Question:
I am 31 years old and just have been diagnosed with early squamous
cell skin cancer. I had a reddish, flaky lesion about a 1/4 inch in
diameter and was raised about a 1/4 inch that developed about 3 years
ago. It was diagnosed by my GP as eczema and I was given a
hydrocortisone cream. The lesion disappeared when I was using the
cream. Soon after I stopped using the cream, the lesion would come
back. For almost 3 years that cycle of appearance and disappearance
continued. My GP was not worried as he told me "since it responds to
the cream, it isnt skin cancer". I didnt use the cream continuously
through that 3 years as I was pregnant twice. During 18 months out of
the 35 total, I stopped the cream and the lesion just remained red,
flaky, and sore.
Something just didnt seem right, so I finally want to derm a few weeks
ago and a biposy of "my spot" (i had it so long, I had even given it a
name!) revealed early squamous cell cancer. I cant want to wait the 2
months to see a Moh's surgeon due to insurance reasons (insurance is
being cancelled at the end of the year) so the derm is going to do
excision surgery next week.
I have read a lot about squamous cell cancer since then and I admit
that I am worried about metastasis. I have probably had it for 3
years. My derm doesnt seem concerned about the possibility of it
spreading. She told me that at this stage it is more of annoyance
rather than a major problem. She is not sure when the cancer may have
developed. It may have been cancer from the start. It may have
developed from the chronic spot of eczema, or the eczema may have
actually been a misdiagnosed actinic keratosis that developed into
cancer over time. All she knows is that at this time it is early
squamous cell carcinoma. She said the skin underneath and around the
biopsy site look normal. I trust her judgement and the lab results
(she did get a second opinion from a dermopathologist) but that fear
of dying from cancer overwhelms me.
I do have several questions about my diagnosis.
1. Has anyone had squamous cell cancer for several years without
metastasis? If it had spread, what symptoms would I have? I havent
been felling well lately (fatigue, chills, neck aches) and assume that
it must be secondary cancer. I may be over-reacting here as it was
"early stage". My symptoms may just be from having three children
under 3, winter coming, and poor posture.
2. Does the fact that I may have had undiagnosed cancer through 2
pregnancies affect the potential for metatasis? Does my having cancer
during pregnancy affect the future health of those children?
3. Am I a higher risk now for developing other cancers, such a breast,
lung, lymph, etc?
4. Is the fact that this appeared at a young age worrisome? Will it
effect my life expectancy? I am only 31. I feel too young to have
cancer. If i have cancer now, what am I going to have in 30 years? I
do have fair skin so I knew I was at risk for skin cancer. I expected
to have it someday but not until I was in my 40s and 50s. It is
discouraging as I always have taken precautions in the sun, even as a
child. Guess it wasnt good enough.
5. Can early squamous cancer still spread? Would a squamous cancer
that spread have a different pathology? Or is staging based not upon
microscopic examination but upon whether cancer cells appear
elsewhere?
Answer:
1.Happens all the time that they sit and grow slowly.
A 1/4 inch scc will not have spread, though
> 2. Does the fact that I may have had undiagnosed cancer through 2
> pregnancies affect the potential for metatasis? Does my having cancer
> during pregnancy affect the future health of those children?
No
> 3. Am I a higher risk now for developing other cancers, such a breast,
> lung, lymph, etc?
No. You are at higher risk for getting more skin cancers
> 4. Is the fact that this appeared at a young age worrisome? Will it
> effect my life expectancy? I am only 31. I feel too young to have
> cancer. If i have cancer now, what am I going to have in 30 years? I
> do have fair skin so I knew I was at risk for skin cancer. I expected
> to have it someday but not until I was in my 40s and 50s. It is
> discouraging as I always have taken precautions in the sun, even as a
> child. Guess it wasnt good enough.
We sometime see them in people your age
> 5. Can early squamous cancer still spread? Would a squamous cancer
> that spread have a different pathology? Or is staging based not upon
> microscopic examination but upon whether cancer cells appear
> elsewhere?
Get a shot of radiotherapy. Just as good as Moh's and quicker and cheaper
