Understanding Squamous Cell Carcinoma
- Jessica Tappenden-Rowell, 23, was diagnosed with a type of oral cancer called squamous cell carcinoma after dismissing a lesion on her tongue as a “mouth sore.”
- It wasn’t until the sore became painful when eating or yawning that she sought medical advice, prompting her to get a biopsy. Now she’s urging others to get sores in their mouth checked and be your own advocate.
- Squamous cell carcinoma is the second most common type of skin cancer. It forms in squamous cells just beneath the skin’s outer surface, typically indicated by hard, red bumps or scaling flat lesions. It can also present as an ulcer or induration that bleeds. While SCC often grows slowly, it’s more likely to spread to other tissues and organs, so it cannot be taken lightly.
- Advocating for your health is extremely important. You never know when speaking up about issues with your body can make a world of difference for health outcomes. One of our experts says there should be a plan for what the doctor will do for you after you leave every appointment.
The 23-year-old woman first noticed a sore in her mouth last May, which became painful after a few months, causing her pain when she ate and yawned.
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After seeing her doctor, she was advised to go to a nearby hospital, where a biopsy was taken on the mouth “sore,” ultimately leading to her diagnosis in August 2024.
Tappenden-Rowell was told she had a type of mouth cancer that begins in one’s skin cells, called squamous cell carcinoma (SCC), the most common type of skin cancer that may also develop in the mouth and throat.
Squamous cell carcinoma forms in squamous cells just beneath the skin’s outer surface, typically indicated by hard, red bumps or scaling flat lesions. It can also present as an ulcer or induration that bleeds. While SCC often grows slowly, it’s more likely to spread to other tissues and organs, so it cannot be taken lightly.
She explained further the shock of the diagnosis, “Suddenly I had cancer and had to have life-changing surgery. It was wild.”
The type of surgery she underwent to remove the tumor in her mouth was called free flap surgery, which John Hopkins Medicine explains, “Free flaps are transplants of your own tissue, instead of tissue from another donor.
“The subspecialty of plastic surgery that performs free flaps is called microsurgery. This is because during free flaps, surgeons use a microscope during the operation to connect blood vessels.”
Doctors removed the malignant part of her tongue and put a piece of forearm in it’s place, in addition to a vein and an artery to allow for blood flow into the tongue.
As for her recovery, Tappenden-Rowell, who is now cancer free, said, “You have to get used to your tongue and using it to speak, it took me months. Only recently people have said to me ‘you sound so much like you did before.’
She continued, “‘I’m not there yet, I still have some days where I struggle a bit. … It was amazing when I heard I was cancer free, my surgeon was choking up on the phone.
“It’s incredible what they can do, it really is amazing. They’ve taken my arm and put it in my mouth.”
As what what caused the cancer diagnosis, her doctor reportedly told her it was simply “bad luck.” She warns other now, “If you have an ulcer that has not gone away within two weeks, get it checked.
“The earlier you go, the less chance of this type of surgery. If I had gone earlier I might not have [needed] such a large portion of my tongue removed.”
Understanding Oral Cancer
Oral cancer can occur anywhere in the mouth, including the tongue, gums, lining of the mouth, and back of the mouth near your throat.
The National Institute of Dental and Craniofacial Research says some common symptoms of oral cancer may include:
- A sore lump in your mouth, lip, or throat
- Persistent sore throat
- Lump in your neck
- Trouble swallowing or moving your jaw or tongue
- Pain or bleeding in your mouth
- Ear pain
“From the 1980s to the 2010s, the rate of HPV-related head and neck cancers has gone up by 300 percent,” Dr. Ted Teknos, a head and neck cancer specialist and president and scientific director of University Hospitals Seidman Cancer Center in Cleveland, Ohio, told SurvivorNet during a previous interview.
More On Head and Neck Cancers
- New Evidence Suggests Benefit Of Keytruda Immunotherapy For Some Head And Neck Cancer Patients
- The FDA Approves Immunotherapy Drug Keytruda For Some People With Head and Neck Cancer
- Can Mouthwash Really Lead to Cancer? Listerine & The Major New Questions About Alcohol Based Brands
- The ‘Top Chef’ Alum Shirley Chung, 47, Diagnosed With Tongue Cancer After Experiencing ‘Dental Issues’ & Mouth Sores
- Stanley Tucci, 60, Says Radiation for Oral Cancer Left Him Bedridden With a Feeding Tube For Six Months: ‘Drinking Water Burned My Mouth So Much’
- Brave Australian Man, 27, Has Half of His Tongue Removed During Cancer Fight, Learns The Disease Has Spread to His Heart; Understanding Head and Neck Cancers
- Remembering Superstar Sammy Davis Jr. Who Died From Throat Cancer at 64; Head and Neck Cancer Treatment Has Advanced With Proton Therapy
- Majority of Throat Cancer Diagnoses Are Caused by HPV – Here’s What You Need to Know
Though not all oral cancer is caused by the human papillomavirus (HPV), the most common sexually transmitted infection in the United States, there is a link. It’s unclear if Tappenden-Rowell had this virus.
RELATED: Why the HPV Vaccine is so Important in Preventing Cancer
WATCH: Understanding the Human papillomavirus.
The vast majority of humans in the United States, both men and women, will eventually get infected with HPV, according to Dr. Allen Ho, a head and neck surgeon at Cedars-Sinai.
“The important thing to know about HPV is that there are many different strains, and only a couple of them tend to be more cancer-inducing,” Dr. Ho previously told SurvivorNet during an interview.
