Video Production by Josh Melendez

This video discusses squamous cell skin cancer, its different levels and treatment options.

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Video Transcript:

So this video is going to talk about squamous cell cancers. Now squamous cell cancers are the second most common type of skin cancer there is. And squamous cell cancers are more dangerous than basal-cell cancers. So we really need to respect these because they have an increased chance of spreading internally, going to other organs, and wreaking havoc in your body.

Now squamous cell cancers tend to be less locally destructive. But again, they tend to go deeper and spread more easily, especially in certain locations like the ears, around the mouth, and around the nose. So, squamous cell cancers still come from increased exposure over a lifetime to ultraviolet light in other forms of radiation, so we do need to limit those. And if you’ve been diagnosed with one of these, it’s really important that you look at your skin once a month in the mirror to determine if anything is new, changing, growing, or simply not healing.

Now, we are going to talk about the precursors to squamous cell cancers which are called actinic keratosis. And you will find in the links below a video about actinic keratosis, what that means for you, and what risk that puts you at for having more squamous cell carcinomas or squamous cell cancers. The treatment for squamous cell cancers are the same as the treatments for basal-cell cancers, and those include procedures like ED & Cs, procedures like excisions, Mohs, or even radiation, and you can find links below to all of these so that you understand them.

We’re going to be showing you a couple of pathology slides right now, so that you can understand what they look like under the microscope, and why some treatments might be better than others. So in this first example we have a squamous cell cancer in situ, and in situ means in the surface of the skin. It doesn’t really have depth. And so you can think of these as cancers that are on the surface of the skin, and if they’re just on the surface of the skin, then sometimes we can treat these with a modality that just treats the surface of the skin, like an ED&C. Now if a squamous cell cancer has depth to it, whether that depth is diving down a hair follicle, or whether there is depth deep into the biopsy, then we probably need a procedure that addresses the depth. And those procedures are the excisions, the Mohs surgeries and also the radiation.

Now in this example, you’re going to see a pathology slide of a squamous cell cancer with follicular extension, and you can see the squamous cells that are atypical or cancerous diving down the hair follicle. And on either side of that, you can see strong collagen, the stuff that holds our skin together, the stuff that makes it so that our skin doesn’t droop on the floor. If you imagine that we treated the squamous cell cancer with follicular extension or diving down the hair follicle with just a scrape and burn procedure like an ED & C, you can see how that probably would not be the best treatment, because the scrape of the surface of the skin doesn’t address the depth.

Now, we’re also going to be showing you an example of a squamous cell cancer that has depth to it. And this one is called Well Differentiated. And you can see that if we just treated this with a superficial scrape process, it probably would not address the cancer that’s down deep. It’s in between those strong collagen bundles. And so we’d need to treat this with something that addresses the depth, like an excision, or Mohs, or perhaps even radiation.

So your dermatologist has the pathology report for your individual lesion, they will know the location and they’ll take into account factors like age, how big it is, and lots of other factors, and recommend a treatment modality for you. All you need to do is make sure that it makes sense to you, and that you ask any and all questions you have before the procedure. Please also watch all the different procedure videos below, so you know what each one entails, and so that you can enter into the conversation with your dermatologist in an educated fashion. Because like we always say, “An educated patient is the best patient.”

Patient: I’ve had a squamous cell, I had one on my neck, and that was a fairly easy procedure, and that we didn’t even do a Mohs, you didn’t do a Mohs, he didn’t get it took it off with an excision. It just kind of stayed within its bounds, and so it was easy enough to take off. They found that it was a clean border, and so that’s all there was to it. So that one was pretty easy.

About the author

Dr. Anderson with Doctors Quarterly Magazine - Cropped
Dr. Reagan Anderson

Dr. Anderson is a Board Certified Dermatologist and Mohs Micrographic Surgeon. He serves as a Clinical Professor of Dermatology and is actively involved in patient and healthcare provider education on dermatology conditions and treatment.

Colorado Dermatology Institute
8580 Scarborough Drive / 1220 Lake Plaza Drive
Colorado Springs, Colorado