Metastasis of cutaneous squamous cell carcinoma (cSCC) is rare. However, certain tumor and patient characteristics increase the risk of metastasis. Prior studies have demonstrated metastasis rates of 3-9%, occurring, on average, one to two years after initial diagnosis [6].
Metastatic squamous cell carcinoma is often referred to as a neck cancer because it tends to travel to the lymph nodes in the neck and around the collarbone. Because of this, signs of metastasis may include a painful or tender lump in the neck or a sore throat that doesn't improve or go away.
Most (95% to 98%) of squamous cell carcinomas can be cured if they are treated early. Once squamous cell carcinoma has spread beyond the skin, though, less than half of people live five years, even with aggressive treatment. There are many ways to treat squamous cell carcinoma that has not spread.
Although squamous cell carcinoma can be more aggressive than basal cell cancer, the risk of this type of cancer spreading is low—as long as the cancer is treated early, Dr. Leffell says. He notes that the lesions must be treated with respect because they may grow rapidly and invade deeply.
Although rare, research describes SCC in MU as more aggressive than other skin cancers. It has a prevalence of 1–2% in burn scars but a metastatic rate of 27%, and once it has spread to regional lymph nodes, mortality is predicted within 2–3 years.
In general, the squamous cell carcinoma survival rate is very high—when detected early, the five-year survival rate is 99 percent. Even if squamous cell carcinoma has spread to nearby lymph nodes, the cancer may be effectively treated through a combination of surgery and radiation treatment.
They are of concern because of the similarity to squamous cell cancer. Squamous cell carcinoma is one of the three most common types of skin cancer. Basal cell, squamous cell, and melanoma. Squamous cell cancers can metastasize (spread) and should be removed surgically as soon as they are diagnosed.
Treatment should happen as soon as possible after diagnosis, since more advanced SCCs of the skin are more difficult to treat and can become dangerous, spreading to local lymph nodes, distant tissues and organs.
Stage 2 squamous cell carcinoma
In stage 2, the cancer is larger than 2 centimeters across, and has not spread to nearby organs or lymph nodes, or a tumor of any size with two or more high risk features.
Squamous cell carcinoma rarely metastasizes (spreads to other areas of the body), and when spreading does occur, it typically happens slowly. Indeed, most squamous cell carcinoma cases are diagnosed before the cancer has progressed beyond the upper layer of skin.
It is estimated that about 2,000 people die from basal cell and squamous cell skin cancer each year. Older adults and people with a suppressed immune system have a higher risk of dying from these types of skin cancer. It is estimated that 7,990 people will die from melanoma in the United States in 2023.
About 60 percent of people who have had one skin cancer will be diagnosed with a second one within 10 years, says a 2015 study in JAMA Dermatology. Your odds increase dramatically if you've been diagnosed with a second BCC or SCC (or third, or any other number beyond first).
If you've had SCC, you have a high chance of recurrence. You also have an elevated risk of developing another SCC or basal cell carcinoma (BCC), since sun damage is the primary cause of both forms of skin cancer. If you have had a previous diagnosis of BCC, you also have a greater chance of developing SCC.
Squamous cell carcinoma of the skin is usually not life-threatening, though it can be aggressive. Untreated, squamous cell carcinoma of the skin can grow large or spread to other parts of your body, causing serious complications.
What does SCC look like? SCCs can appear as scaly red patches, open sores, rough, thickened or wart-like skin, or raised growths with a central depression. At times, SCCs may crust over, itch or bleed.
The most common sites are the lung (21%), bone (18%), central nervous system (6%) and liver (4%). Distant metastasis is generally associated with a poor prognosis with a 3-year disease-free survival rate in adult transplant patients of 56% (3).
In general, the squamous cell carcinoma survival rate is very high—when detected early, the five-year survival rate is 99 percent. Even if squamous cell carcinoma has spread to nearby lymph nodes, the cancer may be effectively treated through a combination of surgery and radiation treatment.
Symptoms of stage 4 squamous cell carcinoma usually begin with some kind of skin lesion or growth. Often, the tumors of squamous cell carcinoma look like a scaly red patch of skin that won't heal. These tumors are often crusty and raised, and they may cause sores or ulcers that last for several weeks.
Stage 2 – Cancer has grown deep into the skin and displays one or more high-risk features (such as metastasis to nerves or lower skin layers), but has not spread to nearby lymph nodes or healthy tissues. Stage 3 – Cancer has grown into lymph nodes, but has not spread to any organs other than the skin.
The recommended treatment for cutaneous squamous cell cancer (CuSCC) of the head and neck is Mohs surgical excision or wide local excision. Excision is recommended to a gross surgical margin of 4–6 mm however this is based on limited evidence and specify a goal histologic margin.
Most squamous cell carcinomas of the skin can be completely removed with relatively minor surgery or occasionally with a medicine applied to the skin. Which treatments are best for you depends on the size, location and aggressiveness of the tumor, as well as your own preferences.
Treatment overview
In June 2020, pembrolizumab (Keytruda®) was approved by the FDA for the treatment of recurrent or metastatic SCC that is not curable by radiation or surgery. In July 2021, the FDA expanded this approval to include SCC that is locally advanced and not curable by radiation or surgery.
Yes, squamous cell carcinoma can make you feel tired. It can make a person feel weak and exhausted. During the treatment procedures of squamous cell carcinoma, the patient tends to feel more tired. These types of fatigue that are related to cancer are known as cancer-related fatigue (CRF).
Systemic chemotherapy is not widely used for treating squamous cell carcinoma. In most cases, the cancer cells are confined to one area of skin and, if detected early, can be effectively addressed with localized treatments, such as surgery.
The key warning signs are a new growth, a spot or bump that's getting larger over time, or a sore that doesn't heal within a few weeks. (See Signs and Symptoms of Basal and Squamous Cell Skin Cancer for a more detailed description of what to look for.)