Treatment Options

In the majority of cases, squamous cell carcinoma (SCC) is easily cured using local surgery and/or medications applied to the skin (called topical therapies).

Treatment will depend on the 1) size, 2) location and 3) how deep the tumor is in the skin, as well as if it has spread elsewhere.

Treatments usually include:

Surgery


There are several different types of surgical procedures that can be used:
  • Excision - the entire growth is removed along with a surrounding border of normal skin
  • Curettage and electrodessication – the tumor is scraped down to its base followed by pulses of electrical energy
  • Mohs surgery – the goal is to remove skin cancer one layer at a time to spare healthy tissue. After each layer is removed, it is sent to an off-site laboratory to be examined, so the surgeon knows whether more layers need to be removed in real-time.
  • Laser surgery – lasers can be used to kill SCCs that are very early and sit on the surface of the skin. It is often used on the lip, face or scalp.
  • Cryosurgery – may be considered for patients with small, well-defined primary tumors; this involves freezing the cancer cells.

SCC can invade nearby tissue. If this happens, several surgeries may be needed to try to remove all of the cancer cells. These procedures can be disfiguring and very upsetting. If nearby lymph nodes are involved, a lymph node dissection may also be required.

Medications for the skin


If SCC is “superficial” (in other words, not very deep in the skin), creams containing chemotherapy medications (imiquimod, 5-Fluorouracil) can be applied to the skin.

Photodynamic therapy


This treatment uses a medication, called a photosensitizer, and a particular type of light to kill cancer cells.

Radiation therapy


Radiation therapy uses high-energy x-rays to target and kill cancer cells. It may be considered for patients who have:
  • undergone lymph node dissection
  • remaining SCC cells after surgery (positive margins)
  • evidence that cancer cells are spreading to the space surrounding a nerve (called perineural invasion) on a pathology report)

Otherwise, the use of radiation is controversial.


For SCC that has spread (metastasized), systemic therapy can be considered which includes chemotherapy, targeted therapy, and clinical trials. To find out what clinical trials might be available, click here.

For organ transplant patients who have many SCCs, transplant physicians can consider adjusting the immunosuppressive treatment if appropriate.

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