Squamous Cell Carcinoma (SCC) In Dogs Explained (2023)

Squamous Cell Carcinoma (SCC) In Dogs Explained (1)What is Squamous Cell Carcinoma?

Cutaneous squamous cell carcinoma (SCC) or actinic keratosis is a malignant tumor of epidermal cells in which cells show differentiation in keratinocytes (it is the major constituent of the epidermis, constituting 95% of the cells found there). It accounts for 5% of all cutaneous tumors found in dogs.

These tumors generally grow slowly, but are aggressive in nature. They, however, do not metastasize to the regional lymph nodes. They are usually found in those areas within the epidermis where there is a dearth of pigmentation, hair or a very sparse hair coat. The peak incidence of squamous cell carcinoma in the dog is between 6 and 10 years of age.

The breeds that are at increased risk include Keeshond, Standard Schnauzer, Basset Hound, Collie. The Boxer is, however, believed to be at a decreased risk. Short, coated dogs that spend a long time outdoors, also have a higher incidence of squamous cell carcinoma. No sex predisposition has been found.

What Causes Squamous Cell Carcinoma In Dogs?

There are several factors associated with the development of squamous cell carcinoma including prolonged exposure to ultraviolet radiation. Sunlight causes genetic damage of cells, (mutations in the DNA genome), but fail to repair the damaged DNA. Loss of an adhesion molecule called E-cadherin (protein present in the cells involved with the binding in other cells) induces these damaged epithelial cells to attack surrounding tissues. Weak immune system also induces the onset of malignancy. In dogs, the theory of exposure to sun is less obvious. It is believed that there may be some association with papilloma virus.

What are some of the symptoms of Squamous Cell Carcinoma?

Most cutaneous squamous cell carcinomas appear as firm, raised, frequently ulcerated plaques and nodules; sometimes they can be extremely exophytic (outwardly growing) and have a surface that resembles a wart. These usually develop on ventral abdominal, preputial (exocrine glands present in front of the genitals), scrotal, and inguinal skin in white-skinned, shorthaired breeds such as Dalmatians, Bull Terriers, and Beagles.The appearance may vary from time to time. The clinical signs usually depend upon the location of the tumor. For instance dogs with tumors on their feet may limp.

What is the prognosis of Squamous Cell Carcinoma?

There are two types ofsquamous cell carcinomas, that of the mouth and that of the toe. While both are classified as SCCs, the impact on your dog’s health can be wildly different depending on the specific type of cancer.

Cutaneous or skin carcinomas are generally locally destructive with infrequent metastasis (spread elsewhere). Any recurrence is usually seen within weeks to months.

Digital, nail bed tumors also referred to as “toe tumors” may recur in the same digit or in another after several months or years.

Common Squamous Cell Carcinoma Types

Subungual Squamous Cell Carcinoma (SSCC)

This is a tumor of the nailbed epithelium. It is most commonly seen in dogs in the age group of 7-11 years. Breeds at increased risk are Giant Schnauzer, Gordon Setter, Standard Poodle, Standard Schnauzer, Scottish Terrier, Labrador Retriever, Rottweiler, Dachshund, Miniature Schnauzer. Breeds with lower incidence include Golden Retriever, Boxer, Lhasa Apso, Collie, Basset Hound, Beagle and Shetland Sheepdog.

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No sex predisposition has been observed. The rate of growth of these lesions is variable and depends upon the extent of the involvement of the underlying tissues. Metastases are not so common in subungual squamous cell carcinoma. It occurs via lymphatics to regional lymph nodes and lungs. Tumors arise on multiple digits, often on different extremities. They are grow slowly and are cured by amputation of the affected digit.

Studies however revealed that in certain dogs with subungual squamous cell carcinoma there was evidence of pulmonary metastasis at the time of diagnosis. Tumors sometimes also involve the bursa (fluid filled sac that provides cushion between the bone and tendons) of the digital flexor or extensor tendons.

