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Squamous Cell Carcinoma Treatment

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.

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. 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.

Mohs surgery

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 1%.4 It also saves the most healthy skin. Mohs surgery can be a good option for large, invasive, or tumors on very visible places.

Other local treatment procedures

Local procedures that may be used to remove some thin, low-risk non-melanoma skin cancers are curettage and electrodesiccation, cryotherapy, and photodynamic therapy.

Topical medications

Fluorouracil may be used off-label to treat non-melanoma skin cancers that affect only the very top layers of skin. Topical medications should generally not be used for invasive squamous cell carcinomas. However, it is more common to use topical medications to treat precancer.1,4

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.

Chemotherapy

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.

Immunotherapy

In 2018, the U.S. FDA approved Libtayo® (cemiplimab-rwlc) for the treatment of metastatic or locally advanced cutaneous squamous cell carcinoma (CSCC). This approval was important as it is the first and only treatment available for advanced CSCC.5

Written by: Sarah O'Brien | Last reviewed: May 2019.
  1. American Cancer Society. Basal and squamous cell skin cancers. Accessed January 5, 2017 at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003139-pdf.pdf
  2. NCCN Clinical Practice Guidelines in Oncology. Basal cell skin cancer. Version 1.2017. Published October 3, 2016. https://www.nccn.org/professionals/physician_gls/pdf/nmsc.pdf
  3. NCCN Clinical Practice Guidelines in Oncology. Squamous cell skin cancer. Version 1.2017. Published October 3, 2016. https://www.nccn.org/professionals/physician_gls/pdf/squamous.pdf
  4. Firnhaber JM. Diagnosis and treatment of basal cell and squamous cell carcinoma. Am Fam Physician. 2012;86:161-168.
  5. https://skincancer.net/news/fda-approves-immunotherapy-drug-libtayo-advanced-cutaneous-squamous-cell-carcinoma/