Squamous cell carcinoma (SCC) is a common type of skin cancer that develops in the squamous cells, which are thin, flat cells found in the outermost layer of skin. SCC often occurs on sun-exposed areas of the body and can develop in people who have had a lot of sun exposure over the course of their lifetime.
Can you get squamous cell carcinoma more than once?
Yes, it is possible to develop squamous cell carcinoma multiple times. Some key points:
- Having one SCC increases your risk of developing another SCC within the next few years.
- Around 30-50% of people who have had one SCC will develop another SCC within 5 years.
- The more SCCs you have had, the higher your risk of developing another one.
- It is not uncommon for some people to develop 10 or more SCCs over their lifetime.
There are a few reasons people can develop multiple SCCs:
Ongoing sun exposure
Too much exposure to ultraviolet (UV) radiation from the sun or tanning beds is the main cause of SCC. People who continue to get excessive sun exposure after already having SCC are at very high risk of developing more tumors.
Weakened immune system
Certain health conditions and medications can suppress the immune system and make the skin more vulnerable to new SCCs forming. This includes:
- Having an autoimmune disease like lupus.
- Taking immunosuppressant drugs after an organ transplant.
- Undergoing chemotherapy or radiation treatment.
Previous skin damage
The more accumulated skin damage you have from sun exposure or other sources (scars, burns, ulcers etc.), the higher your chances of SCC popping up again in those damaged areas.
Genetics and skin type
Some people are genetically prone to developing multiple SCCs. This includes:
- People with very fair skin that freckles and burns easily.
- Those with a family history of skin cancer.
- People who have conditions causing skin fragility like albinism.
How many SCCs can a person get in their lifetime?
There is no specific limit on the number of individual SCCs a person can develop over time. In extreme cases, some people have developed hundreds of SCC tumors. Factors that influence lifetime risk include:
- Total sun/UV exposure: The more accumulated sun exposure, the greater the risk of developing multiple tumors during one’s lifetime.
- Age: SCC risk increases steadily with age as skin accumulates more damage over decades.
- Location: Lifetime risk is higher for those residing in sunny climates year-round.
- Occupation: People who work outdoors are more prone to multiple SCCs.
- Genetics and skin type: Fair skin has greater vulnerability to UV damage and SCCs.
- Immune status: Weakened immune system increases susceptibility.
- History of SCC: Having one SCC substantially increases risk of developing more.
What increases your chances of getting squamous cell carcinoma again?
There are several main risk factors that can increase a person’s chances of developing multiple or recurring SCCs:
Ongoing sun exposure and tanning
Exposure to UV light damages skin cell DNA, which can lead to new skin cancers. Those who continue tanning and unprotected sun exposure after an initial SCC diagnosis are more likely to develop additional tumors.
Multiple precancerous skin lesions
Actinic keratoses are rough, scaly patches on sun-exposed skin that are considered precancerous lesions. Studies show the more actinic keratoses present, the higher the risk of developing new SCCs over time.
Previous radiation treatment
Radiation for an earlier skin cancer can cause genetic mutations that raise susceptibility for new SCCs developing in those treated areas later on.
Weakened immune system
A compromised immune system hampers the body’s ability to detect and destroy precancerous skin cells before they form SCC tumors. This makes people more vulnerable to SCCs recurring.
HPV infection
Certain strains of human papillomavirus (HPV) are thought to contribute to development of some SCCs. HPV infection may potentially increase risk of getting multiple SCCs.
Skin damage
Pre-existing skin damage from chronic sun exposure, scarring, ulcers, burn sites etc. can provide a prime environment for new SCCs to form repeatedly.
Older age
The risk of getting another SCC after an initial tumor increases substantially with age due to accumulated skin damage over time.
Fair skin type
Those with fair skin, light hair and eyes, who burn easily are more susceptible to successive SCCs as they age.
Male gender
Research shows men are at slightly higher risk of developing multiple SCCs compared to women.
