This is the first part of our series about the condition based on our patient booklet “Fast Facts for Patients and their Supporters: Advanced Cutaneous Squamous Cell Carcinoma”. This article focuses on what cutaneous squamous cell carcinoma and advanced cutaneous squamous cell carcinoma are.

First, The Facts

  1. Cutaneous squamous cell carcinoma (shortened to cSCC) is typically treated with surgery, without the need for other treatment.
  2. cSCCs that are large, have high-risk features under the microscope or come back after surgery are more likely to need additional tests or treatments.
  3. A cSCC is called “advanced” if it grows into (invades) areas below the skin or spreads to other parts of the body.
  4. Diagnosis of advanced cSCC involves looking at biopsy samples of skin and lymph nodes under the microscope and also sometimes scans or images of the area.
  5. Advanced cSCC is treated with surgery, radiation treatment or drugs, or a combination of these.
  6. If treatment is unsuccessful, palliative care helps to relieve the symptoms of cancer.

What Is Cutaneous Squamous Cell Carcinoma?

  1. Cutaneous squamous cell carcinoma (cSCC) is a type of cancer that grows in the outermost layer of the skin (cutaneous = of the skin). This outer layer of skin is called the epidermis. It is the body’s barrier against the environment.
  2. cSCC is a non-melanoma skin cancer. It differs from melanoma, which comes from a different kind of cell, a melanocyte.

Squamous cell carcinoma and basal cell carcinoma

  1. cSCC is more common in older, fair-skinned men. People who develop freckles or burn easily in the sun have a higher risk, as do people who have spent lots of time outdoors or have used indoor tanning beds.

Normal squamous cells in the skin and development of cancer

Because cSCC is caused by sunlight, it is common for patients with lots of sun damage to their skin to have more than one cSCC. Having more than one cSCC in an area of sun damage is not the same as having a cSCC that has spread to other parts of the body. 

Actinic keratosis, squamous cell carcinoma in situ and invasive cutaneous squamous cell carcinoma

 Some medications increase sun sensitivity and cancer risk. And some people’s immune systems do not work effectively, making cSCC more likely.

Questions You May Have …

Is cSCC contagious?

  • cSCC is not contagious – you can’t catch it from someone else. And you can’t spread it to anyone else, either.

Did I inherit cSCC from my parents?

  • Yes and no; If you have fair skin or light-colored eyes or hair, you inherited those risk factors for cSCC from your parents. But cSCC is not usually considered to be a genetic condition. There are exceptions where cSCC develops because the person has a very rare genetic condition such as xeroderma pigmentosum or oculocutaneous albinism. These conditions make the person more likely to develop cSCC. But in most people, cSCC is not directly related to an inherited genetic disease.

What Is Advanced cSCC?

The cSCC that’s diagnosed first is called a primary cSCC. It’s usually an isolated cancer on the skin and can be removed by surgery.

But in some cases, the cancer can be more aggressive and is said to be advanced. An advanced cSCC is either:

  • locally advanced, meaning it has grown very large or is complicated to remove, or;
  • metastatic, meaning it has spread to other places.

What Is My Advanced cSCC Timeline?

The timeline is different for each person. In some people, a primary cSCC is treated with surgery but the cancer later comes back in the same place; this is called a recurrent cancer. Other people are diagnosed with both primary and metastatic cSCC at the same time. And some people are diagnosed with metastatic cSCC in other parts of the body years after the primary cSCC was treated.

Local Invasion

There are two main types of local invasion:

  • Locally advanced cSCC can grow into nearby healthy areas. This may include the underlying fat, muscle or bone – it depends on the location of the cancer. The cancer can also affect a nearby body part such as an eye or an ear.
  • Perineural invasion: Locally advanced cSCC can also grow into the nerves of the skin or along the sleeve or sheath that surrounds nerves. This is called perineural invasion, perineural spread or perineural metastasis.

 

Information based on Fast Facts for Patients and their Supporters: Advanced Cutaneous Squamous Cell Carcinoma (Karger, 2020).

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