What Is Squamous Cell Carcinoma?

Squamous cell carcinoma is a type of skin cancer that develops in the squamous cells, which form the middle and outer layers of the skin. These cancers typically appear as scaly red patches, open sores, rough thickened skin, or wart-like growths, most commonly on sun-exposed areas like the face, ears, neck, and hands.

SCC is primarily caused by cumulative ultraviolet (UV) radiation exposure over a lifetime, whether from the sun or artificial sources like tanning beds. People with fair skin, a history of sunburns, compromised immune systems, or previous skin cancers face higher risks. While rarely life-threatening when caught early, SCC can become invasive and spread to other body parts if left untreated, making prompt intervention essential.

Early Detection and Diagnosis

Early detection significantly improves treatment outcomes for squamous cell carcinoma. Regular self-examinations and annual skin checks with a dermatologist are crucial preventive measures, especially for those with risk factors. During these examinations, doctors look for persistent, scaly red patches, elevated growths with central depression, or wart-like growths that bleed or crust.

When a suspicious lesion is identified, the diagnostic process typically involves a skin biopsy, where a small tissue sample is removed for microscopic examination. Several biopsy methods exist, including shave, punch, and excisional biopsies, with the choice depending on the lesion's size, location, and suspected depth. Histopathological examination confirms the diagnosis and determines the cancer's aggressiveness, which guides treatment decisions.

Surgical Treatment Options

Surgery remains the primary treatment for most squamous cell carcinomas. The simplest approach is excisional surgery, where the tumor and a margin of healthy tissue are removed under local anesthesia. For smaller, superficial lesions, curettage and electrodesiccation may be used, involving scraping away cancer cells followed by electric current to destroy remaining cells.

For more complex cases, Mohs micrographic surgery offers the highest cure rate while preserving the maximum amount of healthy tissue. During this procedure offered by specialized dermatologists at American Academy of Dermatology, thin layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains. This precision makes Mohs particularly valuable for treating SCCs on cosmetically sensitive areas like the face or for aggressive tumors.

Non-Surgical Treatment Approaches

For patients who aren't surgical candidates or have superficial tumors, several non-surgical options exist. Radiation therapy uses high-energy rays to destroy cancer cells and is particularly useful for patients who cannot undergo surgery. Treatment typically involves multiple sessions over several weeks at centers like those affiliated with the American Society for Radiation Oncology.

Topical treatments such as 5-fluorouracil (5-FU) and imiquimod creams work by killing cancer cells or stimulating the immune system to target them. These medications, available through dermatology practices or through AAD-affiliated physicians, are applied directly to the skin for several weeks. While less invasive, they require strict adherence to treatment protocols and regular follow-up to ensure effectiveness.

For more advanced cases, systemic therapy may be necessary. This includes immunotherapy with checkpoint inhibitors like Libtayo (cemiplimab) from Regeneron Pharmaceuticals, which helps the immune system recognize and attack cancer cells. Targeted therapy drugs that block specific molecules involved in tumor growth are also emerging as valuable treatment options for advanced SCC.

Treatment Selection and Provider Comparison

Selecting the appropriate treatment depends on various factors including tumor size, location, depth, and patient health status. Here's a comparison of treatment approaches and providers:

Treatment Approach Best For Provider Examples Typical Recovery
Mohs Surgery Facial tumors, recurrent SCC American College of Mohs Surgery 1-2 weeks
Excisional Surgery Well-defined tumors on body American Society for Dermatologic Surgery 2-4 weeks
Radiation Therapy Elderly patients, non-surgical candidates American Society for Radiation Oncology Gradual over months
Topical Treatments Superficial SCC, multiple lesions American Academy of Dermatology 4-8 weeks with redness
Immunotherapy Advanced or metastatic SCC National Comprehensive Cancer Network Ongoing treatment

When choosing a provider, consider factors such as physician specialization, experience with your specific type of SCC, and whether they offer comprehensive care including follow-up monitoring. The Skin Cancer Foundation provides resources to help locate qualified specialists in your area.

Conclusion

Squamous cell carcinoma is highly treatable when detected early, with cure rates exceeding 95% for localized disease. The range of treatment options—from simple excisions to advanced immunotherapies—allows for personalized care plans based on each patient's unique circumstances. After treatment, regular follow-up examinations are essential, as individuals with a history of SCC have an increased risk of developing new skin cancers.

While facing a skin cancer diagnosis can be concerning, working with qualified specialists and understanding your treatment options empowers you to make informed decisions. Regardless of which treatment path you choose, combining medical intervention with sun protection habits and regular skin examinations provides the best long-term strategy for skin health. Remember that early intervention remains the most powerful tool in successfully managing squamous cell carcinoma.

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This content was written by AI and reviewed by a human for quality and compliance.