Is Squamous Cell Carcinoma Deadly?

Squamous cell carcinoma (SCC) is a type of skin cancer with typically high survival rates. By some estimates, between 700,000 and 1.8 million people are diagnosed with SCC in the United States each year, and an estimated 2,500 people in the U.S. die of it each year

Many cases of SCC are easily cured, especially when they’re caught early. Even though treatment for early-stage SCC is almost always effective, the condition can still be deadly under some circumstances.

How often is squamous cell carcinoma life-threatening? What are the risk factors for SCC becoming deadly? We’ll answer those questions in this article and provide some statistics on SCC-related deaths.

How Common Are Deaths From SCC?

SCC is generally less deadly than melanoma and many other cancers, especially when found and treated early. However, SCC can sometimes metastasize (spread) and become deadly. It’s also worth noting that being diagnosed with SCC increases your risk of developing other forms of skin cancer (including more deadly types) later in life.

Melanoma is the most deadly type of skin cancer. But among nonmelanoma skin cancers, SCC causes the most fatalities. Melanoma is more likely to spread to the lymph nodes (small, bean-shaped immune system organs throughout the body), but SCC is a much more common type of cancer.

When SCC is diagnosed and treated early, the five-year survival rate is almost 100 percent. This means that almost 100 percent of people are still alive five years after being diagnosed with early-stage SCC.

It’s uncommon for SCC to metastasize. When it does, it tends to spread slowly, though some tumors can spread or behave aggressively. Once SCC cells spread to the lymph nodes or other areas outside the skin, the five-year survival rate for SCC drops to under 50 percent.

Risk Factors for SCC Becoming Deadly

Certain details about a person’s SCC and their overall health can increase their risk of dying from the condition. Here are some of the factors that raise the risk for SCC becoming deadly.

SCC Diagnosed at a Later Stage

When SCC is diagnosed at a later stage, it may mean the cancer has grown deeply into nearby tissue, spread to lymph nodes, or spread to distant parts of the body. There are four stages for SCC, and you may see them rendered with Roman numerals, such as stages I through IV.

Staging for SCC is based on factors such as:

• Tumor size
• How deeply the tumor has grown into nearby structures
• Whether it has spread to lymph nodes or distant parts of the body

SCC diagnosed at a later stage is more likely to become deadly than SCC that remains in the skin’s top layer. SCC often grows slowly, but some tumors can grow more quickly or behave more aggressively. When SCC is found at a later stage, it’s often been growing for a long time.

Advanced squamous cell carcinoma can still be treatable, but treatment is more complicated compared with early-stage SCC. In general, treatment for squamous cell carcinoma focuses on removing the initial SCC lesion and containing the spread of cancer cells so they don’t reach other organs.

Higher-Grade SCC

The grade of your SCC skin cancer tells you how abnormal the cancer cells are compared with healthy, noncancerous cells. The less they look like normal skin cells, the higher the grade of SCC. Doctors account for both the stage and grade of your skin cancer while recommending treatment.

High-grade SCC tumors are linked to lower SCC survival rates. If your SCC was diagnosed at a high grade, the cancer may be more likely to advance, metastasize, and become deadly.

A Weakened Immune System

In a healthy immune system, certain immune cells are able to recognize and destroy cancer cells. This defense system isn’t often enough to get rid of cancer entirely, but it can help keep it contained. Types of cancer treatments called immunotherapies harness the immune system as a tool to help fight cancer.

Being immunocompromised (having a weakened immune system) can affect your squamous cell carcinoma prognosis (outlook). A weakened immune system may be less capable of performing its usual functions, including tracking down and getting rid of cancer cells.

Research shows that people who are immunocompromised are at an overall increased risk of developing SCC. They also have lower survival rates and higher cancer recurrence rates.

Older Age at Diagnosis

People who were diagnosed with SCC at an older age also have lower survival rates. Older people are more likely to have health conditions that limit which cancer treatments they can tolerate. Limited treatment options can affect life expectancy.

Delayed Treatment

A delayed diagnosis gives SCC cancer more time to advance. The same is true for delayed treatment. Most health experts recommend starting SCC treatment as soon as the cancer is discovered.

Immediate treatment of SCC may not be feasible in some cases. When possible, follow your skin cancer specialist’s recommendations for treating SCC. When SCC is left untreated or when treatment is delayed, you risk a worse outcome.

Large or Deep Tumors

A large tumor size is a risk factor for SCC becoming deadly. An SCC tumor is also more likely to be difficult to treat if it’s grown deeper into the skin. Large or deep SCCs usually have a higher risk of metastasis and recurrence (returning), making them more deadly than smaller and shallower tumors.

SCC tumors with unclear borders are also more likely to be difficult to treat or even deadly.

SCC in Certain Locations

Squamous cell carcinoma is more likely to spread from certain parts of the body than from others. As a type of cancer that tends to develop from ultraviolet (UV) exposure, SCC is most commonly found in areas of skin with a lot of sun exposure, such as the:

• Forearms
• Hands
• Lower legs
• Scalp
• Ears
• Face

SCC tumors in certain locations — such as the ear, lip, face, scalp, or genitals — may be considered higher risk. Since SCC in these locations is more likely to advance, they may be more likely to affect a person’s life expectancy.

SCC in certain locations, such as the face and the genitals, may be considered higher risk than SCC in some other locations, such as the trunk, arms, or legs. SCC lesions are also higher risk when they develop in open wounds.

When SCC Isn’t Deadly but May Have Unfavorable Outcomes

Higher-risk SCC can be treatable. However, delayed diagnosis and treatment can lead to some unfavorable treatment outcomes in people who’ve survived advanced SCC.

Advanced SCC requires more complex treatment, which can be more expensive and time-consuming than treatment for lower-risk SCC.

Surgery for SCC lesions that have grown large or deep into the skin can leave major scars, and the cancer itself can be disfiguring.

Systemic (whole-body) treatments for SCC that has spread, such as immunotherapy and chemotherapy, can have undesirable side effects.

Talk to Your Doctor

If you have any concerns about squamous cell carcinoma and its risk of becoming deadly, talk to your skin cancer specialist. They can tell you more about your personal risk factors, help you understand your prognosis, and choose the most effective treatment options for your SCC.

To minimize your risk of developing deadly squamous cell skin cancer, it’s important to learn what it looks like, as well as the signs of precancerous conditions such as actinic keratosis.

Tell your dermatologist right away if you notice any unusual skin changes, including scaly patches, lumps, or sores that won’t heal on their own. Early detection is key to better outcomes.

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