Treatments for squamous cell carcinoma

The following are treatment options for squamous cell carcinoma (SCC) of the skin. Your healthcare team will suggest treatments based on the risk group. They will work with you to develop a treatment plan.

SCC is most often treated with local therapy. This means that only the cancer on the skin and the area around it are treated.

But if SCC has spread to other parts of the body, systemic therapy may be used. Systemic therapy travels through the bloodstream to reach and destroy cancer cells all over the body.

Surgery is usually offered for SCC. The type of surgery done depends on the risk group, where the cancer is located and the size of the cancer.

Surgical excision removes the cancer along with some normal tissue around it (called the surgical margin). It is a common treatment for most types of SCC.

Mohs surgery removes the cancer in layers, little by little, until no cancer remains. It is mainly done for high-risk SCC or SCC that comes back after treatment. It can also be used when SCC could not be completely removed by surgical excision. Mohs surgery is often used for cancers with a border that is uneven, especially on the face, hands or feet.

Curettage and electrodesiccation uses a sharp tool (called a curette) to scrape the cancer. Then the area is treated with an electrical current to destroy any remaining cancer cells. It is commonly used for low-risk SCC, including SCC in situ.

Cryosurgery uses extreme cold to freeze and destroy tissue. It is often used to treat small tumours on the surface of the skin with clear and smooth borders. It is usually offered when other surgical options can’t be done.

Reconstructive surgery repairs the skin and nearby area after SCC is removed. It may be done if a large area of skin is removed to make sure the cancer is completely gone. The doctor takes a piece of skin from another part of the body, called a skin graft or skin flap, to rebuild the area.

Lymph node dissection removes lymph nodes from the body. It is not used very often, but may be used for SCC that has spread to lymph nodes. Imaging tests or a physical exam will be done to see which lymph nodes need to be removed.

You may be offered external beam radiation therapy for SCC. It uses high-energy rays or particles to destroy cancer cells. It is used for SCC that can’t be treated with surgery or if surgery will have a poor effect on how you look or how the area functions. Radiation therapy may also be used for SCC that comes back after treatment. It is also used as a palliative therapy to help relieve or control symptoms. Sometimes radiation therapy is used for high-risk tumours along with other treatments, such as surgery. Radiation therapy is usually given daily for several weeks.

You may be offered photodynamic therapy (PDT) for SCC in situ. It uses a light-sensitive drug (photosensitizer) and a special type of light to destroy cancer cells.

You may be offered drug therapy for SCC. The type of drug therapy used depends on where the cancer is located.

Topical therapy uses a cream or gel to put drugs directly on the skin. It may be offered to treat SCC in situ. In some cases, topical therapy is used for other low-risk tumours. The topical therapy drugs used are 5-fluorouracil (5-FU, Efudex) or imiquimod (Aldara, Zyclara).

Systemic chemotherapy is not usually offered for SCC. But it may be used for SCC that has spread. The most common chemotherapy drug used is cisplatin (Platinol AQ). It is given with a needle into a vein (intravenously). It can be used alone or combined with other drugs in some cases, including interferon alfa (Intron A, Wellferon) and retinoid drugs. There is no standard chemotherapy treatment plan for SCC.

Cemiplimab (Libtayo) may be used for SCC that has spread to other parts of the body when surgery or radiation can’t be done. Cemiplimab is an immunotherapy drug that is given by a needle into a vein every 2 or 3 weeks.

You may be asked if you want to join a clinical trial for skin cancer. Find out more about clinical trials.