- Calling us at 6532 2400
- WhatsApp at 8318 6332
We are currently using Zoom as our preferred teleconferencing software. Our friendly Patient Care Executive will kindly guide you through this process after you contact us.
Our doctors will examine your mole during the teleconsultation. If a malignant growth is suspected, we will arrange for a mole removal treatment as soon as possible.
What is Squamous Cell Carcinoma?
Squamous Cell Carcinoma is the second most common type of skin cancer in the world, second only to Basal Cell Carcinoma, the most common skin cancer in the world. It develops from cutaneous squamous cells, which are flat, cells located near the surface of the skin, in the epidermis layer. It commonly develops from actinic keratoses, which are lesions that can develop from sun-damaged skin. Skin areas often exposed to direct sunlight like the face, neck and lateral (outer) side of the forearms are at a higher risk of developing squamous cell carcinoma, like most other skin cancers.
As with most other skin cancers, the most common cause of squamous cell carcinoma is excessive exposure to ionising radiation like the UV rays from the sun. The radiation causes DNA damage in the associated cells (cutaneous squamous cells in the case of squamous cell carcinoma) which eventually develops into malignant growths.
squamous cell carcinoma, although less common than basal cell carcinoma, has a higher mortality rate. This is because squamous cell carcinoma has a higher incidence of metastasis (cancer cells spreading) and hence tends to have slightly more serious prognoses if not treated early. Other than mortality, these prognoses can include disfigurement, damaged nerves, blood vessels and other functional skin tissue. Squamous cell carcinoma also tends to be more aggressive compared to basal cell carcinoma, possibly because cancer cells associated with squamous cell carcinoma typically carry more mutations than other skin cancers.
Risk factors associated with Squamous Cell Carcinoma
- Ionising radiation
Ionising radiation such as UV rays from the sun, or artificial tanning beds can cause DNA damage and mutation, eventually leading to cancer.
People living in the highest and lowest latitudes (closer to poles and tropics) are exposed to harsher sunlight, and are especially at risk compared to the middle latitudes.
- Immunocompromised or immunosuppressed individuals:
Compared to other skin cancers like basal cell carcinoma and melanoma, squamous cell carcinoma tends to affect immunocompromised or immunosuppressed individuals more. These include people with immunity system related diseases, or those on immunosuppression medication for various reasons (Example: post organ transplant). These people are both more likely to develop squamous cell carcinoma and more serious associated complications.
- Genetic factors
Some people naturally have higher risks of developing skin cancer since birth due to genetic factors. This includes those who are naturally more prone to sunburns, sun damage, have family history of skin cancers or are immunocompromised like mentioned before.
- Elderly individuals
Older individuals both have more cumulative exposure to sunlight and weaker immune systems, and hence are more likely to develop skin cancer. Additionally, ratios comparing squamous cell carcinoma and basal cell carcinoma incidence rates tend to trend towards the former with increasing age. Hence, it is possible that older individuals are more likely to develop squamous cell carcinoma as compared to basal cell carcinoma. The mean age of squamous cell carcinoma diagnoses is around the mid-60s.
In general, skin cancer is more common in men as compared to women.
- Skin tone
Skin cancer is more likely to develop in fairer-skinned individuals as they have less natural protection from the sun’s UV rays. However, it is worth noting squamous cell carcinoma can be harder to detect on darker-skinned individuals and cases tend to be diagnosed at later stages.
- Cigarette consumption
In addition to the damage they can cause to the lungs, cigarettes contain known human carcinogens and DNA mutagens like aromatic amines and acrolein. Hence, their consumption is closely associated with increased cancer risks including skin cancer.
- A medical history of skin cancers or other malignant growths
Most cancers, including skin cancers like squamous cell carcinoma, has a significant chance of relapse even if completely treated. Hence, it is important to protect yourself from cancer risk factors like UV light if you have a such a medical history
- History of Human Papillomavirus infection
Human Papillomavirus (HPV) is one of the most common Sexually-transmitted infections in humans. Infected individuals may experience persistent warts or sores around the genital areas, in the mouth, or on any other areas on the skin. However, in many cases, the infected are asymptomatic until serious complications like skin cancer develop.
Signs and symptoms
Squamous cell carcinoma usually appears as small skin growth that may be mistaken for common moles and skin lesions. As with most other cancers, they can only be definitively diagnosed with a skin biopsy. Still, you can refer to the following as a general guide.
- Mole or wart-like elevated growth with a scaly/crusty surface, which may bleed or ooze pus.
- Persistent open sores or scaly red patches with crusty surface that lasts for weeks
- Any of the above growths that rapidly increases in size over a few days or weeks
To differentiate potentially cancerous moles or sores from benign ones, you should always observe them over a few weeks. Benign moles and growths will usually heal during this period, while malignant ones can persist, and even rapidly increase in size despite proper wound care.
Any moles or skin growths suspected to be associated with squamous cell carcinoma should be removed as early as possible, because of the tendency for metastasis. These are some procedures offered by The Clifford Clinic to address and remove cancerous moles
- Surgical excision
The most obvious and straightforward approach is to surgical more removal. After administering local anaesthesia, our doctors will carefully cut out/shave down the mole along with any other potentially malignant tissue. A histological lab will then examine the mole to determine if it is cancerous. If the mole is benign, you can safely be discharged. Otherwise, our doctors will follow-up as necessary and provide you with further medical advice.
- Non-surgical laser mole removal
Unlike basal cell carcinoma, laser treatment is for squamous cell carcinoma is more limited. Nonetheless, it can be considered when surgery or other treatments have failed or are undesired. In this case, an ablative laser like the Edge Fractional CO2 laser is used to ablate away the superficial layers of the skin, removing the mole along with any other potentially malignant tissue.
Laser treatment is the most effective at removing moles and skin growths that have shallow roots and are localised to the surface of the skin. For nodular, wart-like and raised growths, the effects of laser treatment cannot be guaranteed. Hence, laser treatment is usually only recommended for squamous cell carcinoma in the very early stages.
It is also important to note that unlike basal cell carcinoma, non-ablative lasers are less effective at removing squamous cell carcinoma as the latter tends to be more invasive in nature, and penetrate to deeper layers of the skin.
What should I do if I suspect my mole is cancerous?
If you think that a mole or open sore on your skin is related to squamous cell carcinoma, you should be safe and get it examined by a doctor. As squamous cell carcinoma has a higher chance to spread compared to other skin cancers, it is important that we detect and remove any malignant moles early. You can schedule a teleconsultation with our doctors to have your mole examined. If needed, we will arrange to remove the mole as soon as possible.