Often, a specialist can diagnose an SCC with relative confidence and proceed with treatment. Occasionally, the diagnosis is not obvious and a biopsy is needed – a small sample is taken and sent to a lab, and treatment decided according to the results.
Once a squamous cell carcinoma has been diagnosed, there are a number of treatment options, including:
Surgery – this is probably one of the most common treatment methods. The tumour is removed, often under local anaesthetic, and sent to the lab for confirmation of diagnosis. An extra margin of normal-looking skin is also taken at the same time to try and ensure that all the tumour is removed. If the area is relatively small, the defect can usually be closed with stitches. Larger areas may need a skin graft or other procedure to provide skin cover
Radiotherapy – some SCCs may be treated with radiotherapy, which is generally painless. Radiation treatment can affect the skin though, with ulceration and scarring occurring over the following years – for this reason, younger people are usually not suitable for radiotherapy. Older people that are unfit for surgery, or those with very large SCCs tend to benefit the most.
Mohs surgery – this is a form of surgery whereby small samples of the tumour are removed and examined in a lab on the same day. The process is continued until all the tumour has been removed. This can sometimes result in less normal tissue being removed than in standard surgery, with a slightly higher cure rate, but does often need multiple visits to the operating theatre. For this reason, Mohs surgery for squamous cell carcinoma is often reserved for areas such as the nose, where spare skin is in short supply, or for SCC that has recurred or been incompletely removed by standard surgery
Chemotherapy & immunotherapy – chemotherapy may occasionally be used for squamous cell carcinoma that cannot be removed or treated by the above options. Newer drugs will usually be used first though, such as immunotherapy drugs. These drugs may help slow the growth of SCC, or even shrink it enough to be treated with surgery or radiotherapy
The final treatment option will often depend on the body area, tumour size & progress, and of course patient preference. Your specialist will be able to discuss treatment options with you