Squamous Cell Carcinoma Treatment

Non-melanoma skin cancer includes squamous cell carcinoma (SCC). SCC is often treated in the doctor’s office with relatively minor surgery. The type of SCC treatment depends on various factors, including the size and location of the tumor, as well as the likelihood of recurrence.¹

Local treatment procedures

If the SCC is small, is only in the top layer of skin, and there is a low risk of it spreading, you may have one of these procedures done to remove it:^1-3

• Curettage and electrodesiccation – Doctors use a small, sharp tool to carefully remove the top layer of the cancerous skin. After that, they use a special needle that sends an electric current to the base of the wound. This electric current heats up and destroys any leftover cancer cells, and also helps stop bleeding.
• Freezing (cryotherapy) – Doctors use very, very cold liquid nitrogen to freeze the cancerous cells. The extreme cold kills the cells.
• Photodynamic therapy – A special medicine, which makes cancer cells extra sensitive to light, is put on the skin. Then, a special light is used on the area. The light activates the medicine, which destroys the cancer cells.
• Laser therapy – Doctors use a powerful, focused beam of light, called a laser, to burn away the cancer cells. The laser is very precise, so it can target just the cancerous tissue while minimizing damage to the healthy skin around it.

Excision

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 (return). Wider margins are used for tumors that are more likely to recur. However, for tumors at high risk of recurrence, Mohs surgery is preferred.^1-3

Mohs surgery

A specially trained surgeon performs Mohs surgery. The surgeon removes 1 layer of skin at a time until all the cancer cells have been removed. This surgical procedure has the highest cure rates. It can also save much of the healthy skin around the tumor. Mohs surgery can be a good option for large, invasive tumors or tumors in very visible places.^1-3

Topical medicines

Topical 5-fluorouracil (5-FU) and imiquimod may be used in certain situations to treat SCC that affects only the very top layers of skin. Topical medicines should generally not be used for invasive squamous cell carcinomas. It is more common to use topical medicines to treat precancer.²

Radiation therapy

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.^1-3

Chemotherapy

Though used less often, chemotherapy is an option for squamous cell carcinoma that has spread beyond the skin tumor. Chemotherapy may be combined with radiation therapy.^1-3

Immunotherapy

Immunotherapy helps your own body’s immune system fight the cancer. Cemiplimab-rwlc (Libtayo®), cosibelimab-ipdl (UnloxcytTM), and pembrolizumab (Keytruda®) may be used to treat people with certain forms of advanced cutaneous squamous cell carcinoma.^1-3

When to see a doctor

It is important to seek treatment for squamous cell carcinoma as soon as you notice any suspicious skin changes. Here are some examples of what you should look for:⁴

• New growths on the skin
• Sores that do not heal
• Rough or scaly patches
• Raised bumps with a central depression

If you have a spot that bleeds easily, changes in size or color, or feels tender or painful, see a doctor right away. Early detection and treatment of SCC can prevent it from growing larger or spreading to other parts of your body. Do not wait – if you are worried about a skin change, get it checked out by a dermatologist.⁴