Does the number of times you have had squamous cell carcinoma affect your prognosis?
In most cases, getting squamous cell skin cancer more than once does not affect a person’s prognosis or chances of survival. Some key points on this:
- Having multiple separate SCC tumors generally does not make an individual tumor more dangerous or deadly.
- The vast majority of SCCs are localized and non-aggressive in nature.
- Prognosis mainly depends on the specific characteristics of each tumor rather than total number of SCCs.
- Exceptions are if SCC spreads to other organs or into lymph nodes, which is uncommon.
However, there are a few reasons a higher number of SCCs may potentially impact prognosis:
- The more total SCCs, the higher the chances of a particularly aggressive tumor developing eventually.
- Multiple recurrences can lead to increased skin damage and cosmetic impact.
- Higher lifetime SCC count makes it more difficult to monitor and detect new tumors early.
- Young age at first SCC diagnosis correlates with lifetime risk of metastatic disease.
Talk to your dermatologist about your individual prognostic outlook if you have had multiple SCCs. They can assess your specific risk profile.
What’s the prognosis and survival rate for recurring squamous cell carcinoma?
The prognosis for squamous cell carcinoma recurring in the same general area as previously treated SCC is usually excellent, with cure rates over 95% in most cases. Some general points about recurring SCC prognosis:
- 5-year survival rate is over 95% for local SCC recurrence if caught and treated early.
- Metastatic spread to distant sites occurs in only about 5% of recurring SCCs.
- Aggressive subtypes like spindle cell SCC have higher recurrence risk and lower survival rates.
- Squamous cell cancers in immunocompromised patients carry higher risk of recurrence and metastasis.
- Good prognosis relies on regular skin exams to detect new tumors when small and localized.
Recurrence risk depends on the initial tumor characteristics and treatment methods used. Mohs microsurgery has the lowest recurrence rates.
Talk to your doctor about your specific recurring SCC for accurate prognosis based on its individual characteristics and spread.
Can squamous cell carcinoma spread to lymph nodes after recurrence?
It is possible but relatively uncommon for recurring squamous cell carcinomas to spread to nearby lymph nodes after initially being diagnosed at an early, localized stage. Some general points:
- Estimated only about 1-5% of recurring SCCs metastasize to lymph nodes.
- Risk is higher if the initial tumor was poorly differentiated, had deep invasion, or perineural growth.
- Aggressive SCC subtypes like spindle cell carcinoma have increased metastatic potential.
- Recurring SCCs located on ear, lip, eyelid, temple, scalp have higher lymph node spread risk.
- A recurring tumor with sudden rapid enlargement warrants node evaluation for spread.
Signs that a recurring SCC may have reached nearby lymph nodes include:
- Palpable lump or thickening near the SCC site.
- Enlarged lymph node that is round, hard, and not moveable under the skin.
- Lymph node that feels firm or tender when touched.
- Redness and abnormal warmth over the lymph node.
Let your dermatologist know if a recurring SCC shows any signs of possible lymph node involvement. Catching metastatic spread early is key for optimal treatment.
Can you die from squamous cell carcinoma?
Dying from squamous cell carcinoma is very rare, as it usually grows slowly and remains confined to the outermost skin layers when detected early. However, SCC can potentially be deadly if left untreated long enough to advance deeper or spread to lymph nodes or internal organs. Some general statistics on SCC mortality:
- The 5-year survival rate for localized SCC is over 95%.
- Metastatic SCC has a 5-year survival rate of about 35%.
- Approximately 2,000 people in the U.S. die from SCC each year.
- High-risk SCCs on the ears, lips, scalp and face have higher mortality rates if not treated promptly.
- People with weakened immune systems have poorer survival for SCC.
SCC can potentially turn deadly if:
- It invades deeply beyond the skin layers into tissues beneath.
- Cancer cells spread through lymph vessels to nearby lymph nodes.
- Cancer metastasizes to distant organs like the lungs, liver or brain.
