Squamous Cell Carcinoma (SCC):
Information for adults

If your physician suspects squamous cell carcinoma, he or she will first want to establish the correct diagnosis by performing a biopsy of the lesion. The procedure involves:

• Numbing the skin with an injectable anesthetic.
• Sampling a small piece of skin by using a flexible razor blade, a scalpel, or a tiny cookie cutter (called a "punch biopsy"). If a punch biopsy is taken, a suture (stitches) or two may be placed and will need to be removed 6–14 days later.
• Having the skin sample examined under the microscope by a specially trained physician (dermatopathologist).

If caught early and treated appropriately, squamous cell carcinomas generally have a good prognosis. Treatment of a biopsy-proven squamous cell carcinoma depends upon many factors, including its microscopic appearance, its size and depth, its location on the face or body, and the general health of the patient. In general, the following treatment options exist for squamous cell carcinoma:

• Cryosurgery with liquid nitrogen – Very cold liquid nitrogen is sprayed on the lesion, freezing it and destroying it in the process. This is a good option for low-risk squamous cell carcinomas.
• Electrodesiccation and curettage, also known as "scrape and burn" – After numbing the lesion, the doctor uses a curette to "scrape" the skin cancer cells away, followed by an electric needle to "burn," or cauterize, the tissue. The electrodesiccation helps to kill the cancer cells and also to staunch any bleeding of the site. This is a good option for low-risk squamous cell carcinomas.
• Excision – The squamous cell carcinoma is cut out with a scalpel, and stitches are usually placed to bring the wound edges together. This is a good option for low-risk and some high-risk squamous cell carcinomas.
• Mohs micrographic surgery – In this technique, the physician takes tiny slivers of skin from the cancer site until it is completely removed. This technique is particularly useful for high-risk squamous cell carcinomas and for lesions located on the nose, the ears, the lips, and the hands.
• Radiation treatment – X-ray therapy is often useful for patients who are not good surgical candidates because of other health issues.

Rarely, the squamous cell carcinoma may spread internally (metastasize). Squamous cell carcinomas that develop in scars, on the lip, and on the ear have the highest risk of spreading. Lymph nodes may need to be examined for the presence of SCC. If internal spread is suspected, referral to an oncologist (a physician specializing in cancer treatment) for possible chemotherapy or other treatments would be appropriate.

Finally, it is important to remember that treatment of squamous cell carcinoma is not complete once the skin cancer has been removed. Frequent follow-up appointments with a dermatologist or with a physician trained to examine the skin are essential to ensure that the SCC has not recurred and that a new skin cancer has not developed. In addition, good sun protection habits (see Self-Care) are vital to preventing further ultraviolet light damage.