Learn about Skin cancer (squamous cell) diagnosis at Consumer Reports Health.

Skin cancer (squamous cell)

How do doctors diagnose squamous cell skin cancer?

If you're worried about a spot, lump, flaky patch or blemish on your skin, you should see your doctor.

It can be hard to diagnose squamous cell skin cancer just by looking at it. Sometimes it's hard to tell the difference between this type of skin cancer and another type of damage caused by the sun (called a solar keratosis).

Source:
Green A, Leslie D, Weedon D.
Diagnosis of skin cancer in the general population: clinical accuracy in the Nambour survey.
Medical Journal of Australia. 1988; 148: 447-450.

If your doctor thinks you might have squamous cell skin cancer, he or she can do a simple operation to remove some skin cells so that a laboratory can check them for cancer under a microscope.

Source:
Green A, Leslie D, Weedon D.
Diagnosis of skin cancer in the general population: clinical accuracy in the Nambour survey.
Medical Journal of Australia. 1988; 148: 447-450.

¹ This operation is called a biopsy.

What happens during a biopsy?

During a biopsy, your doctor removes part or all of the spot on your skin. Before the biopsy, your doctor will probably give you a shot that numbs the area so you won't feel any pain.

During the biopsy your doctor may:

Remove part of the spot and send it to a laboratory to check for cancer
Remove all of the spot and send it to a laboratory to check for cancer.

Your doctor will probably want to remove all of the spot. This is because there may be just a few cancer cells in one part of the spot, and if your doctor takes out just a part of it, these cells could be missed.

But if your spot is very big or is on your face, your doctor probably won't take out all of it until they know for sure that it's cancer. This is so you don't get a big scar if you don't need to.

Source:
Slominski A, Wortsman J, Carlson AJ, et al.
Malignant melanoma.
Archives of Pathology and Laboratory Medicine. 2001; 125: 1295-1306.

You'll need to go back to your doctor to find out the results of your biopsy. Your doctor will tell you one of three things.

Your skin sample didn't contain any cancer cells.
Your skin sample had some cancer cells in it, but they were all removed during the biopsy. You won't need to have any more surgery. (When the laboratory technician checks a skin sample, they look at how much healthy tissue there is around the cancer. If enough healthy tissue was removed, it means that all the cancer cells have been taken out. If there were any cancer cells left behind, they could spread to other parts of the body.)
Your skin sample had some cancer cells in it, and some other cells may have spread. You will need to have surgery to remove all the cancer. You will also have some more tests to see whether your cancer has spread. See the sections below for what happens next.

Finding out whether your cancer has spread

If you do have cancer, your doctor will need to find out whether it has spread and, if so, how far it has spread. This is called staging. Staging helps your doctor tell how serious your cancer is and decide what treatment you might need. There's a greater chance that your cancer has spread if you've had the spot on your skin for a long time or if it's large.

Your doctor may check for cancer in the

lymph nodes
Lymph nodes (also called glands) are small, bean-shaped lumps that you cannot usually see or easily feel. They are located in various parts of the body, such as the neck, armpit and groin. Lymph nodes filter the lymph fluid and remove unusual things, such as bacteria and cancer cells.

lymph nodes near the spot on your skin. And if your doctor thinks your cancer has spread further, you may need other tests, such as

X-ray
X-rays are pictures taken of the inside of your body. They are done by passing very small amounts of radiation through your body and onto film. X-rays can also be used as a treatment, such as in radiation therapy for cancer.

X-rays.

Source:
National Cancer Institute.
What you need to know about skin cancer.
January 2005. Available at http://www.cancer.gov/cancertopics/wyntk/skin (accessed on 13 March 2009).

³ The test results will help you and your doctor decide which treatment is best for you.

To learn more, see What stage is my cancer?

Checking the rest of your body

Your doctor may do tests to see whether your cancer has spread to other parts of your body, especially if the spot on your skin is large. (If your cancer has spread, your doctor may say that it has

metastasis
This happens when cancer cells spread to parts of the body that are far away from the primary tumor. The cancer can travel through the bloodstream, lymph system or other fluids. New tumors may form in another area of the body as a result.

metastasized.)

Your doctor might:

Source:
Slominski A, Wortsman J, Carlson AJ, et al.
Malignant melanoma.
Archives of Pathology and Laboratory Medicine. 2001; 125: 1295-1306.

Feel the area around your abdomen
Listen to your lungs
Take an X-ray of your chest
Do a blood test
Check the levels of chemicals in your blood (levels of some chemicals in your blood go up if your cancer has spread).

But most people don't need these tests.

Sources for the information on this page:

Green A, Leslie D, Weedon D.Diagnosis of skin cancer in the general population: clinical accuracy in the Nambour survey.Medical Journal of Australia. 1988; 148: 447-450.

Slominski A, Wortsman J, Carlson AJ, et al.Malignant melanoma.Archives of Pathology and Laboratory Medicine. 2001; 125: 1295-1306.

National Cancer Institute.What you need to know about skin cancer.January 2005. Available at http://www.cancer.gov/cancertopics/wyntk/skin (accessed on 13 March 2009).

This information was last updated on Apr 14, 2009

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2009. All rights reserved.

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