Most squamous cell skin cancers are found and treated at an early stage, when they can be removed or destroyed with local treatment methods. Small squamous cell cancers can usually be cured with these treatments – the recurrence rate is similar to that for basal cell cancers. Larger squamous cell cancers are harder to treat, and the recurrence rates for aggressive cases of this cancer can be as high as 50% for large, deep tumors.
In rare cases, squamous cell cancers may spread to lymph nodes or distant sites. If this happens, further treatment with radiation therapy and/or chemotherapy may be needed.
Simple excision
Simple excision is often used to treat squamous cell carcinomas.
Electrodesiccation and curettage
Electrodesiccation and curettage is sometimes useful in treating small squamous cell carcinomas, but it is not recommended for larger tumors.
Cryosurgery
Cryosurgery is used for some early squamous cell carcinomas but is not recommended for larger invasive tumors or those on certain parts of the nose, ears, eyelids, scalp, or legs.
Mohs surgery
Mohs surgery has the highest cure rate. It is especially useful for squamous cell carcinomas larger than 2 cm (about 4/5 inch) across or with poorly defined edges, for tumors that have come back after other treatments, for cancers that are spreading along nerves under the skin, and for cancers on certain areas of the face or genital area.
Radiation therapy
Radiation therapy is often a good option for patients with large cancers, especially in areas where surgery is difficult (eyelids, ears, or nose), or for patients who may not be able to tolerate surgery.
Radiation is sometimes used after surgery (simple excision or lymph node dissection) if all of the cancer was not removed (if the surgical margins were positive), or if there is a chance that some cancer may remain.
Radiation can also be used to treat cancers that have come back after surgery and have become too large or deep to be removed surgically.
Lymph node dissection
Removing regional (nearby) lymph nodes is recommended for some squamous cell carcinomas that are very large or deeply invasive and in cases where the lymph nodes feel enlarged and/or hard. After the lymph nodes are removed, they are looked at under a microscope to see if they contain cancerous cells.
Systemic chemotherapy
Systemic chemotherapy is an option for patients with squamous cell cancer that has spread to lymph nodes or distant organs. In some cases it may be combined with surgery or radiation therapy.
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