Treatment

Most squamous cell carcinomas of the skin can be completely removed with relatively minor surgery or occasionally with a medicine applied to the skin. Which treatments are best for you depends on the size, location and aggressiveness of the tumor, as well as your own preferences.

Treatments for very small skin cancers

If your skin cancer is very small and has a low risk of spreading, you might consider less invasive treatments, including:

• Curettage and electrodessication (C and E). C and E treatment involves removing the surface of the skin cancer with a scraping instrument (curet) and then searing the base of the cancer with an electric needle. This treatment is often used for small or very superficial squamous cell cancers of the skin.
• Laser therapy. An intense beam of light vaporizes growths, usually with little damage to surrounding tissue and with a reduced risk of bleeding, swelling and scarring. Laser treatment may be an option for very superficial skin lesions.
• Freezing. This treatment involves freezing cancer cells with liquid nitrogen (cryosurgery). It may be an option for treating superficial skin lesions. Freezing might be done after using a scraping instrument (curet) to remove the surface of the skin cancer.
• Photodynamic therapy. Photodynamic therapy combines photosensitizing drugs and light to treat superficial skin cancers. During photodynamic therapy, a liquid drug that makes the cancer cells sensitive to light is applied to the skin. Later, a light that destroys the skin cancer cells is shined on the area.

Treatments for larger skin cancers

More invasive treatments might be recommended for larger squamous cell carcinomas and those that extend deeper into the skin. Options might include:

• Simple excision. In this procedure, your doctor cuts out the cancerous tissue and a surrounding margin of healthy skin. Your doctor may recommend removing additional normal skin around the tumor in some cases (wide excision). To minimize scarring, especially on your face, consult a doctor skilled in skin reconstruction.
• Mohs surgery. During Mohs surgery, your doctor removes the cancer layer by layer, examining each layer under the microscope until no abnormal cells remain. This allows the surgeon to be certain the entire growth is removed and avoid taking an excessive amount of surrounding healthy skin.
• Radiation therapy. Radiation therapy uses high-energy beams, such as X-rays and protons, to kill cancer cells. Radiation therapy is sometimes used after surgery when there is an increased risk that the cancer will return. It might also be an option for people who can't undergo surgery.

Treatments for skin cancer that spreads beyond the skin

When squamous cell carcinoma spreads to other parts of the body, drug treatments might be recommended, including:

• Chemotherapy. Chemotherapy uses powerful drugs to kill cancer cells. If squamous cell carcinoma spreads to the lymph nodes or other parts of the body, chemotherapy can be used alone or in combination with other treatments, such as targeted drug therapy and radiation therapy.
• Targeted drug therapy. Targeted drug treatments focus on specific weaknesses present within cancer cells. By blocking these weaknesses, targeted drug treatments can cause cancer cells to die. Targeted drug therapy is usually combined with chemotherapy.
• Immunotherapy. Immunotherapy is a drug treatment that helps your immune system to fight cancer. Your body's disease-fighting immune system might not attack cancer because the cancer cells produce proteins that blind the immune system cells. Immunotherapy works by interfering with that process. For squamous cell carcinoma of the skin, immunotherapy might be considered when the cancer is advanced and other treatments aren't an option.