Squamous cell carcinoma
and Martina Feichter, medical editor and biologistDr. med. Fabian Sinowatz is a freelancer in the medical editorial team.
More about the expertsMartina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.
More about the experts All content is checked by medical journalists.
Squamous cell carcinoma is also known as spinalioma, spinocellular carcinoma or squamous cell cancer. It is the second most common type of skin cancer after basal cell carcinoma. Both together are called "white skin cancer". Every year around 98,000 people in Germany are newly diagnosed with spinalioma - most often men between the ages of 70 and 80. Read more about squamous cell carcinoma here!
ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. C44
Squamous cell carcinoma: affected areas of skin
Squamous cell carcinoma mainly develops on parts of the body that are exposed to a lot of the sun (called light or sun terraces) - and especially on the face (e.g. on the nose). Sometimes the shoulders, arms, backs of the hands or transition areas to the mucous membranes (e.g. lower lip) are also affected. In people with sparse or missing head hair, a spinalioma often also forms in the bald area, neck or at the tips of the ears.
Squamous cell carcinoma: risk factors
UV light and actinic keratosis
The most important risk factor for a spinalioma is UV light - mostly via actinic keratosis (also known as solar keratosis). This is a skin change caused by UV rays, which in very many cases becomes a precursor to a spinalioma. It occurs exclusively on parts of the body that are exposed to the sun, mostly on the face, on the back of the hand or on a bald head.
Actinic keratosis typically shows up as a relatively sharply defined reddening that can come and go and feels like fine sandpaper (i.e. a bit rough). This skin change is not malignant, but it often develops into squamous cell carcinoma. Therefore actinic keratoses should always be treated medically.
Especially in people with a weakened immune system (e.g. when taking immunosuppressants after an organ transplant), the UV exposure that has accumulated over the course of life can ultimately lead to squamous cell carcinoma.
Other risk factors
In addition to actinic keratosis, there are other risk factors for a spinalioma: Skin that has been previously damaged by certain toxins such as tar, arsenic or soot is very at risk for squamous cell carcinoma. The tongue and mouth are often damaged by chronic tobacco and alcohol consumption, which promotes squamous cell carcinoma in this area.
However, a spinalioma can not only develop on such skin damage caused by chemical poisons. In rarer cases, this skin cancer develops from chronic wounds, burn scars or from other skin diseases.
Squamous cell carcinoma: treatment
Surgical removal of the tumor is standard therapy for a spinalioma. Alternatively (for example if an operation is not possible for medical reasons) doctors switch to other therapy methods. These include, for example, freezing (cryotherapy), local chemotherapy or immunotherapy and radiation therapy.
You can find out more about the treatment of squamous cell carcinoma and its precursors (actinic keratosis) under Skin Cancer: Treatment.
Squamous cell carcinoma: chances of recovery
As with other types of skin cancer, the same applies to squamous cell carcinoma: the earlier the tumor is discovered and treated, the more favorable the prognosis. So there is an almost 100 percent chance of recovery if the spinalioma is not yet larger than one centimeter. Usually such a small tumor has not yet formed any daughter settlements (metastases), which makes it easier to treat.
But once there are metastases, the prognosis deteriorates significantly. It is also unfavorable if the patient has a suppressed immune system (immunosuppression) - for example through the use of immunosuppressants or through an HIV infection. The skin cancer is then usually much more aggressive.
About 40 to 50 out of 1,000 spinalioma patients die of the cancer.
Squamous cell carcinoma: follow-up care
Squamous cell carcinoma can recur even after successful treatment and healing. In around half of the patients, a second tumor develops within five years of the first illness. Therefore, regular follow-up examinations during these five years are very important.
The intervals at which the examinations make sense depends on the individual case. Quarterly checks are usually recommended in the first year.
Squamous cell carcinoma: prevention
Excessive UV exposure to the skin is one of the main risk factors not only for spinal cancer but also for other skin cancers such as basal cell carcinoma and black skin cancer. Therefore the urgent advice: Protect yourself from too much sun! Whenever possible, avoid direct sunlight and use full sun protection, such as sunscreen, clothing and a hat. For men with thin hair or bald head, it is very advisable to wear a hat.
Especially with children, make sure they are adequately protected from the sun. Their skin is much more sensitive than that of adults.
You are not only exposed to cancer-promoting UV rays in sunlight, but also on the sunbed. That is why the German Cancer Aid recommends: Avoid visiting the solarium!
This advice is particularly important if you have had squamous cell carcinoma in the past - to reduce the risk of relapse.
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