Squamous Cell Carcinoma - Treatment

Most squamous cell carcinomas may be treated by one of the following methods. More healthy tissue around the lesion is removed than for basal cell carcinomas because of the potential of squamous cell carcinomas to spread. Nearby lymph nodes are also examined carefully. The choice of treatment is influenced by:

• size, location, grade, and type of tumour
• whether the tumour is primary or is recurring
• person's age and health
• people with organ transplants are at a high risk of aggressive squamous cell carcinoma, which is considered in their treatment plan
• availability of the treatment

Surgery (Wide Excision)

- most small lesions that are less than 2 cm
- superficial or SCC that has not spread
- verrucous carcinomas (slow growing and less aggressive)
- tumours that have previously been treated with radiation therapy
- lesions on the eyelid, forehead, scalp, lip, penis, vulva and anus

Mohs Micrographic Surgery

• used for all types of squamous cell cancer
• commonly used for:
- areas that are at high risk of recurrence (eyelids, nose, ears, forehead, scalp), as well as areas that have - already recurred
- areas where it is important to keep function and appearance
- lesions that are larger than 2 cm, and lesions with poorly defined borders
- aggressive tumours, and invasive lesions that have spread to nerves, cartilage or bone
- tumours that have been left untreated for a long time
- lesions that had not been completely removed with prior surgery
• it involves a meticulous study of tissues removed by a pathologist at the time of surgery

Radiation Therapy

• used after surgery for:
- elderly individuals
- ensuring cancer free margins
- treatment of involved lymph nodes
- squamous cell carcinoma that has recurred after surgery
- to relieve or control the symptoms of very large tumours
- for people who are unwilling or unable to undergo surgery
- tumours on the eyelid, cheek, earlobe and nose
• not used for verrucous carcinomas (slow growing and less aggressive)

Chemotherapy

• systemic chemotherapy is used for squamous cell cancer that has spread to other parts of the body
• drugs used most often in chemotherapy:
- cisplatin
- doxorubicin
- bleomycin

Curettage And Electrodesiccation (C & E)

• used for
- small areas that are less than 2 cm
- lesions that haven’t spread
- squamous cell carcinoma with distinct margins in Actinic Keratosis
• should not be used for:
- larger lesions that are greater than 2 cm
- recurrent tumours
- aggressive squamous cell carcinoma
- lesions with poorly defined borders
- hairy areas like the underarms, scalp, and the pubic area
- areas where it is important to keep function and appearance
• uncommonly used