“Probably less than 1 percent of the population who get infected happen to have the cancer-causing virus that somehow their immune system fails to clear, and over 15 to 20 years it develops from a viral infection into a tumor and cancer.”
While surgery is often required to remove the cancerous cells, other treatments include chemotherapy, radiation, and targeted drug therapies. If the cancer is advanced, some of these treatments can affect a patient’s ability to eat or speak, though it’s possible to regain those functions through rehabilitation therapy.
All About Squamous Cell Carcinoma
Squamous Cell Carcinoma (SCC) is a type of skin cancer that arises from the uncontrolled growth of abnormal cells in the squamous cells. These cells are located in the outer layers of the skin and also line various organs and tracts within the body. SCC is a prevalent form of skin cancer, ranking as the second most common type after basal cell carcinoma.
This cancer typically develops in areas of the body that receive frequent sun exposure, such as the face, ears, neck, lips, and the backs of the hands. However, it can also appear in less exposed areas, including the inside of the mouth, the soles of the feet, and the genital region. It’s important to note that SCC can affect individuals regardless of their sun exposure habits.
What You Need to Know About Skin Cancer
While SCC is generally not life-threatening, it can be aggressive in certain cases. Early detection and treatment are crucial to prevent the cancer from spreading to other parts of the body and causing serious health complications.
Treatment Options for Squamous Cell Carcinoma
Following a diagnosis of Squamous Cell Carcinoma (SCC), a range of treatment options are available. The choice of treatment depends on various factors, including the size and location of the cancer, whether it has spread, and your overall health. Here’s an overview of the current treatment guidelines for SCC:
1. Surgery: Surgery is often the primary treatment for SCC, especially for localized tumors. The type of surgery depends on the tumor’s size and location:
- Mohs Surgery: This is particularly indicated for SCCs located in areas where preserving cosmetic appearance and function is important, such as on the face. It’s also used for recurrent cancers or those with poorly defined edges. Mohs surgery allows for the removal of all cancerous cells while sparing as much healthy tissue as possible.
- Simple Excision: This is often the first-line treatment for small, well-defined SCCs in non-critical areas. It involves removing the tumor along with a margin of healthy tissue to ensure all cancerous cells are excised.
2. Radiation Therapy: This uses high-energy X-rays to target cancer cell DNA and is typically used in situations where surgery isn’t possible due to the tumor’s size or location or for patients who are not good candidates for surgery due to other health issues. It’s also used as an adjunct therapy after surgical removal of larger or more aggressive SCCs to ensure any remaining cancer cells are destroyed.
3. Topical Treatments: These are used for very early-stage SCCs or actinic keratoses (pre-cancerous skin lesions). They are most effective for superficial lesions that have not invaded deeper layers of the skin.
4. Systemic Therapy: In advanced SCC, treatments that affect the whole body may be necessary. This includes:
- Chemotherapy: This is generally reserved for advanced SCC that has spread (metastasized) to other parts of the body and cannot be treated effectively with surgery or radiation.
- Targeted Therapy: These drugs are used for advanced SCC, particularly when the cancer has specific genetic mutations that can be targeted by these therapies.
- Immunotherapy: This is a newer form of treatment that’s showing promise for advanced or metastatic SCC, especially for tumors that are resistant to other forms of treatment. It works by boosting the body’s immune system to fight the cancer cells.
5. Photodynamic Therapy (PDT): PDT is used for treating superficial or thin SCCs, especially in patients who have multiple lesions or who cannot undergo surgery.
6. Cryosurgery: This method is suitable for small, superficial SCCs, particularly in older patients or those with multiple lesions where more invasive surgery might not be ideal.
7. Clinical Trials: These are an option for patients with advanced SCC, especially when standard treatments have not been effective. Clinical trials offer access to new therapies that are still in the research phase.
Each of these treatments is chosen based on the individual patient’s situation, including the size, location, and aggressiveness of the SCC, as well as the patient’s overall health and preferences. It’s important to have a detailed discussion with your healthcare team to understand which treatment or combination of treatments is best suited for your specific case of SCC.
Leading Experts Urge Patients to Be Proactive
As we highlight in several areas of SurvivorNet, highly respected doctors sometimes disagree on the right course of treatment for an ailment, and advances in medicine are always creating new options. Also, in some instances the specific course of treatment is not clear cut.
That’s even more reason why understanding the potential approaches to your disease is crucial.
Cancer Research Legend Urges Patients to Get Multiple Opinions
Furthermore, getting another opinion may also help you avoid doctor biases. For example, when seeking care for cancer, some surgeons may have an affiliation with a radiation center.
“So there may be a conflict of interest if you present to a surgeon that is recommending radiation because there is some ownership of that type of facility,” Dr. Jim Hu, director of robotic surgery at Weill Cornell Medical Center, previously told SurvivorNet.
Other reasons to get a second opinion include:
- To see a doctor who has more experience treating your type of disease
- You have a rare disease
- There are several ways to treat your illness
- You feel like your doctor isn’t listening to you, or isn’t giving you good advice
- You have trouble understanding your doctor
- You don’t like the treatment your doctor is recommending, or you’re worried about its possible side effects
- Your insurance company wants you to get another medical opinion
Bottom line, being proactive about your health could be a matter of life or death. Learn as much as you can from as many experts as you can, so that you know that you did your best to take control of your health.
Contributing: SurvivorNet Staff
Learn more about SurvivorNet's rigorous medical review process.
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