When Is Squamous Cell Carcinoma Considered High Risk?
Squamous Cell Carcinoma is the 2nd most common type of skin cancer after basal cell carcinoma. Although these tumors are generally not considered as aggressive as melanoma, it is often advised to treat them as soon as they are recognized or diagnosed. “Although the chance on squamous cell carcinoma metastasizing is low, it is not zero,” says Dr. Adam Mamelak, board-certified Dermatologist and Mohs Micrographic Surgeon in Austin, Texas. “There are also a number of scenarios where the risk of spread can increase quite dramatically.”
Squamous Cell Carcinoma and Metastases
Like other types of non-melanoma skin cancer, squamous cell carcinoma is considered locally aggressive, capable of invading into and destroying surrounding skin and tissues. The overall risk of metastasis with squamous cell carcinoma has been estimated at 2-6%. “While this is considered low compared to other types of malignancies, it is still taken very seriously.” Dr. Mamelak practices at Sanova Dermatology and the Austin Mohs Surgery Center where he uses Mohs micrographic surgery, surgical excision, and other treatments to remove cancerous tissue from skin.
This risk of metastasis actually increases in certain clinical situations. “When squamous cell carcinoma develops on the lips or ears, the risk of metastasis increases significantly,” says Dr. Mamelak. Other areas that carry an increased risk include squamous cell carcinoma on the genitals or those that develop within scars.
Medical Conditions Can Contribute To Risk
The immune system is now recognized to play an intricate and crucial role in the surveillance of cancerous growths in the body. Therefore, suppression or a defect in this system could predispose to the development of cancer. “We know that patients with solid organ transplants possess a higher risk of developing skin cancers,” notes Dr. Mamelak. “But the cancers they develop also tend to be much more aggressive compared to individuals without transplants.” Solid organ transplant recipients take a number of immune suppressing medications designed to keep their transplant viable. Unfortunately, these medications also place these patients at significant risk for aggressive and metastatic squamous cell carcinoma. Skin tumors in individuals with HIV, AIDS, or other immunosuppresive conditions can also possess these aggressive growth patterns.
Other Considerations
Squamous Cell Carcinomas that are large, develop quickly, grow around nerves (perineural spread or invasion) or have aggressive undifferentiated cells when examined under the microscope also possess an increased risk to spread and metastesize. It is because of these reasons that Dr. Mamelak advises patients diagnosed with squamous cell carcinoma not to delay their treatment. “Once you have been diagnosed, it is important to seek treatment as soon as possible,” says Dr. Mamelak.
“When Squamous Cell Carcinoma skin cancer develops in an area like the ear, nose, or mouth, we try to expedite treatment. This not only decreases the chances of the cancer spreading to other areas of the body, but also affects how the skin is closed and repaired after surgery.” It is also highly suggested that you protect yourself from further sun exposure by wearing sunscreen, reapplication, sun protective clothing, hats, and any other means necessary.
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