Cancer screening exams can help find squamous cell carcinoma at its earliest stage when the chances for successful treatment, optimal outcomes and fewer side effects are greatest. These tests are usually done when a patient is healthy and has no specific symptoms.

Not only are expert cancer researchers at the OSUCCC – James continually working to detect and diagnose squamous cell carcinoma early, but they are also developing additional tests to detect and diagnose cancer even earlier, leading to improved outcomes, faster responses and fewer side effects.

If you carry risk factors for squamous cell carcinoma, you should regularly examine moles and other skin lesions.

Squamous Cell Carcinoma Risk Factors

Skin color and being exposed to sunlight can increase the risk of nonmelanoma skin cancer and actinic keratosis.

A risk factor is anything that increases your chance of getting a disease. Talk with your doctor if you think you may be at risk. Risk factors for squamous cell carcinoma include the following:

  • Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time
  • Having a fair complexion, which includes the following:
  • Fair skin that freckles and burns easily, does not tan or tans poorly
  • Blue or green or other light-colored eyes
  • Red or blond hair
  • Having actinic keratosis
  • Past treatment with radiation
  • Having a weakened immune system
  • Having certain changes in the genes that are linked to skin cancer
  • Being exposed to arsenic

Risk factors for actinic keratosis include the following:

  • Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) over long periods of time
  • Having a fair complexion, which includes the following:
  • Fair skin that freckles and burns easily, does not tan or tans poorly
  • Blue or green or other light-colored eyes
  • Red or blond hair

(Source: National Cancer Institute)

The presence of risk factors does not necessarily mean you have squamous cell carcinoma. But if you have risk factors, you should discuss them with your doctor.

You can lower your risk for melanoma and other skin cancers by regularly using sunscreen and minimizing exposure to ultraviolet radiation from the sun, sunlamps and tanning beds.

Diagnosing Squamous Cell Carcinoma

The following examinations and tests are used to detect and diagnose squamous cell carcinoma:

Skin Exam

A doctor examines the skin for signs of abnormal moles, birthmarks or other pigmented areas. The doctor also analyzes the size, color, shape and texture of any mole, mark or pigmented area.

Biopsy

A doctor removes a sample of skin cells so they can be analyzed under a microscope by a specially trained pathologist. There are several ways to remove skin cells for biopsy, including:

Shave Biopsy

A doctor uses a sterile blade to shave off a growth that looks abnormal.

Punch Biopsy

A special instrument is used to cut out circular pieces of skin or tissue.

Incisional Biopsy

The doctor removes part of a growth using a scalpel.

Excisional Biopsy

The doctor removes the entire growth or abnormal area of skin using a scalpel.

Tests Used to Stage Squamous Cell Carcinoma

After a squamous cell carcinoma diagnosis, your doctor may recommend staging the cancer depending on your individual condition, which includes information on whether the cancer has spread. The following laboratory tests and imaging exams can be used determine if squamous cell carcinoma has spread to other areas of your body.

Computed Tomography (CT) Scan

A CT scan is an X-ray examination that produces a series of detailed images taken from different angles. An X-ray machine linked to a computer revolves around your body to create multidimensional images.

Magnetic Resonance Imaging (MRI)

MRI uses a high-powered magnet and radio waves to produce detailed images of the body.

Lymph Node Biopsy

A surgeon removes lymph nodes near squamous cell carcinoma and analyzes samples from the nodes for signs of cancer.

(Source: National Cancer Institute)

Staging Squamous Cell Carcinoma

If you receive a squamous cell carcinoma diagnosis, staging is a way of determining the degree and type of your cancer. This information helps your team of specialists plan the best treatment.

The staging classification is based on nonmelanoma skin cancer and remains the same throughout treatment.Your doctor may base your treatment in part on the type of non skin cancer or other diagnosed skin condition.

Staging of nonmelanoma skin cancer depends on whether the tumor has certain "high-risk" features and whether the tumor is on the eyelid.

