Understanding Squamous Cell Carcinoma 

SCC can look different from one person to another. It may appear as a rough, scaly patch, a firm bump, a crusted growth, or a sore that does not heal. Some SCCs are tender or painful, while others do not cause any symptoms. They may also bleed easily or repeatedly scab over and then return. SCCs are especially common on areas of the skin that receive a lot of sun exposure; however, SCC can develop on other areas of the body as well.  

The most important risk factor for SCC is cumulative exposure to ultraviolet (UV) radiation. Other factors can also increase the risk of SCC, including having had skin cancer before, having a weakened immune system, certain types of previous radiation exposure, and chronic or severely damaged skin. Developing SCC does not necessarily mean that you did something wrong. Skin cancer results from multiple factors, and not all risk factors can be controlled. 

Diagnosis 

If your dermatologist is concerned about a particular spot, the next step is usually a skin biopsy. During a biopsy, a small amount of tissue is removed and examined under a microscope by a pathologist. 

A biopsy can determine whether the lesion is an SCC and provide information that helps guide treatment. The pathology report may describe characteristics of the cancer that are important when deciding how it should be treated. 

The size, location, depth, and microscopic features of the tumor can all affect treatment decisions. Your dermatologist will consider these factors along with your overall health and medical history. 

Treatment at Calvert Dermatology 

There is not one treatment that is appropriate for every SCC. For many SCCs treatment involves removing the cancer surgically. The appropriate approach depends on the individual cancer and its risk of returning or spreading.  

One common approach is what we call a standard surgical excision. This involves removing the visible cancer along with a margin of surrounding skin. The tissue is then sent to a pathologist to determine whether the cancer has been completely removed. 

For selected skin cancers, Mohs micrographic surgery may be recommended. During Mohs surgery, the cancer is removed in stages, and each layer is examined under a microscope during the procedure. Additional tissue is removed only from areas where cancer cells remain. This allows the surgeon to carefully examine the edges of the tumor while preserving as much normal skin as possible.  

Mohs surgery is particularly useful for certain SCCs, including cancers in areas where preserving healthy tissue is important, cancers with poorly defined borders, cancers that have returned after previous treatment, and tumors with other characteristics that increase the risk of recurrence. At Calvert Dermatology, Dr. Faris Hawit is a board-certified dermatologist and Mohs micrographic surgeon. He has extensive experience managing melanoma, basal cell carcinoma, and squamous cell carcinoma, with advanced training in skin cancer surgery and Mohs micrographic surgery.  

Depending on the type and risk of the SCC, other treatments may sometimes be appropriate. These can include a local destruction which is a process where the area the cancer is located will be numbed, the roots will be scrubbed using a scrubbing technique, a medicine will then be applied to destroy the remaining roots or, in certain circumstances, radiation therapy. More advanced skin cancers may require care from multiple specialists, including radiation or medical oncology.  

When we recommend a particular treatment at Calvert Dermatology, we consider the characteristics of the cancer as well as the location and the patient’s individual circumstances. Our goal is to explain the options clearly so that patients understand why a particular treatment is being recommended.