Squamous Cell Carcinoma Treatment
Reviewed by: HU Medical Review Board | Last reviewed: January, 2022. | Last updated: March 2022
Non-melanoma skin cancer includes squamous cell carcinoma. These lesions are often treated in the doctor’s office with relatively minor surgery.1 The specific type of surgery depends on the location of the tumor and likelihood of recurrence.
Your doctor will cut out (excise) the tumor using a surgical knife. When an elliptical (football shaped) incision is made, the scar will be a flat, thin line. Narrower margins are used for tumors that are unlikely to recur. Wider margins are used for tumors that are more likely to recur (return).2,3 However, for tumors at high risk of recurrence, Mohs surgery is preferred.
A specially trained surgeon performs Mohs surgery. The surgeon removes one layer of skin at a time until all the cancer cells have been removed. This surgical procedure has the highest cure rates: the 5-year recurrence rate is approximately 1%.4 It also saves the most healthy skin. Mohs surgery can be a good option for large, invasive tumors, or tumors on very visible places.
Other local treatment procedures
Fluorouracil may be used off-label to treat certain squamous cell carcinomas that affect only the very top layers of skin. Topical medications should generally not be used for invasive squamous cell carcinomas. It is more common to use topical medications to treat precancer.1,4
Radiation therapy is a treatment option when surgery is not possible. It may be used as adjuvant therapy when the risk of recurrence is high. Adjuvant therapy is a second treatment given after the primary (main treatment, such as surgery). Adjuvant therapy may reduce the risk of recurrence.
Though rare, chemotherapy is an option for squamous cell carcinoma (SCC) that has spread beyond the skin tumor.3 Chemotherapy may be combined with radiation therapy.
Cemiplimab-rwlc (Libtayo®) and pembrolizumab (Keytruda®) may be used to treat people with certain forms of advanced cutaneous squamous cell carcinoma.6