Persons who present with early SCC lesions and who receive adequate treatment have a 5-year survival rate of greater than 90%. Conversely, patients with advanced SCC tumors with lymph node involvement have a dramatically lower 5-year survival rate, of 25% to 45%.8

Long-term follow-up. Persons with SCC should be counseled similarly to persons with BCC in terms of using sun protection, taking other steps to prevent recurrence, and undergoing skin examinations. Persons with SCC also should undergo regional lymph node examinations.7 

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Clinicians should be aware that like persons with a history of BCC, persons with a history of SCC are at increased risk for cutaneous melanoma.7

Both groups of patients also should be counseled to avoid the carcinogenic exposure of tanning beds: Utilizing indoor tanning devices more than doubles an individual’s risk of developing SCC.8

Summary

Primary-care clinicians are in a unique and critical position of being able to flag patients with risk factors for BCC and/or SCC. These providers also often can identify clinically abnormal lesions that require a biopsy and a subsequent treatment plan. There are two common themes when talking about BCC and SCC: Early detection is key, and prevention is essential.

Abby Jacobson, PA-C, is a physician assistant practicing in dermatology at Delaware Valley Dermatology Group in Wilmington, Delaware, and at Dermatology and Skin Surgery Center of York in York, Pennsylvania.


References

    1. American Cancer Society. Skin cancer.
    2. Bader RS. Basal cell carcinoma. Medscape. Updated March 27, 2014emedicine.medscape.com/article/276624-overview.
    3. National Institutes of Health National Library of Medicine. Fluorouracil topical. MedlinePlus website. Available at www.nlm.nih.gov/medlineplus/druginfo/meds/a605010.html
    4. Love WE, Bernhard JD, Bordeaux JS. Topical imiquimod or fluorouracil therapy for basal and squamous cell carcinoma: a systematic review.Arch Dermatol. 2009;145(12):1431-1438.
    5. Sekulic A, Migden MR, Oro AE, et al. Efficacy and safety of vismodegib in advanced basal-cell carcinoma. N Engl J Med. 2012;366(23):2171-2179. Available at www.nejm.org/doi/full/10.1056/NEJMoa1113713#t=articleTop.
    6. Levi F, Randimbison L, Maspoli M, et al. High incidence of second basal cell skin cancers. Int J Cancer.2006;119(6):1505-1507. Available at
    1. National Comprehensive Cancer Network, Inc. Guidelines Version 2.2014: Basal Cell and Squamous Cell Skin Cancers. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). 2014; p. MS-3.
    2. Monroe MM. Cutaneous squamous cell carcinoma. Medscape. Updated April 7, 2014. Available at
    1. Rowe DE, Carroll RJ, Day CL Jr. Prognostic factors for local recurrence, metastasis, and survival rates in squamous cell carcinoma of the skin, ear, and lip. Implications for treatment modality selection.
    2. Cook BE Jr, Bartley GB. Epidemiologic characteristics and clinical course of patients with malignant eyelid tumors in an incidence cohort in Olmsted County, Minnesota. Ophthalmology. 1999;106(4):746-750.

All electronic documents accessed June 09, 2014.

This article originally appeared on Clinical Advisor

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