The recurrence of tumor within the subcutaneous tissue at the amputation site bears testimony to the fact. Generally, all are darkhaired breeds, and a dark coat color has been associated with the development of subungual squamous cell carcinomas. Females have a slightly higher rate of occurrence and both the fore and hind limbs are equally predisposed to tumor development.

Symptoms & Stages of a Dog’s Toe Tumor

With subungual squamous cell carcinoma, There is frequent loss of the nail with secondary infection of the nail bed.

The initial form of this cancer appears as tumors in the animal’s toes and spread to other parts of the body in subsequent stages. Unfortunately, cancer of the dog’s toes and nails while rare is typically far more aggressive. It can quickly spread to the lymph nodes.

Diagnosis & Treatment for SSCC

For accurate diagnosis ofcutaneous or skin squamous cell carcinoma vets depend on microscopic examination of tissue. These may include fine needle aspiration with cytology (FNAC), punch biopsy and complete resection of the suspect tumor. Cytology is the microscopic examination of small cell samples. A more accurate diagnosis will help in determining the outcome.

Clinically, this tumor resembles many other skin tumors. Loss of the nail is common when tumors arise in the nail bed and in this site; it resembles inflammatory diseases such as infections and foreign bodies.

For dogs surgical excision, like amputation of the involved digit or pinnae (outer projecting portion of the ear) is the treatment of choice, and margins of at least 2 cm are recommended. Clinical reports suggested that 95% dogs who underwent amputation, showed 1 year survival. If the tumors developed in other parts of the digit, the survival time of 1 year was in 60% of the cases. Excision may be supplemented with radiation and chemotherapy. For invasive neoplasms however, the 1 year survival time is less than 10%. Cryosurgery and hyperthermia may be helpful for local therapy especially in early lesions, but proper investigation has not been done to determine their effectiveness. Intralesional implant chemotherapy with 5-fluorouracil, cisplatin, or carboplatin along with retinoids and photodynamic therapy has been used with a fair amount of success.

Administration of etretinate for 90 days produces total regression of pre neoplastic lesions but for aggressive lesions partial response has been noted. In dogs treated with controlled localized radio frequency in combination with isotretinoin (another synthetic retinoid), better result was achieved. Using either 5-fluoracil and or/cisplatin for a minimum of 3 weeks produces partial or total regression of the tumors.

The nonsteroidal anti -inflammatory drug piroxicam, also known for its immunomodulating (adjustment of the immune response to a desired level) effects, has been given to dogs with nonresectable squamous cell carcinoma. Partial responses were noted in half of the 10 patients treated, with a resulting median survival of 150 days.

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In those cases where surgery is not feasible alternative options like photodynamic therapy may be useful.

Common Prognosisesfor SSCC

Caught early enough, your dog can make a full recovery from SSCC. However, approximately 1/3 of tumors in this site will metastasize even after amputation of the digit because they can spread up to the nerves when there is a complete surgical margin around the tumor. Tumors that histologically show well-differentiated cells may still metastasize and unlike oral squamous cell carcinomas, SSCC can aggressively spread to the lymph nodes and beyond.

Oral Squamous Cell Carcinoma (OSCC)

When squamous cell carcinoma occurs in the mouth and throat, including the dog’s tongue, it is called oral squamous cell carcinoma. It is mostly located in the gums or tonsils. It also invades the bone in dogs. The metastatic rate for non tonsillar tumor in dogs is approximately 20%, but it is dependant on the site. The rostral oral cavity (located towards the oral or nasal region) has a low metastatic rate while the caudal tongue and tonsil have a high metastatic potential.

Symptoms & Stages for Dog Mouth Cancer

Clinical signs may comprise drooling (with or without blood), difficulty in eating, and halitosis (bad breath) due to orophayngeal obstruction. Depending on the site of the tumor, the dog may face difficulty in swallowing or lose excessive weight. Nagging cough may also be a case in point. Other symptoms include loose teeth, facial swelling, abnormal salivation and oral hemorrhage.

