Squamous cell carcinoma (SCC) is an epithelial malignancy involving many anatomical sites and is the most common cancer capable of metastatic spread. Development of early diagnosis methods and novel therapeutics are important for prevention and mortality reduction.
Squamous cell carcinoma of the skin is usually not life-threatening, though it can be aggressive. Untreated, squamous cell carcinoma of the skin can grow large or spread to other parts of your body, causing serious complications.
Metastasis of cutaneous squamous cell carcinoma (cSCC) is rare. However, certain tumor and patient characteristics increase the risk of metastasis. Prior studies have demonstrated metastasis rates of 3-9%, occurring, on average, one to two years after initial diagnosis [6].
In general, the squamous cell carcinoma survival rate is very high—when detected early, the five-year survival rate is 99 percent. Even if squamous cell carcinoma has spread to nearby lymph nodes, the cancer may be effectively treated through a combination of surgery and radiation treatment.
What is squamous cell carcinoma? Also called squamous cell skin cancer, this is a common type of skin cancer. It tends to develop in people who have had lots of sun exposure, use(d) tanning beds, or both.
The key warning signs are a new growth, a spot or bump that's getting larger over time, or a sore that doesn't heal within a few weeks. (See Signs and Symptoms of Basal and Squamous Cell Skin Cancer for a more detailed description of what to look for.)
Chemotherapy. Chemotherapy uses powerful drugs to kill cancer cells. If squamous cell carcinoma spreads to the lymph nodes or other parts of the body, chemotherapy can be used alone or in combination with other treatments, such as targeted drug therapy and radiation therapy.
Most squamous cell carcinomas (SCCs) of the skin can be cured when found and treated early. Treatment should happen as soon as possible after diagnosis, since more advanced SCCs of the skin are more difficult to treat and can become dangerous, spreading to local lymph nodes, distant tissues and organs.
In general, the squamous cell carcinoma survival rate is very high—when detected early, the five-year survival rate is 99 percent. Even if squamous cell carcinoma has spread to nearby lymph nodes, the cancer may be effectively treated through a combination of surgery and radiation treatment.
Patients with stage I, II, or III cancer have the best survival, whereas patients with stage IV or recurrent cancer who are older than 66.5 years have the worst survival.
Signs and symptoms of metastatic squamous neck cancer with occult primary include a lump or pain in the neck or throat. Check with your doctor if you have a lump or pain in your neck or throat that doesn't go away. These and other signs and symptoms may be caused by metastatic squamous neck cancer with occult primary.
Although squamous cell carcinoma can be more aggressive than basal cell cancer, the risk of this type of cancer spreading is low—as long as the cancer is treated early, Dr. Leffell says. He notes that the lesions must be treated with respect because they may grow rapidly and invade deeply.
Stage 2 squamous cell carcinoma
In stage 2, the cancer is larger than 2 centimeters across, and has not spread to nearby organs or lymph nodes, or a tumor of any size with two or more high risk features.
Systemic chemotherapy is not widely used for treating squamous cell carcinoma. In most cases, the cancer cells are confined to one area of skin and, if detected early, can be effectively addressed with localized treatments, such as surgery.
Treatment overview
In June 2020, pembrolizumab (Keytruda®) was approved by the FDA for the treatment of recurrent or metastatic SCC that is not curable by radiation or surgery. In July 2021, the FDA expanded this approval to include SCC that is locally advanced and not curable by radiation or surgery.
It is estimated that about 2,000 people die from basal cell and squamous cell skin cancer each year. Older adults and people with a suppressed immune system have a higher risk of dying from these types of skin cancer. It is estimated that 7,990 people will die from melanoma in the United States in 2023.
Death from basal and squamous cell skin cancers is uncommon. It's thought that about 2,000 people in the US die each year from these cancers, and that this rate has been dropping in recent years.
Having a weakened immune system due to medications or infections increases the risk of aggressive SCC. History of radiation exposure or use of psoralen UVA treatment are other risk factors for aggressive SCC.
Most skin SCCs show relatively benign behavior and can be cured by local surgical and dermatologic methods. However, some of these lesions can have a locally invasive and aggressive course.
Basal or squamous cell skin cancers may need to be removed with procedures such as electrodessication and curettage, surgical excision, or Mohs surgery, with possible reconstruction of the skin and surrounding tissue. Squamous cell cancer can be aggressive, and our surgeons may need to remove more tissue.
Squamous cell carcinomas arise from keratotic patches and become more nodular and erythematous with growth, sometimes including keratin plugs, horns, or ulceration. Because they may metastasize, they often are treated with excisional biopsy.
Squamous cell carcinoma initially appears as a skin-colored or light red nodule, usually with a rough surface. They often resemble warts and sometimes resemble open bruises with raised, crusty edges. The lesions tend to develop slowly and can grow into a large tumor, sometimes with central ulceration.
Squamous cell carcinoma is most curable in the early stages before it spreads. If it's diagnosed early, the five-year survival rate is approximately 99%.
On average, most people will recover within two to four weeks after treatment to remove cancer from their body. Your healthcare provider will meet with you a few weeks after treatment to make sure your body is healing properly and to make sure treatment was successful at removing cancer.