Squamous Cell Carcinoma Management

By Kira Mayo

If you’ve been diagnosed with squamous cell carcinoma, there are many ways to manage this cancer, each with associated pros and cons. Some of the most popular treatment options are discussed below. Be sure to talk with your doctor before starting any treatment.

Topical chemotherapy. This is used most often for superficial cancers. These topical agents can produce significant inflammation and scarring, so be sure to discuss potential complications with your doctor.

5-Flurouracil cream. This anti-metabolite stops cell division by damaging the DNA that tells the cancerous cell to keep replicating. People typically apply this cream once or twice a day for several weeks.

Imiquimod cream. This topical treats superficial basal cell carcinoma and actinic keratoses (lesions that have the potential to become squamous cell carcinoma). The way it works is not clearly understood. Treatment frequency and length varies, so talk with your doctor to come up with an individualized treatment plan.

Cryosurgery. Cancerous cells are frozen with liquid nitrogen that gets as cold as -58 degrees Fahrenheit. The frozen cancer cells are destroyed and slough off, allowing the underlying normal skin to heal. This is a highly effective way to treat actinic keratoses and small squamous cell carcinomas. When treating larger squamous cell carcinomas, it is used more aggressively and scarring can result.  In addition, the cure rate for larger skin cancers is not very high.  Therefore, in the treatment of larger cancers, it may be used to relieve pain or reduce growth only, without actually curing the patient.

Curettage and electrodessication. This is often used to treat small squamous cell carcinomas. It involves scraping the tumor with a curette, a small spoon-like instrument, and then using an electric needle to gently burn the remaining cancer cells and a margin of normal-looking tissue. This process if often repeated a few times, and the wound generally heals without stitches. This method is best for treating a new small lesion, and does not work well if the lesion is recurrent or near a scar.

Photodynamic therapy. This treatment is primarily used to treat actinic keratoses, and consists of two phases. During the first phase, a photosensitizing chemical is applied to the tumor and stays on for several hours. The photosensitizing chemical increases the skin’s reaction to light. During the second phase, an intense beam of light vaporizes the now-photosensitive tumor. Since the laser does not destroy cancer cells found deeper in the skin, follow-ups with a dermatologist are important.

Surgical excision. This can be used to treat primary and recurrent squamous cell carcinomas, and consists of surgically removing the tumor and a margin of cancer-free skin around the tumor to removal of the entire tumor. After surgery, the excised tissue is examined under a microscope to ensure that the complete lesion was excised.

Mohs surgery. This is often considered the most effective treatment for squamous cell carcinomas, especially ones that are larger than 2cm, have recurred, or are located on the face, mucous membranes or genital area. During the procedure, your doctor removes the tumor layer by layer, examining each layer under the microscope until no abnormal cells remain. This allows the tumor to be removed without excising an excessive amount of healthy skin.

While treatment of squamous cell carcinoma has a high cure rate when it is detected early, this cancer can recur. Those who have had one or more skin cancer lesions are at an increased risk of developing another. As a skin cancer patient, you should perform regular self-examinations of your skin and keep your follow-up appointments with your dermatologist.  Early detection and removal offer the best chance for a cure.

Originally written for DermHub.com

References: Dr. Jeffrey Ellis, belaray.com

Photos via bing.com and flickr.com

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