Skin Cancer - Squamous Cell Carcinoma

2023 Author: Wallace Forman | [email protected]. Last modified: 2023-08-25 11:04

Skin cancer: squamous cell carcinoma

Cutaneous squamous cell carcinoma (SCC) is the second most common skin tumor after basal cell carcinoma (BCC). According to the German Cancer Society, the annual rate of new cases in Central Europe is around 25 to 30 per 100,000 people. The frequency has increased significantly over the past three decades. Squamous cell carcinoma occurs mainly on parts of the body exposed to the sun, especially on the face, shoulders, arms and hands. Metastases are formed in about ten to 15 percent of cases, so early diagnosis and therapy are important.

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• What are the causes of squamous cell carcinoma?
• How can squamous cell carcinoma be prevented?
• What are the symptoms?
• How is the diagnosis made?
• How is squamous cell carcinoma treated?
• Whom can I ask?
• How are the costs going to be covered?

What are the causes of squamous cell carcinoma?

The most important causal factor is chronic exposure to UV light, especially in people who are sensitive to sunlight. Relevant risk factors for tumor development include:

• older age,
• the sum of solar radiation,
• light skin pigmentation,
• the development of actinic keratosis (excessive cornification from exposure to radiation) as the first stage of squamous cell carcinoma.

In addition, radioactive radiation, treatments with light and X-rays, chronic inflammation and particularly pronounced scars can promote the development of squamous cell carcinoma. In addition to the skin, mucous membranes such as those in the mouth or larynx can also be affected. The main triggers here are the consumption of nicotine and alcohol. Furthermore, human papilloma viruses (HPV) are likely to play a role in the development.

How can squamous cell carcinoma be prevented?

In addition to sensible use of the sun, regular skin self-examinations (at least twice a year) are the best protection against skin cancer. In addition, an annual examination should be carried out by the dermatologist. People with an increased risk of skin cancer should have a check-up twice a year.

Since it cannot be predicted from which actinic keratosis a squamous cell carcinoma will develop, early and consistent treatment of all actinic keratoses is recommended. Various options are available for this:

• surgical removal,
• Freezing with liquid nitrogen (cryotherapy),
• X-ray therapy,
• Removal by laser,
• local chemotherapy in the form of solutions or creams (e.g. imiquimod, diclofenac sodium, 5-fluorouracil, ingenol mebutate),
• photodynamic treatment,
• immunological therapy.

The choice of method depends on the size, location and number of diseased skin areas.

What are the symptoms?

Preferred areas are body regions that are more exposed to the sun. Typical of actinic keratosis as an early stage of squamous cell carcinoma are flat, punctiform, rough skin changes that are initially easier to feel than to be seen. Their surface appears matt, skin-colored to yellow-gray or reddish. Irregular, warty, yellowish-gray to whitish bumps develop over months and years. They have a tough consistency but are easily vulnerable. They often look like "lime splashes" on the face. When fully developed, squamous cell carcinomas are skin-colored, rough, nodular changes in the skin. Uninhibited growth can destroy adjacent tissue.

How is the diagnosis made?

Actinic keratosis and squamous cell carcinoma can usually be recognized by the typical skin changes. The diagnosis can be confirmed by the histological examination of a tissue sample. If the findings are unclear, dermatoscopy, confocal laser microscopy and optical coherence tomography can be helpful.

How is squamous cell carcinoma treated?

The standard treatment is the complete surgical removal of the squamous cell carcinoma. In most cases it can be performed by a dermatologist under local anesthesia and is associated with relatively little stress for those affected. In the case of larger tumors or in an unfavorable position (e.g. near the eyes), the operation is carried out in several steps: If there are tumor residues after removal and microscopic inspection, these are removed in a second operation and checked again. Only then is the wound closed.

Other procedures such as radiation or freezing of the tumor are only used in special cases, e.g. if an operation is out of the question due to age or a serious illness of the person concerned. With timely treatment and without metastasis, the chances of recovery are very good.

Whom can I ask?

If your skin changes appear suspicious, you should contact a dermatologist immediately. Early diagnosis and therapy are important because squamous cell carcinomas can develop from actinic keratoses and in some cases these in turn form metastases and thus become potentially life-threatening.

How are the costs going to be covered?

The e-card is your personal key to the benefits of the statutory health insurance. All necessary and appropriate diagnostic and therapeutic measures are taken over by your responsible social insurance agency. A deductible or contribution to costs may apply for certain services. You can obtain detailed information from your social security agency. Further information can also be found at:

• Right to treatment
• Visit to the doctor: costs and deductibles
• What does the hospital stay cost?
• Prescription fee: This is how drug costs are covered
• Medical aids & aids
• Health Professions AZ
• and via the online guide to reimbursement of social insurance costs.