Staging for nonmelanoma skin cancer that is on the eyelid is different from staging for nonmelanoma skin cancer that affects other parts of the body.

The following are high-risk features for nonmelanoma skin cancer that is not on the eyelid:

  • The tumor is thicker than 2 millimeters
  • The tumor is described as Clark level IV (has spread into the lower layer of the dermis) or Clark level V (has spread into the layer of fat below the skin)
  • The tumor has grown and spread along nerve pathways
  • The tumor began on an ear or on a lip that has hair on it
  • The tumor has cells that look very different from normal cells under a microscope

The following stages are used for nonmelanoma skin cancer that is not on the eyelid:

Stage 0

In stage 0, abnormal cells are found in the squamous cell layer of the epidermis (topmost layer of the skin). These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Stage I

In stage I, cancer has formed. The tumor is not larger than 2 centimeters at its widest point and may have one high-risk feature.

Stage II

In stage II, the tumor is either:

  • Larger than 2 centimeters at its widest point; or
  • Any size and has two or more high-risk features

Stage III

In stage III:

  • The tumor has spread to the jaw, eye socket or side of the skull. Cancer may have spread to one lymph node on the same side of the body as the tumor. The lymph node is not larger than 3 centimeters; or
  • Cancer has spread to one lymph node on the same side of the body as the tumor. The lymph node is not larger than 3 centimeters and one of the following is true:
  • The tumor is not larger than 2 centimeters at its widest point and may have one high-risk feature
  • The tumor is larger than 2 centimeters at its widest point
  • The tumor is any size and has two or more high-risk features

Stage IV

In stage IV, one of the following is true:

  • The tumor is any size and may have spread to the jaw, eye socket or side of the skull; cancer has spread to 1 lymph node on the same side of the body as the tumor and the affected node is larger than 3 centimeters but not larger than 6 centimeters, or cancer has spread to more than 1 lymph node on one or both sides of the body and the affected nodes are not larger than 6 centimeters; or
  • The tumor is any size and may have spread to the jaw, eye socket, skull, spine or ribs; cancer has spread to 1 lymph node that is larger than 6 centimeters; or
  • The tumor is any size and has spread to the base of the skull, spine or ribs; cancer may have spread to the lymph nodes; or
  • Cancer has spread to other parts of the body, such as the lung

The following stages are used for nonmelanoma skin cancer on the eyelid:

Stage 0

In stage 0, abnormal cells are found in the epidermis (topmost layer of the skin). These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Stage I

Stage I is divided into stages IA, IB and IC.

  • Stage IA: The tumor is 5 millimeters or smaller and has not spread to the connective tissue of the eyelid or to the edge of the eyelid where the lashes are
  • Stage IB: The tumor is larger than 5 millimeters but not larger than 10 millimeters or has spread to the connective tissue of the eyelid or to the edge of the eyelid where the lashes are
  • Stage IC: The tumor is larger than 10 millimeters but not larger than 20 millimeters or has spread through the full thickness of the eyelid

Stage II

In stage II, one of the following is true:

  • The tumor is larger than 20 millimeters.
  • The tumor has spread to nearby parts of the eye or eye socket.
  • The tumor has spread to spaces around the nerves in the eyelid.

Stage III

Stage III is divided into stages IIIA, IIIB and IIIC:

  • Stage IIIA: To remove all of the tumor, the whole eye and part of the optic nerve must be removed; the bone, muscles, fat, and connective tissue around the eye may also be removed
  • Stage IIIB: The tumor may be anywhere in or near the eye and has spread to nearby lymph nodes
  • Stage IIIC: The tumor has spread to structures around the eye or in the face, or to the brain, and cannot be removed in surgery

Stage IV

The tumor has spread to distant parts of the body.

(Source: National Cancer Institute)

 

If you have received a squamous cell carcinoma diagnosis, or if you want a second opinion or just want to speak to a squamous cell carcinoma specialist, we are here to help you. Call 800-293-5066 or 614-293-5066 to make an appointment.

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