Squamous Cell Carcinoma of the Skin – Diagnosis and Treatment
Checking for Squamous Cell Carcinoma
A health professional, often a dermatologist, starts the diagnosis with a careful review of your skin. They look for signs like persistent scaly red patches, open sores, or unusual spots that do not heal.
These signs often appear on areas exposed to sunlight where epidermal keratinocytes are present. When doctors find a suspicious lesion, they perform a biopsy. The doctor removes a small piece of the area with a special tool.
A lab technician checks this sample under a microscope for cancer cells in the epidermis. Doctors use both the clinical exam and test results to determine if squamous cell carcinoma is present.
Treatment
Care for Tiny or Surface-Level Skin Tumors
Doctors often use simple treatments when a skin cancer is very small, shallow, or not likely to spread. Common methods include:
Scraping and Electrical Treatment: Doctors use a sharp tool called a curet to scrape away the cancer cells. An electric needle then destroys any remaining cells and controls bleeding.
Laser Destruction: A focused light beam targets and removes cancerous tissue. Laser treatments can limit harm to surrounding healthy skin and lower the chance of swelling or scars.
Cold Treatment (Cryosurgery): Doctors use liquid nitrogen to freeze and kill cancer cells. Sometimes, they first use a curet to remove the top layer before freezing the deeper parts of the tumor.
Light-Activated Therapy: In photodynamic therapy, a medicine is put on the skin to make cancer cells sensitive to light. A special light then destroys those cells.
Topical Medicines: For certain early, shallow cancers, a cream or solution with drugs like fluorouracil or topical imiquimod may be applied. These medicines target cancer cells without surgery.
Strategies for Treating Bigger Skin Tumors
Doctors use more involved treatments for tumors that are larger, have grown deeper, or seem more aggressive.
Surgical Removal (Simple Excision): The doctor cuts out the cancer and a zone of normal skin around it. If the cancer is big, they remove a wider area to prevent cancer from coming back.
Mohs Micrographic Surgery: Mohs surgery is often chosen for tumors where saving healthy skin is very important, such as on the face or hands. The doctor removes cancerous tissue in thin layers and examines each under a microscope until all the cancer is gone.
Radiation Treatment: Sometimes doctors use powerful X-rays or other beams to target the cancer. Radiation therapy can be used after surgery when there’s a higher risk the cancer might return, or if a person cannot have an operation.
Approaches for Cancer That Has Reached Beyond the Skin
Doctors use special medications and therapies when skin cancer spreads deeper or moves to lymph nodes or other organs.
| Type | Used For | How it Works |
|---|---|---|
| Chemotherapy | SCC, melanoma, cancers that metastasize | Kills fast-dividing cells |
| Targeted Therapy | SCC, melanoma, nonmelanoma skin cancers | Blocks growth signals in cancer cells |
| Immunotherapy | Advanced SCC, melanoma, BCC | Boosts the immune system’s response |
Chemotherapy: Doctors give strong anti-cancer drugs by mouth, injection, or directly on the skin. Chemotherapy attacks and kills fast-growing cancer cells in the body.
Targeted Medicines: These treatments interrupt specific parts of cancer cell growth. Targeted therapy can stop chemicals that help cancer grow, leading to cancer cell death.
Immunotherapy: Immunotherapy helps your immune system find and destroy cancer cells. These treatments allow immune cells to spot and attack cancer cells.
Getting Ready for Your Visit
Ways to Prepare
Before seeing a healthcare professional about a possible skin issue, gather important information. Bring a trusted friend or family member for support and to help remember details from the appointment.
Prepare the following:
- Medical History: Note any health problems, such as past skin cancers, organ transplants, or immune system conditions.
- List of Medicines: Write down all medications, vitamins, or herbal supplements, with dosages.
- Questions for the Doctor: Prepare specific questions about diagnosis, treatment plans, and ways to lower the chance of skin cancer coming back.
Sample questions you may want to ask include:
| Suggested Question | Purpose |
|---|---|
| Do I have skin cancer? If so, what type? | To understand the diagnosis. |
| What treatments are safest for me? | To review options based on health and risk factors. |
| Could this cancer spread or come back? | To discuss chances for recurrence and quality of life. |
| How can I prevent future skin cancers? | To learn about sun safety, sunscreen use, and protective clothing. |
If you have a history of sun exposure, tanning bed use, or risk factors like immunosuppression from medications, mention these to help guide your care.
Also, bring up any history of actinic keratoses, as these increase the risk for some skin cancers.
Questions Your Doctor Might Ask
The healthcare provider or dermatologist will ask about your skin problem and your lifestyle.
Here are common topics they may ask about:
- When you first noticed the spot and if it has changed in size or color.
- Whether the area feels painful, bleeds, or itches.
They may ask about your past experiences with skin cancer or actinic keratosis. You might need to talk about your habits around sun exposure, such as using sunscreen, wearing protective clothing, or checking your skin regularly.
Your doctor may ask if you have used tanning beds, smoked, or taken medications that suppress the immune system, especially after an organ transplant.
They might also want to know about any recent changes in your risk factors or routines for skin cancer prevention.
