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Non-melanoma skin cancer

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Treatment of squamous cell carcinoma

The following are treatment options for squamous cell carcinoma (SCC). The types of treatments given are based on the unique needs of the person with cancer.

Treatment plans are designed to meet the unique needs of each person with cancer. Treatment decisions for SCC are based on:

  • person’s age
  • person’s overall health
  • desired cosmetic result
  • number of lesions or tumours
  • size of the tumour
  • definition of tumour border
  • location of tumour
  • history of radiation therapy
  • whether the tumour is low or high risk

Surgery

Surgery is the primary treatment for SCC. The types of surgery that may be offered for SCC include:

  • Mohs surgery
    • This surgery is used to treat primary SCC, particularly tumours:
      • that occur at sites known to have high treatment failure rates (periorbital area, nasolabial fold, nose-cheek angle, posterior cheek sulcus, pinna, ear canal, forehead, scalp or tumours that start in a scar)
      • with poorly defined borders
      • larger than 2 cm in diameter
      • in areas where the maximum preservation of tissue is desired (tumours on the face, head or genitalia)
  • surgical excision
    • It is used for most well-defined tumours less than 2 cm in diameter.
  • curettage and electrodesiccation
    • This treatment is only used for very small SCC, not for larger tumours.
  • lymph node removal
    • Nearby lymph nodes may be removed if SCC is very large or deeply invasive, or if lymph nodes feel enlarged or hard.

Radiation therapy

Radiation therapy may be the primary treatment for some SCC and is the main treatment used as an alternative to surgery. External beam radiation therapy is used as the primarily treatment for:

  • tumours requiring difficult or extensive surgery (such as those on the eyelids, nose or ears)
  • elderly people who cannot tolerate surgery
  • recurrent tumours that are too large or deep to remove by surgery
  • relief of pain or to control symptoms of very large tumours (palliation)

Radiation therapy may be given after surgery (adjuvant therapy):

  • for tumours that cannot be removed completely (positive margins)
  • for tumours with nerve involvement
  • if there is a chance that some cancer remains

Chemotherapy

Topical chemotherapy may be used to treat in situ SCC (Bowen’s disease). The most common topical chemotherapy drug is 5-fluorouracil (5-FU, Efudex).

It is rare for SCC to metastasize, so systemic chemotherapy is not commonly used to treat it. Depending on the nature of the tumour, SCC may have the potential to spread to other parts of the body. Systemic chemotherapy may be used to treat squamous cell carcinoma of the skin that has spread to lymph nodes or distant organs. Although chemotherapy will not cure the cancer, it may slow the growth of the cancer and relieve symptoms.

The most common systemic chemotherapy drugs used to treat SCC that has spread to other parts of the body include:

  • cisplatin (Platinol AQ)
  • doxorubicin (Adriamycin)
  • 5-fluorouracil (5-FU, Adrucil)
  • mitomycin (Mutamycin)

Clinical trials

People with SCC may be offered the opportunity to participate in clinical trials. For more information, go to clinical trials.

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