The cervical swelling associated with regional lymph node metastasis can be misdiagnosed as a primary thyroid tumor or lymphosarcoma. Therefore, whenever a dog exhibits firm, thick, ventral proximal semi-circular cervical swelling, a thorough examination of the tonsils should be done to rule out the possible presence of a primary tonsillar carcinoma.

Diagnosis & Treatment for OSCC

Before planning out the course of treatment, a complete blood count and blood chemistry should be performed to reveal any concurrent disease. Thoracic radiographs should be taken to detect the presence of pulmonary metastatic disease. A complete oral examination should be performed under general anesthesia and radiographs of the mandible or maxilla should be taken to determine the degree of invasiveness of the lesion. Computed tomography (CT) is helpful in evaluating the extent of tumor involvement. An incisional biopsy should also be taken.

Sometimes a fine needle aspirate with cytology (FNAC) will provide enough sample tissue for diagnosis.

Treatment may involve surgery, radiation therapy, and/or chemotherapy. Treatment depends upon the location of the tumor and the degree of invasiveness and proliferation.

If the tumor hasn’t spread to other locations, surgery is the treatment of choice. The tumor, including the extensions into underlying tissue and bone, are removed enbloc. Sometimes even part of the jawbone has to be removed. Surgery is considerably successful if the pet has clean margins (the tumor was completely removed). Dogs function quite well with partial jaws. Even if surgery isn’t curative, surgery can extend survival.

Radiation therapy is beneficial if the tumor is unresectable, or if surgery can’t remove the tumor completely.

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Chemotherapy may be added to therapy, depending on the circumstances.

Common Prognosisesfor OSCC

The prognosis for oral squamous cell carcinoma entirely depends on the location of the tumor and metastatic rate. A complete cure is not possible unless diagnosed early. If the tumor is not located in the tonsils and has not metastasized, the prognosis is gratifying with surgery and/or radiation treatment. Tumors that originate in the tonsils are usually quite aggressive and have a poor prognosis. They tend to spread to regional lymph nodes. Tumors located in the rostral oral cavity are operable with a considerable chance of survival. Local recurrence is common with insufficient resection. The mean survival time is 15.8 months, with 80% of patients being clinically free of tumor at the time of their death. One study showed that 85% of the dogs were alive even 1 year after surgery.

Surgical margins greater than 1 cm (2 cm if possible) around the lesion are generally recommended. Remission of oral non-tonsillar squamous cell carcinoma has been reported in another limited study using piroxicam and carboplatin.

Site of the lesion seems to influence radiosensitivity (it is the relative susceptibility of cells, tissues, organs or organisms to the harmful effects of ionizing radiation).A recent study showed that dogs with maxillary (relating to the jaw or jaw bone) tumors had a longer response to radiation therapy (12 months) than ones with mandibular (3.4 months) or soft tissue tumors (1.8 months). Dogs with rostrally located tumors had longer survival times than dogs with caudally located tumors or tumors extending rostrally to caudally.

Thank you for utilizing our Canine Cancer Library. Please help us keep this ever-evolving resource as current and informative as possible with adonation.

References

Tumors in Domestic Animals-Donald J. Meuten, DVM, PhD, is a professor of pathology in the Department of Microbiology, Pathology, and Parasitology at the College of Veterinary Medicine, North Carolina State University, Raleigh

Withrow and MacEwen’s Small Animal Clinical Oncology– Stephen J. Withrow, DVM, DACVIM (Oncology), Director; Animal Cancer Center Stuart Chair In Oncology, University Distinguished Professor, Colorado State University Fort Collins, Colorado; David M. Vail,DVM, DACVIM (Oncology) Professor of Oncology, Director of Clinical Research, School of Veterinary Medicine University of Wisconsin-Madison Madison, Wisconsin

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FAQs

What is squamous cell carcinoma in dogs? ›

Squamous cell carcinomas are common tumours in dogs, often appearing as a mass or raised lump on the skin, in the nail beds of the toes or in the mouth. They are malignant cancers that are typically locally aggressive, although they metastasise slowly.

