Squamous cell carcinoma (SCC) is the second most common type of skin cancer, following basal cell carcinoma (BCC). It originates from squamous cells, which form the outermost layer of the skin (epidermis).
Common Locations of SCC:
- Sun-exposed areas such as the face, ears, neck, scalp, hands, and arms.
- Can also occur on the lips, genitals, and other non-sun-exposed areas.
Risk Factors
- Chronic sun exposure and a history of sunburns.
- Tanning bed use.
- Fair skin and light-coloured eyes.
- Weakened immune system (e.g., organ transplant recipients).
- History of actinic keratosis (precancerous skin condition).
Potential for Spread
- Unlike basal cell carcinoma, SCC can grow aggressively and has the potential to metastasise (spread to lymph nodes and other parts of the body) if left untreated.
- Early detection and treatment are crucial for preventing progression.
Management of Squamous Cell Carcinoma
The treatment approach depends on the size, location, depth, and subtype of SCC, as well as the patient’s overall health.
Surgical Treatments
Surgical Excision (Most Common Treatment)
- The tumour is surgically removed along with a margin of healthy tissue.
- Ensures complete removal and reduces
recurrence risk.
Mohs Micrographic Surgery
- Used for tumours in cosmetically sensitive areas (e.g., face, ears, nose).
- Removes the cancer layer by layer, preserving as much healthy tissue as possible.
Laser Therapy and Curettage
- Laser Therapy (ALMA HYBRID and ACCLARO ULTRACLEAR): Effective for early-stage, well-differentiated superficial SCCs.
- Electrodesiccation and Curettage (ED&C) Scrapes away the tumour and cauterises the area.
- Laser Vermilionectomy (ALMA HYBRID and ACCLARO ULTRACLEAR) Used for precancerous and early SCC affecting the lips.
Alternative and Adjunctive Treatments
Topical and Skin-Directed Therapies:
- 5-Fluorouracil (5-FU) Cream Destroys abnormal cells.
- Imiquimod Cream Stimulates the immune system to clear superficial SCC.
Photodynamic Therapy (PDT) and Laser-Assisted PDT:
- A photosensitising agent is applied to the lesion.
- The area is then exposed to specific light wavelengths, activating the agent to destroy cancerous cells.
Laser-Assisted PDT
- Enhances the penetration of the photosensitising agent.
- Effective for superficial SCC, Bowen’s disease, and in situ SCC.
Cryotherapy Liquid nitrogen is used to freeze and destroy small, superficial SCCs.
Advanced Treatments for Aggressive or Metastatic SCC
Radiation Therapy
- Used when surgical excision is not feasible or for high-risk tumours.
- Often combined with surgery for better outcomes.
Systemic Therapies (For Advanced SCC)
- Immunotherapy (e.g., Cemiplimab – PD-1 inhibitor) Helps the immune system destroy cancer cells.
- Targeted therapies Used for locally advanced or metastatic SCC.
KDAA collaborates with the St George and Sutherland Hospital multidisciplinary teams (Head & Neck plus Melanoma MDT) to manage advanced and aggressive SCCs.
Importance of Prevention and Follow-Up
Prevention and early detection are essential for reducing the risk of SCC recurrence and future skin cancers.
Sun Protection Measures:
- Broad-spectrum sunscreen (SPF 50+) applied daily.
- Protective clothing, including hats and sunglasses.
- Avoiding peak UV radiation (10 AM–4 PM).
- Avoiding tanning beds, which significantly increase SCC risk.
Regular Dermatology Check-Ups:
- Patients with a history of SCC have a higher risk of developing additional skin cancers.
- Routine skin checks help detect new or recurrent SCCs early.
Self-Examinations:
- Patients should regularly monitor their skin for any new, changing, or non-healing lesions.
- Report any suspicious changes to a dermatologist promptly.
Key Takeaways –
- Squamous cell carcinoma is a potentially aggressive skin cancer that requires timely diagnosis and appropriate treatment.
- A variety of effective treatment options are available, ranging from surgical excision and Mohs surgery to laser therapy, PDT, and immunotherapy.
- Early detection, ongoing surveillance, and sun protection are critical for long-term skin health.
For expert assessment and management of SCC, schedule a consultation with our dermatology team at KDAA.
