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What Makes Squamous Cell Carcinoma of the Skin More Dangerous?

Squamous cell carcinoma (or squamous cell skin cancer) is the second most common skin cancer. These skin cancers arise from normal cells in the epidermis (or the top layer of skin). When these cells mutate into cancerous cells, usually from excessive UV light exposure, they invade into the deeper layers of skin. Although squamous cell skin cancer is not usually deadly, if left untreated, it could spread to surrounding tissues and organs with disfiguring or debilitating effects.

So, when is squamous cell carcinoma considered more aggressive?

There are a number of factors that could make a squamous cell carcinoma more concerning.

  1. Tumor Characteristics. “The tumor itself can have a number of factors that would make it more concerning” says Dr. Bobbak “Bobby” Mansouri, board-certified dermatologist at Sanova Dermatology in Austin, Texas. “These facts include its diameter, the depth it invades deep into the skin, and how malignant the cells appear under the microscope to a dermatopathologist,” he continues. When the cells appear to be more malignant or concerning under the microscope, the tumor is termed “poorly differentiated.”
  2. Certain tumor locations have shown to increase the risk of spread of the tumor to other parts of the body, such as the ears, temples, and lips. “Squamous cell skin cancers on the lip have the highest likelihood of spreading to other parts of the body and should be assessed immediately by a board-certified dermatologist,” suggests Dr. Mansouri.
  3. Patient Characteristics. Certain types of people are more likely to have aggressive skin tumors, much of which is out of their control. For example, those people who have had organ transplants, are significantly immunosuppressed, or have been pilots are at higher risk of more aggressive squamous cell skin cancers.

The best treatment for squamous cell carcinomas is either wide local excision in body regions with more forgiving skin (arms, upper legs, and trunk) or Mohs micrographic surgery in cosmetically sensitive areas (head, neck, ears, hands, and lower legs). Mohs micrographic surgery is the gold standard for treatment for skin cancers and should only be performed by specially trained board-certified dermatologists.

If squamous cell cancer is caught in the early stages before it has had a chance to spread, it can be easily treated in your dermatologist’s office under local anesthesia. With proper precautionary measures and prompt treatment, there is no reason for this disease to progress to more aggressive stages.

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Please contact us for more information on how you can protect yourself and for any questions about skin abnormalities that could be a cause for concern.