Receiving a diagnosis of skin cancer can be a worrying experience. Among the various types, Squamous Cell Carcinoma (SCC) is a common form that develops from the squamous cells in the outer layer of the skin. While it is often treatable when detected early, it’s important to understand its medical aspects and potential legal considerations arising from diagnosis, treatment, or related workplace exposure.
This guide will provide clear, practical information about SCC, how it’s managed from a medical perspective, and relevant legal points that individuals in the UK should be aware of.
What is Squamous Cell Carcinoma (SCC)?
Squamous Cell Carcinoma is the second most common type of skin cancer. It develops from squamous cells, which are flat, scale-like cells found in the outermost layer of the skin (the epidermis). These cells are constantly shedding and being replaced. When their DNA is damaged, often by ultraviolet (UV) radiation, they can grow abnormally and uncontrollably, leading to SCC.
Unlike other skin cancers that appear dark moles, SCC often looks like a persistent sore or a patch of rough, scaly skin that does not heal. While SCC typically grows slowly, it can spread to other body parts if not treated, though this is less common than with melanoma.
Common areas where SCC develops include sun-exposed regions such as the face, ears, lips, scalp (especially for bald individuals), neck, hands, and forearms. However, it can appear anywhere on the body, including areas not exposed to the sun.
Causes and Risk Factors for SCC
The primary cause of Squamous Cell Carcinoma is exposure to harmful ultraviolet (UV) radiation from sunlight or tanning beds. Repeated, unprotected exposure damages the DNA in skin cells, leading to abnormal growth.
Other risk factors include:
- Fair Skin: People with fair skin, light hair, and light-coloured eyes are more susceptible.
- Age: The risk increases with age due to cumulative sun exposure over a lifetime.
- Weakened Immune System: Individuals with suppressed immune systems (e.g., organ transplant recipients and those on certain medications) are at higher risk.
- Previous Skin Cancer: Having had SCC or any other type of skin cancer increases the risk of developing more.
- Precancerous Lesions: Conditions like actinic keratoses (rough, scaly patches on sun-damaged skin) can sometimes progress to SCC.
- Chronic Skin Inflammation/Wounds: SCC can develop in long-term skin inflammation, scars from burns, or chronic non-healing ulcers.
- Certain Genetic Syndromes: Rare genetic conditions can increase susceptibility.
- Exposure to Certain Chemicals: Occupational exposure to some chemicals, like arsenic or polycyclic aromatic hydrocarbons, can increase risk.
Recognising SCC: Signs and Symptoms
Early detection of SCC is very important for effective treatment. It’s crucial to be aware of your skin and consult a doctor if you notice any suspicious changes.
Look out for:
- A persistent, rough, scaly patch that may bleed easily.
- A firm, red nodule or lump.
- An open sore that does not heal, or heals and then reappears.
- A wart-like growth.
- A flat lesion with a depressed centre.
These growths may or may not be tender or painful. A doctor should check any new skin lesion or an existing one that changes in size, shape, colour, or texture, bleeds, itches, or becomes tender.
Medical Considerations
Diagnosis
If a doctor suspects SCC, they will typically perform a biopsy. This involves removing a small sample of the suspicious tissue, which a pathologist examines under a microscope. The biopsy confirms the diagnosis and identifies the type of skin cancer.
Treatment
Treatment for SCC primarily aims to remove the cancerous cells and depends on the tumour’s size, location, and aggressiveness.
- Surgical Excision: This is the most common treatment. The surgeon removes the tumour along with a small margin of healthy tissue around it to ensure all cancer cells are gone.
- Mohs Micrographic Surgery: This specialised technique is often used for SCCs in cosmetically sensitive areas (like the face) or for larger, more aggressive tumours. It involves removing very thin layers of skin one at a time and examining each layer under a microscope immediately until all cancer cells are removed. This preserves as much healthy tissue as possible.
- Curettage and Electrodesiccation: Used for smaller, less aggressive SCCs. The growth is scraped off with a curette, and the base is cauterised (burned) to destroy any remaining cancer cells.
- Radiation Therapy: Used for SCCs that cannot be removed surgically, or for patients who are not candidates for surgery. It uses high-energy rays to kill cancer cells.
- Topical Medications: Certain creams (e.g., 5-fluorouracil, imiquimod) may be used for superficial SCCs.
- Photodynamic Therapy (PDT): Involves applying a special light-sensitive cream to the skin, which is then activated by a light source to destroy cancer cells. Used for superficial lesions.
- Systemic Therapies (e.g., Chemotherapy, Targeted Therapy, Immunotherapy): These treatments target cancer cells throughout the body for very advanced SCC that has spread.
Prognosis and Follow-up
The vast majority of SCCs are cured with early treatment. However, regular follow-up appointments with your dermatologist are crucial. This includes routine skin checks to monitor for recurrence at the treated site or the development of new SCCs elsewhere, as individuals who have had one skin cancer are at higher risk of developing another.
Prevention Strategies
While not all SCCs can be prevented, reducing your risk is important:
- Sun Protection: This is the most crucial step.
- Seek shade, especially between 11 am and 3 pm in the summer.
- Wear protective clothing (long sleeves, trousers, wide-brimmed hat).
- Use broad-spectrum sunscreen with an SPF of 30 or higher, and apply generously.
- Avoid sunbeds and tanning lamps.
- Regular Skin Self-Exams: Check your skin monthly for new or changing lesions.
- Professional Skin Checks: Have regular skin examinations by a doctor, especially if you have risk factors or a history of skin cancer.
Squamous Cell Carcinoma is a common form of skin cancer that is typically highly treatable, especially with early detection. Understanding the signs to look for and the importance of prompt medical assessment is fundamental to a positive outcome.
Beyond the medical journey, individuals should also be aware of their rights and potential legal avenues if they believe their diagnosis or treatment was compromised by negligence, or if their condition is linked to unsafe workplace conditions. Prioritising sun protection and regular skin checks are key preventative measures for everyone. If you have any concerns about a skin lesion, please consult your GP or dermatologist immediately.