How long will my dog live with squamous cell carcinoma? ›

Squamous cell carcinoma is typically poorly responsive to chemotherapy. The one-year survival rate for dogs with mandibular surgical excision is 80-91 percent with a mean survival time of 9-28 months.

Can squamous cell carcinoma spread in dogs? ›

However, spread is possible. In dogs, oral SCCs tumors are also locally aggressive. Tonsillar SCC is much more aggressive and can metastasize (spread elsewhere in the body), with more than 75% of cases exhibiting spread to local lymph nodes or elsewhere in the body.

How do you describe SCC? ›

SCCs can appear as scaly red patches, open sores, rough, thickened or wart-like skin, or raised growths with a central depression. At times, SCCs may crust over, itch or bleed. The lesions most commonly arise in sun-exposed areas of the body. SCCs can also occur in other areas of the body, including the genitals.

What are the first signs of squamous cell carcinoma? ›

Symptoms
  • A firm, red nodule.
  • A flat sore with a scaly crust.
  • A new sore or raised area on an old scar or ulcer.
  • A rough, scaly patch on your lip that may evolve to an open sore.
  • A red sore or rough patch inside your mouth.
  • A red, raised patch or wartlike sore on or in the anus or on your genitals.
13 May 2021

How long does it take for squamous cell carcinoma to spread? ›

Metastasis of cutaneous squamous cell carcinoma (cSCC) is rare. However, certain tumor and patient characteristics increase the risk of metastasis. Prior studies have demonstrated metastasis rates of 3-9%, occurring, on average, one to two years after initial diagnosis [6].

Is squamous cell carcinoma a big deal? ›

Although squamous cell carcinoma can be more aggressive than basal cell cancer, the risk of this type of cancer spreading is low—as long as the cancer is treated early, Dr. Leffell says. He notes that the lesions must be treated with respect because they may grow rapidly and invade deeply.

Is squamous cell carcinoma fully curable? ›

Most squamous cell carcinomas (SCCs) of the skin can be cured when found and treated early. Treatment should happen as soon as possible after diagnosis, since more advanced SCCs of the skin are more difficult to treat and can become dangerous, spreading to local lymph nodes, distant tissues and organs.

Can squamous cell carcinoma heal without surgery? ›

Chemotherapy uses powerful drugs to kill cancer cells. If squamous cell carcinoma spreads to the lymph nodes or other parts of the body, chemotherapy can be used alone or in combination with other treatments, such as targeted drug therapy and radiation therapy. Targeted drug therapy.

Where does squamous cell carcinoma spread first? ›

Hanke: The first place SCCs metastasize to is the regional lymph nodes. So if you have a squamous cell carcinoma on your cheek, for example, it would metastasize to the nodes in the neck. But there are treatments for that. Patients can have surgery, radiation and, in some advanced cases, immunotherapy medication.

What are the chances of surviving squamous cell carcinoma? ›

In general, the squamous cell carcinoma survival rate is very high—when detected early, the five-year survival rate is 99 percent. Even if squamous cell carcinoma has spread to nearby lymph nodes, the cancer may be effectively treated through a combination of surgery and radiation treatment.

Can you live a long life with squamous cell carcinoma? ›

Most (95% to 98%) of squamous cell carcinomas can be cured if they are treated early. Once squamous cell carcinoma has spread beyond the skin, though, less than half of people live five years, even with aggressive treatment.

How long can a dog live with squamous cell carcinoma without treatment? ›

In one study, the median survival time was only 243 days, with a 1-year survival rate of 40% and a 2-year survival rate of 20%.

What makes SCC high-risk? ›

These factors increase your SCC risk: Unprotected exposure to ultraviolet (UV) radiation from the sun or tanning beds. Weakened immune system due to illness or certain immunosuppressive medications. History of skin cancer including basal cell carcinoma (BCC).

