This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.

How does skin cancer develop?

Skin cancer develops when DNA in skin cells is damaged, most commonly by ultraviolet (UV) radiation from the sun or tanning beds. That damage can cause mutations that make cells grow out of control. Precancerous changes such as actinic keratoses may appear as rough, scaly patches and can progress to squamous cell carcinoma over time if untreated. Other risk factors include fair skin, older age, a history of sunburns, a weakened immune system, and certain exposures such as arsenic.

Many cases begin as small, persistent sores, red bumps, or scaly patches. Regular skin self-exams and periodic checks by a dermatologist—particularly if you have risk factors—help detect suspicious lesions early. Photographs and maps of skin changes can assist clinicians in monitoring growth.

How are cases diagnosed?

Diagnosis typically starts with a clinical examination by a dermatologist. When a lesion looks suspicious, the definitive diagnosis usually requires a skin biopsy—either shave, punch, or excisional—so a pathologist can examine tissue under a microscope. For larger or deeply invasive tumors, imaging studies (ultrasound, CT, or MRI) may be recommended to assess spread to deeper tissues or nearby lymph nodes.

After diagnosis, staging and risk assessment guide treatment planning. High-risk features include large size, location (e.g., ear or lip), poor differentiation on pathology, perineural invasion, and immunosuppression. A multidisciplinary discussion involving dermatology, surgical oncology, radiation oncology, and medical oncology can be valuable for complex cases.

What treatment options exist for squamous cell carcinoma?

For most localized SCCs, surgical removal is the primary treatment. Standard excision with appropriate margins removes the tumor and surrounding tissue; Mohs micrographic surgery offers the highest cure rates for tumors in cosmetically or functionally sensitive areas by examining margins in real time. Less invasive options for small, superficial lesions include curettage and electrodessication, cryotherapy, and topical therapies such as 5-fluorouracil or imiquimod for selected patients.

Radiation therapy is an option when surgery isn’t feasible or as adjuvant therapy for high-risk features. Treatment selection balances tumor characteristics, cosmetic outcomes, patient health, and preferences. Recovery, wound care, and potential side effects vary by modality—surgical wounds need care, and radiation can cause skin changes over time.

How is melanoma different from squamous cell carcinoma?

Melanoma and squamous cell carcinoma are both skin cancers but arise from different cells and behave differently. Melanoma arises from melanocytes (pigment-producing cells) and tends to be more aggressive with a higher risk of early metastasis; it’s often identified by changes in mole shape, color, or size. Squamous cell carcinoma arises from keratinocytes and more commonly affects chronically sun-exposed skin with scaly or crusted lesions.

Diagnosis and staging differ: melanoma often uses depth of invasion (Breslow thickness) and may require sentinel lymph node biopsy for staging, while SCC staging emphasizes size, depth, and high-risk features. Treatments for advanced melanoma and SCC can overlap in systemic therapies, but the initial approaches to localized disease and surveillance strategies are distinct.

What medical therapies are used for advanced disease?

When SCC becomes locally advanced or metastatic and cannot be controlled with surgery or radiation alone, systemic medical therapies may be used. Immune checkpoint inhibitors—agents targeting the PD-1 pathway—have become important options for advanced cutaneous squamous cell carcinoma, offering the ability to harness the immune system against tumor cells. Targeted therapies such as EGFR inhibitors may also be considered in selected cases, and traditional chemotherapy is occasionally used. Clinical trials remain an important route for access to new therapies.

Management of advanced SCC typically involves a medical oncologist working with dermatology and radiation specialists. Coordination with local services and cancer centers helps ensure access to appropriate imaging, laboratory monitoring, and supportive care. Decisions consider patient health, prior treatments, potential benefits and side effects, and goals of care.

Conclusion

Squamous cell carcinoma is a largely treatable skin cancer when detected early, with a spectrum of options from topical therapy to surgery and radiation. For advanced or high-risk tumors, modern medical therapies and multidisciplinary care improve outcomes. Regular skin checks, sun protection, and prompt evaluation of changing lesions help reduce risk and support timely management.