Squamous Cell Carcinoma (SCC) Explained

What is a squamous cell carcinoma?

A squamous cell carcinoma is the second most common form of skin cancer.

Many are slow-growing and remain confined to the skin but if left untreated, this type of skin cancer has the potential to spread to other parts of the body.  So early recognition and removal are important to prevent this happening.

How did I get an SCC?

SCCs commonly occur in areas of the body which have had chronic sun-exposure; so in people who spend a lot of time outdoors, either as part of their work or due to their hobbies.  They also quite often occur in people who are on drugs to suppress their immune system, eg after a transplant.

They can also occur after exposure to radiotherapy or sunbeds, tars or chemicals, after certain viruses and in long-standing ulcers or chronic trauma (damage) to the skin – but these are less common.

What does an SCC look like?

A typical SCC can look like a crusty or warty lump on an area of skin that has been exposed to a lot of sun, over many years.  It may be tender to touch and have grown rapidly.  However, appearances can vary, depending on the underlying cause and some may grow more slowly than others and not be painful at all. (The lump or wart is known as a “lesion”).

What are the treatments for SCCs?

The options are surgery or radiotherapy.

• Surgery
  • Curettage and cautery – the lesion is scraped off the skin, after a local anaesthetic and the base is cauterized (burnt).  This process is repeated several times (within the treatment) to ensure it is cleared.  This procedure is suitable for smaller, slow-growing SCCs and especially for people unable to tolerate an excision.
  • Excision – here the lesion is cut out of the skin, after a local anaesthetic and the wound is repaired with stitches.
  • Plastic surgery – this is for larger lesions which require flaps or grafts, or for SCCs in places such as the face or back of hand where preserving the skin is particularly important.

•  Radiotherapy – this is reserved for those who cannot tolerate surgery.  It requires several trips over several weeks, but can be an effective form of treatment.

What happens afterwards?

After successful treatment, the majority of SCCs are completely cured, especially if caught early.

Depending on your own personal history and the type of SCC you had, your dermatologist will arrange to see you again, as there is a risk that some SCCs may grow back.

Patients on drugs which suppress their immune system will require long-term follow-up. This should be held at a special clinic, at the centre where the transplant was performed.

It is important to check your skin regularly to see if any similar lesions develop, as you are at higher risk of developing another in the future.

It is also important to practice safe sun protection.