What does early stage SCC look like? ›

Squamous Cell Carcinoma Early Stages

At first, cancer cells appear as flat patches in the skin, often with a rough, scaly, reddish, or brown surface. These abnormal cells slowly grow in sun-exposed areas.

What happens if squamous cell carcinoma is left untreated? ›

Like BCCs, SCCs are highly curable when caught and treated early. However, if left to develop without treatment, an SCC can become invasive to skin and tissue beyond the original skin cancer site, causing disfigurement and even death. Over 15,000 Americans die each year from SCCs.

Are SCC painful? ›

Pain was more frequent in invasive SCC with increased surface diameter, deeper invasion, acantholysis and PNI. Pain frequency did not vary between the grades of differentiation in males. In females, pain was less frequent in poorly differentiated than in well-differentiated SCC.

What organs does squamous cell carcinoma affect? ›

If left untreated, squamous cell carcinoma can spread to nearby lymph nodes, bones or distant organs (such as the lungs or liver). Normal squamous tissue usually appears flat. When this tissue develops cancer it can appear as round masses that are can be flat, raised, or ulcerated.

How do you know if squamous cell carcinoma has spread? ›

Ask your doctor if your lymph nodes will be tested. Basal and squamous cell cancers don't often spread to other parts of the body. But if your doctor thinks your skin cancer might spread, you might need imaging tests, such as MRI or CT scans.

Where does squamous cell carcinoma appear most? ›

Usually, squamous cell carcinomas form on areas of your skin that receive the most sun exposure like your head, arms and legs. Cancer can also form in areas of your body where you have mucous membranes, which are the inner lining of your organs and body cavities like in your mouth, lungs and anus.

What is Stage 3 squamous cell carcinoma? ›

More Information. Stage IIIA squamous cell carcinoma of the esophagus. Cancer has spread into the mucosa layer, thin muscle layer, or submucosa layer of the esophagus wall. Cancer is found in 3 to 6 lymph nodes near the tumor; OR cancer has spread into the thick muscle layer of the esophagus wall.

How does squamous cell carcinoma start? ›

Most squamous cell cancers occur on skin that is regularly exposed to sunlight or other ultraviolet radiation. The earliest form of squamous cell cancer is called Bowen disease (or squamous cell carcinoma in situ). This type does not spread to nearby tissues, because it is still in the outermost layer of the skin.

What foods fight squamous cell carcinoma? ›

Food That Lower Your Skin Cancer Risk

Vitamin C – Citrus fruits, strawberries, raspberries, broccoli, bell peppers, and leafy greens. Vitamin D and Omega-3 fatty acids – Fatty fish, like mackerel, sardines, herring, tuna, and salmon. Vitamin D – Milk, cheese, and vitamin D-fortified orange juice.

What is considered a large SCC? ›

Large size (>2 cm). Thick or deeply invasive lesion (>4 mm).

What is Stage 4 squamous cell carcinoma? ›

Stage 4 squamous cell carcinoma: In stage 4, the cancer can be any size and has spread (metastasized) to 1 or more lymph nodes which are larger than 3 cm and may have spread to bones or other organs in the body.

How do you shrink squamous cell carcinoma? ›

Cryosurgery: This treatment involves using an extremely cold substance, such as liquid nitrogen, to destroy the cancer cells. Although seldom used to treat SCC, cryotherapy can be an option when the cancer is caught early, or a patient cannot have any type of surgical removal.

Can squamous cell carcinoma spread to the brain? ›

Squamous cell carcinomas are defined as relatively slow-growing malignant (cancerous) tumors that can spread (metastasize) to surrounding tissue if left untreated. Squamous cell carcinoma may spread to the sinuses or skull base, or other areas of the brain.

Can you pick off squamous cell carcinoma? ›

Yes, you might be able to pick this crusty lesion off with your fingers. But it would grow back. The right thing to do is see a dermatologist and have it removed.

How many stages are there in squamous cell carcinoma? ›

The 5 Stages of Squamous Cell Skin Cancer

This gives doctors greater opportunities to treat the cancer early, which may be final and curative.

