Treating squamous cell carcinoma of the skin

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 chance of recurrence for fast-growing cancers 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 (cutting out the tumor, along with a small margin of normal skin) is often used to treat squamous cell carcinomas.

Curettage and electrodesiccation

Curettage and electrodesiccation is sometimes useful in treating small squamous cell carcinomas (less than 1 cm across), but it is not recommended for larger tumors.

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. It is not used as much as an initial treatment in younger patients because of the possible risk of long-term problems.

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.

Cryosurgery

Cryosurgery is used for some early squamous cell carcinomas, especially in people who can’t have surgery, but is not recommended for larger invasive tumors or those on certain parts of the nose, ears, eyelids, scalp, or legs.

Treating advanced squamous cell cancers

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 cancer cells. In some cases, radiation therapy might be recommended after surgery.

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 is combined with surgery or radiation therapy.