SQUAMOUS CELL CARCINOMA

Squamous cell carcinoma (SCC), the second most common form of skin cancer, is an uncontrolled growth of abnormal cells arising from the squamous cells in the epidermis, the skin’s outermost layer. SCCs often look like scaly red patches, open sores, warts or elevated growths with a central depression; they may crust or bleed. Cumulative, long-term exposure to ultraviolet (UV) radiation from the sun over your lifetime causes most SCCs. Daily year-round sun exposure, intense exposure in the summer months or on sunny vacations and the UV produced by indoor tanning devices all add to the damage that can lead to SCC.

Treatment Options

BIOPSY

A biopsy is a small sampling of the skin tissue. The area is numbed with local anesthetic and then a small piece of tissue is removed. Depending on the type of biopsy taken, sometimes sutures are required. Once proven by biopsy to be A Malignant Melanoma, there are several treatment options, depending on the depth and type of Malignant Melanoma.

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EXCISIONAL SURGERY

The physician uses a scalpel to remove, or excise, the entire cancerous tumor along with a surrounding border of presumably normal skin as a safety margin. The physician bandages the wound or closes the skin with stitches and sends the tissue specimen to a lab to verify that all cancerous cells have been removed. If the lab finds evidence of skin cancer beyond the safety margin, the patient may need to return for another surgery.

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MOHS MICROGRAPHIC SURGERY

Mohs surgery is the gold standard for treating many SCCs (as well as many basal cell carcinomas and some melanomas). This includes those in cosmetically and functionally important areas around the eyes, nose, lips, ears, scalp, fingers, toes or genitals. Mohs is also recommended for skin cancers that are large, aggressive or growing rapidly, that have indistinct edges or that have recurred after previous treatment.

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PHOTODYNAMIC THERAPY (PDT)

PDT may be used for some superficial SCCs on the face and scalp but is not recommended for invasive SCC. The physician applies a light-sensitizing topical agent to the lesion and the area surrounding it. The patient waits for an hour or more to let this absorb into the skin. The doctor then uses a strong blue or red light or laser to activate this medicated area. This selectively destroys the lesion while causing minimal damage to surrounding healthy tissue. Some redness, pain, peeling, flaking and swelling can result. After the procedure, patients must strictly avoid sunlight for at least 48 hours, as ultraviolet exposure will increase activation of the medication and may cause severe sunburns.

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ELECTRODESSICATION AND CURETTAGE (ED&C)

This technique is usually reserved for small squamous cell carcinoma lesions. Using local anesthesia, the physician scrapes off part or all of the lesion with a curette (an instrument with a sharp, ring-shaped tip), then burns the tumor site with an electrocautery needle to stop the bleeding and kill any remaining cancer cells. The physician typically repeats this procedure a few times (often at the same session), scraping and burning a deeper layer of tissue each time to help ensure that no tumor cells remain. The technique can produce cure rates approaching those of surgical excision for superficially invasive squamous cell carcinomas without high-risk characteristics.

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