- The tumor grows rapidly or fails to respond to treatments.
- An aggressive SCC subtype develops, like spindle cell carcinoma.
To avoid dying from SCC, get regular skin cancer screenings and have any suspicious growths biopsied and treated right away before they progress. Controlling SCC early provides an excellent prognosis in most cases.
When is squamous cell carcinoma fatal?
Squamous cell carcinoma is very rarely fatal when detected at an early stage and can be cured with proper treatment. However SCC may potentially become life-threatening if:
- The tumor grows deeper into skin layers like the dermis, fat, or muscle tissue underneath.
- Cancer cells spread to nearby lymph nodes, which often requires aggressive treatment.
- SCC metastasizes to distant organs like the lungs, liver, bones, or brain.
- The tumor develops resistance to standard treatments like surgery, radiation therapy, or chemotherapy medications.
- An aggressive variant of SCC occurs, like spindle cell carcinoma.
- The patient has a weakened immune system that hampers SCC treatment.
- SCC develops in a high-risk location like the lips, ears, eyes or temple.
Once a previously treatable SCC metastasizes and spreads through the body, survival rates drop significantly. Seeking immediate medical care for suspicious skin lesions provides the best chance for early detection and successful treatment.
Can you get squamous cell carcinoma in the same place twice?
Yes, it is possible for squamous cell carcinoma to recur in the exact same location as a previously treated SCC tumor. Reasons SCC can recur in the same spot include:
- The initial cancer was not completely removed during treatment.
- Undetected cancer cells remained around the edges of the treated area.
- Ongoing sun damage caused new precancerous skin cell mutations.
- Scar tissue provided an environment for new SCC growth.
- The person has a weakened immune system.
According to research, the general likelihood of SCC recurring in the same anatomical location is:
- Around 8-10% over 5 years if treated with surgical excision alone.
- Approximately 5-6% over 5 years if treated with Mohs surgery.
- Higher for SCCs on the head, neck and lips.
- Much lower if the area is protected from further sun exposure.
Regular skin self-exams and follow-up visits with a dermatologist are important to monitor for potential SCC recurrence in previously treated spots.
What are the chances of recurrence for squamous cell carcinoma?
Most cases of squamous cell carcinoma are cured with initial treatment, but there is always some risk of SCC recurring in the same area or elsewhere on the body. General SCC recurrence rates:
- Around 8% over 5 years for low-risk SCC treated by surgical excision.
- Approximately 5% over 5 years for low-risk SCC treated with Mohs surgery.
- 10-50% over 5 years for high-risk SCC, depending on treatment method.
- Much higher recurrence risk for SCCs on lips, ears, scalp, face, hands or feet.
- Higher for SCC in immunosuppressed transplant patients or with HPV infection.
Factors that increase risk of SCC recurrence include:
- Large tumor size, deep invasion, and poorly differentiated cells.
- Tumor borders extend deep below visible skin or are poorly defined.
- Lymphatic or perineural invasion identified.
- Incomplete removal with positive surgical margins.
- Tumor resistance and recurrence after radiation therapy.
- Lack of regular skin exams to find recurrences early.
Talk to your doctor about your specific SCC recurrence risk based on tumor characteristics and your individual profile.
Conclusion
In summary, the number of times an individual can develop squamous cell carcinoma is highly variable based on their skin type, genetics, sun exposure history and immune status. While most SCCs are cured with early treatment, some people are prone to getting dozens or even hundreds over a lifetime without proper sun protection. Recurring SCCs are common, especially if ongoing skin damage continues. But if caught early, the prognosis for recurrent squamous cell skin cancer is typically excellent.
The keys to minimizing your lifetime number of SCCs are wearing sunscreen, avoiding tanning, conducting self-exams and getting screened regularly by a dermatologist. Also make sure any suspicious lesions are biopsied and treated right away before cancer cells can multiply and spread. With proper surveillance and early treatment, most people can successfully control squamous cell carcinoma throughout their lifetime.
