Squamous cell skin cancer is highly treatable when found early. A board-certified dermatologist can often treat an early squamous cell skin cancer in the office.
Most squamous cell skin cancers are found and treated at an early stage, when they can be removed or destroyed with local treatment methods. Small squamous cell cancers can usually be cured with these treatments.
Most (95% to 98%) of squamous cell carcinomas can be cured if they are treated early. Once squamous cell carcinoma has spread beyond the skin, though, less than half of people live five years, even with aggressive treatment.
Untreated squamous cell carcinoma of the skin can destroy nearby healthy tissue, spread to the lymph nodes or other organs, and may be fatal, although this is uncommon.
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].
Conclusions At our institution, patients with stage I, II, or III squamous cell carcinoma had a mean survival of approximately 3 years. Those with stage IV or recurrent squamous cell carcinoma could be stratified by either serum albumin concentration or by age into 2 groups with a median survival of 1 or 2 years.
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.
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.
Metastatic squamous neck cancer with occult primary is a disease in which squamous cell cancer spreads to lymph nodes in the neck and it is not known where the cancer first formed in the body. Signs and symptoms of metastatic squamous neck cancer with occult primary include a lump or pain in the neck or throat.
If squamous cell carcinoma has spread, chemo might be an option, although an immunotherapy drug might be used first. If chemo is used, drugs such as cisplatin and 5-fluorouracil (5-FU) might be options. These drugs are given into a vein (intravenously, or IV), usually once every few weeks.
Any spots on the skin that are new or changing in size, shape, or color should be checked by a doctor. Any unusual sore, lump, blemish, marking, or change in the way an area of the skin looks or feels may be a sign of skin cancer or a warning that it might occur.
“Aggressive SCC” or “high-risk SCC” is cancer that is more likely to recur (return after initial treatment) or metastasize (spread to other parts of the body). Features of high-risk SCC are: Larger than 2 centimeters (cm) Deeper than 2 millimeters (mm)
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.
Surgery: When surgery can remove the cancer and you're healthy enough to have surgery, this is often the preferred treatment. After surgery, another treatment, such as radiation therapy or chemotherapy, is often given. Adding another treatment helps to kill any remaining cancer cells.
Guidelines recommend excision margins of 4–6 mm for low risk cSCC and 6–10 mm or more for high risk cSCC (32, 37, 38).
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.
Squamous cell cancers can usually be removed completely (or treated in other ways), although they are more likely than basal cell cancers to grow into deeper layers of skin and spread to other parts of the body.
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.
SCCs can appear as scaly red patches, open sores, rough, thickened or wart-like skin, or raised growths with a central depression. At times, SCCs may crust over, itch or bleed. The lesions most commonly arise in sun-exposed areas of the body. SCCs can also occur in other areas of the body, including the genitals.
Conclusion: A dietary pattern characterized by high meat and fat intakes increases SCC tumor risk, particularly in persons with a skin cancer history.
Stage 4 squamous cell carcinoma
In stage 4, the cancer can be any size and has spread (metastasized) to one or more lymph nodes which are larger than 3 cm and may have spread to bones or other organs in the body.
Epidemiological studies suggest that individuals with basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the skin are more likely to develop other malignancies; however, the factors responsible for this are unknown.
About 60 percent of people who have had one skin cancer will be diagnosed with a second one within 10 years, says a 2015 study in JAMA Dermatology. Your odds increase dramatically if you've been diagnosed with a second BCC or SCC (or third, or any other number beyond first).