starts to really fill up. At some point the tank will overflow- that is when skin cancer happens. Enough damage has been done that there is no turning back. Therefore, it is never too late to start using sunscreen and protecting yourself from the adverse effects of ultraviolet radiation.
Organ transplant recipients, people with immune system compromise (i.e. undergoing cancer treatment), those on certain immunosuppressive medications are also more susceptible to squamous cell carcinoma. If you fall into the high risk category then you should definitely be seeing your Dr. Al Dabagh for a skin screening regularly.
How do I protect myself?
While it feels nice to bask in the sun on a breezy summer day, you should be smart about it. We know the culprit when it comes to squamous cell carcinoma- ultraviolet (UV) exposure from sun light. Part of living healthy is being in equilibrium with your environment including the closest star to us- the sun. The first layer of protection is avoidance. Yes, you can enjoy nice weather but there is no reason to be consistently outside (unless it is part of your job) during peak sunlight hours. This means going outside before 10 AM or after 2 PM. The midday hours (10-2) have the most amount of UV radiation. Seek the shade when possible. Clothing is next including a wide-brimmed hat, long sleeves, pants and clothing that protects from the sun. Clothing have a UPF (Ultraviolet Protection Pactor) rating now which is like SPF (sun protection factor)- shoot for one that has a UPF of 50 or above if possible. Sunscreen is also very important- please see our page on sunscreen for more information. In general, I recommend an SPF of at least 30 to be applied before going outside and reapplied every 2 hours. You can enjoy the sun but please be smart about it.
I think I have a skin cancer and I am freaking out.
Take a deep breath. You might know a relative, friend, or neighbor who had a skin cancer. Someone you know may have even passed away from cancer. It is important to differentiate and know that not all skin cancers are created equal in aggressiveness. Some are less dangerous to deal with (when caught early) like squamous cell carcinoma and some can be lethal like melanoma or merkel cell carcinoma. The other fact to keep in mind is you should not self-diagnose. What you are freaking out about may be benign or what you may think is nothing (pimple or blemish) may actually be cancerous. That’s where I come in- I have the training and expertise to clinically diagnose and treat these skin cancers. I may reassure you or I may have to do a procedure to confirm the diagnosis. It is especially important to be checked regularly especially if you have a longstanding history of excessive sun exposure or if you have a personal or family history of skin cancer. If you already have had a squamous cell carcinoma, your risk for another one is higher than the general population. Squamous cell carcinoma does not usually go to other organs of the body especially if treated early.
You diagnosed a squamous cell carcinoma on my skin, now what?
If the biopsy returns as a squamous cell carcinoma, then I will discuss the options with you. Depending the size, location, and aggressiveness (even squamous cell carcinomas have subtypes) we will come up with the best option to treat it. It may be a topical cream, a surgical procedure, or radiation treatment. The good news is that squamous cell carcinomas are highly curable especially when caught early. The main point to remember is to have them treated early to avoid larger surgical scars and local spread.