Can Stage 4 squamous cell carcinoma be cured? ›

At stage 4 your cancer may not be curable, but it is still treatable.

Does squamous cell carcinoma spread slow? ›

Squamous cell carcinoma rarely metastasizes (spreads to other areas of the body), and when spreading does occur, it typically happens slowly. Indeed, most squamous cell carcinoma cases are diagnosed before the cancer has progressed beyond the upper layer of skin.

What does squamous cell look like on a dog? ›

Squamous Cell Carcinoma

These tumors appear as raised wart-like patches or lumps that are firm to the touch and are most often found on the dog's head, lower legs, rear, and abdomen. Exposure to the sun may be a cause of squamous cell carcinoma, however, there could also be a link to papillomavirus.

Which squamous cell carcinoma has best prognosis? ›

Patients with stage I, II, or III cancer have the best survival, whereas patients with stage IV or recurrent cancer who are older than 66.5 years have the worst survival. Patients with stage IV or recurrent cancer who are younger than 66.5 years have intermediate survival.

Does SCC grow quickly? ›

SCC is generally a slow growing tumor that tends to grow without physical symptoms. However, some forms of this cancer may be fast growing and painful, especially when the lesions are large. They may become irritated and bleed.

Can stress cause squamous cell carcinoma? ›

Stress and Skin Cancer

However, stress may also play a role, as it causes the body to produce unstable oxygen molecules called free radicals. Those can increase inflammation and damage your skin's DNA, leading to mutations and, possibly, skin cancer.

What is aggressive SCC? ›

“Aggressive SCC” or “high-risk SCC” is cancer that is more likely to recur (return after initial treatment) or metastasize (spread to other parts of the body). Features of high-risk SCC are: 4,9. Larger than 2 centimeters (cm) Deeper than 2 millimeters (mm)

Is SCC malignant or benign? ›

Squamous cell carcinoma (SCC) is an epithelial malignancy involving many anatomical sites and is the most common cancer capable of metastatic spread. Development of early diagnosis methods and novel therapeutics are important for prevention and mortality reduction.

What is the survival rate for squamous cell carcinoma? ›

In general, the squamous cell carcinoma survival rate is very high—when detected early, the five-year survival rate is 99 percent. Even if squamous cell carcinoma has spread to nearby lymph nodes, the cancer may be effectively treated through a combination of surgery and radiation treatment.

Is squamous cell carcinoma ever fatal? ›

Cutaneous squamous cell carcinoma is usually easily treated with surgery; however, a subsection of patients with specific disease risk factors are more likely to develop metastases and die from the disease, according to the results of a study published in JAMA Dermatology.

What is the most common cause of squamous cell carcinoma? ›

The cause of most squamous cell carcinoma (SCC) of the skin is well known. People usually develop this skin cancer because ultraviolet (UV) light has badly damaged their skin. Most UV light comes from: The sun.

What kills squamous cell carcinoma? ›

Chemotherapy. Chemotherapy uses powerful drugs to kill cancer cells. If squamous cell carcinoma spreads to the lymph nodes or other parts of the body, chemotherapy can be used alone or in combination with other treatments, such as targeted drug therapy and radiation therapy.

Is squamous cell carcinoma the worst? ›

Although squamous cell carcinoma can be more aggressive than basal cell cancer, the risk of this type of cancer spreading is low—as long as the cancer is treated early, Dr. Leffell says.

Is squamous cell carcinoma painful? ›

Squamous cell skin cancers usually present as an abnormal growth on the skin or lip. The growth may have the appearance of a wart, crusty spot, ulcer, mole or a sore that does not heal. It may or may not bleed and can be painful.

What are high-risk features of squamous cell carcinoma? ›

High-risk features are depth of invasion (>2 mm), poor histological differentiation, high-risk anatomic location (face, ear, pre/post auricular, genitalia, hands, and feet), perineural involvement, recurrence, multiple cSCC tumors, and immunosuppression.

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