Treating Squamous Cell Carcinoma: Options & Outcomes

This article is intended for informational purposes only and does not substitute for professional medical advice. For personalized assessment and treatment recommendations, please consult a licensed healthcare provider.

What is squamous cell carcinoma?

Squamous cell carcinoma (SCC) is a cancer that starts in the squamous cells — the flat cells forming much of the skin’s outermost layer. It most often appears on areas receiving frequent ultraviolet (UV) exposure, such as the face, ears, neck, and hands, but can also arise on mucous membranes or inside the mouth. Common risk factors include cumulative sun exposure, pale skin, advancing age, weakened immune function, and sites of prior injury or chronic inflammation. Although many SCCs grow relatively slowly and remain localized, some lesions can be aggressive, invading deeper tissues or spreading to regional lymph nodes if not treated.

How SCC typically appears and how it affects skin

On the skin, SCC may present in several ways: a firm red bump, a scaly or crusted patch, or a sore that won’t heal. Lesions can bleed, form a crust, or feel tender. Because appearances vary widely, any persistent skin change should be evaluated. Diagnosis is confirmed with a physical exam and a biopsy, which determines the cancer type and how deeply it has invaded. The thickness and extent of invasion, along with other histologic features, guide staging and treatment planning. Superficial, thin tumors are often curable with local therapy, while thicker, recurrent, or high-risk tumors may need more extensive intervention.

Medical and surgical treatments for SCC

Treatment is individualized based on tumor size, depth, location, microscopic characteristics, and the patient’s overall health and preferences. Common options include:

• Surgical excision: Removing the tumor with a margin of healthy tissue is a standard approach for many SCCs.
• Mohs micrographic surgery: This tissue-sparing technique evaluates margins in real time and is especially useful for tumors in cosmetically or functionally sensitive areas or for recurrent lesions.
• Curettage and electrodesiccation: Scraping the tumor followed by controlled burning can be effective for small, superficial lesions.
• Cryotherapy: Freezing may be appropriate for very superficial growths in selected cases.
• Radiation therapy: Used when surgery is not feasible, for patients who are poor surgical candidates, or as an adjunct for certain high-risk tumors.
• Topical therapies: Agents such as 5-fluorouracil or imiquimod can be considered for superficial in situ lesions or select pre-cancers.

For locally advanced or metastatic SCC, systemic treatments are available. Immune checkpoint inhibitors have become a key option for some advanced cases, and conventional chemotherapy or targeted agents may be used based on individual circumstances. Complex or high-risk situations benefit from a multidisciplinary team—dermatologists, surgical oncologists, radiation oncologists, and medical oncologists—to devise the optimal plan.

How SCC differs from melanoma

Both SCC and melanoma are skin cancers but arise from different cells and carry different behaviors. Melanoma originates from melanocytes, the pigment-producing cells, and has a higher tendency to metastasize early, making prompt recognition critical. SCC arises from squamous epithelial cells and frequently follows a more locally invasive path, though aggressive variants exist. Diagnostic approaches differ: melanoma diagnosis often relies on visual criteria and dermoscopy, while biopsy and histology are essential to distinguish between types. Prognosis and follow-up strategies also diverge—melanoma staging emphasizes depth and ulceration and may require broader systemic assessment at higher stages, whereas SCC prognosis hinges on tumor size, depth, location (with lesions on the ear or lip considered higher risk), and recurrence history.

Follow-up care and outlook for survivors

After treatment, follow-up focuses on catching recurrences early, identifying new primary skin cancers, and managing treatment-related effects. Typical surveillance includes periodic skin exams—often every 3 to 12 months initially—education on self-skin checks, and counseling on sun protection and the regular use of broad-spectrum sunscreen. Patients with higher-risk tumors may need imaging or lymph node assessment as advised by specialists. Access to dermatology clinics, oncology services, and wound-care resources can support recuperation and ongoing monitoring.

Overall, the prognosis for most properly treated, localized SCCs is good. However, people who have had one skin cancer face an elevated risk of developing additional lesions, so continued vigilance is important. Protective measures such as sun-avoidance strategies, protective clothing, and routine skin examinations remain central to reducing recurrence and spotting new cancers early.

Conclusion

Squamous cell carcinoma is a generally treatable skin cancer with a range of effective medical and surgical options. The best approach depends on tumor-specific features and patient health, and advanced cases often require systemic therapies and input from multiple specialties. Consistent follow-up, sun protection, and awareness of skin changes enhance outcomes and aid early detection of recurrences or new tumors. For care tailored to your situation, speak with qualified healthcare professionals.