Squamous Cell Carcinoma (SCC) Patient Information - what you need to know

What is Squamous Cell Carcinoma (SCC)?

Squamous cell carcinoma (SCC) is a type of skin cancer. It usually starts as a small, scaly bump or patch that may be red, pink, or brown. SCCs often grow quickly and can become crusty, bleed, or ulcerate.

There are two main types of SCCs:

• Squamous Cell Carcinoma-in-situ (Bowen's disease) - this is an early form of SCC that involves abnormal cells in the uppermost layer of the skin. It typically appears as a red, scaly patch that may be itchy or painful. While Bowen's disease is a form of SCC, it is not invasive, meaning that the abnormal cells have not spread beyond the uppermost layer of the skin. However, if left untreated, Bowen's disease can progress into invasive SCC.

• Invasive Squamous Cell Carcinoma -this is a more advanced form of SCC that has penetrated beyond the uppermost layer of the skin. It can grow into nearby tissues and even spread to other parts of the body, such as lymph nodes. Invasive SCC usually appears as a scaly, raised bump or nodule that may be tender or bleed. While invasive SCC can be more aggressive than Bowen's disease, it is still highly treatable when detected early.

What Causes Squamous Cell Carcinoma?

Exposure to ultraviolet (UV) radiation from the sun or tanning beds is the most common cause of SCC. Other factors that may increase your risk include having fair skin, a weakened immune system, exposure to certain chemicals, and a history of radiation therapy.

How is Squamous cell carcinoma Treated?

The treatment for SCCs depends on the type, size and location of the tumour, as well as your health and lifestyle. It is important to know that not all squamous cell carcinomas require surgery, or sometimes it requires specialised Mohs micrographic surgery. The treatment should be tailored to your specific circumstance.

The treatment options for squamous cell carcinomas include:

• Efudix – this is a topical medication that is used to treat Bowen’s (SCC-in-situ). It contains a type of chemotherapy drug called fluorouracil, which works by destroying cancer cells. Efudix is applied directly to the skin and does not affect healthy skin.

• Photodynamic therapy – this therapy is a treatment that involves applying a photosensitizing agent to the skin, followed by exposure to a specialised light that activates the agent and destroys cancer cells. This treatment is typically used to treat Bowen’s (SCC-in-situ).

• Curette and cautery – this is a treatment that involves scraping away the cancerous tissue with a sharp tool called a curette, followed by cauterization to stop bleeding and destroy any remaining cancer cells. This treatment is usually used for small invasive SCCs and Bowen’s (SCC-in-situ).

• Mohs micrographic surgery - this is a specialised surgical technique that is used to remove SCCs that are located in areas where preserving as much healthy tissue as possible is important, such as the face. During Mohs surgery, the surgeon removes thin layers of tissue one at a time and examines them under a microscope to ensure that all of the cancer cells have been removed.

• Excision - this involves surgically removing the SCC and a margin of healthy tissue around it. This treatment is typically used for larger SCCs that are deeper in the skin.

• Radiotherapy – this is a treatment that involves using high-energy radiation to destroy cancer cells. This treatment is usually used for SCCs that are located in areas where surgery is not feasible or for SCCs that have a high risk of recurrence.

How Can I Prevent Squamous Cell Carcinoma?

The best way to prevent SCCs is to protect your skin from the sun. Wear protective clothing, such as long-sleeved shirts and broad-rimmed hats, and use a broad-spectrum SPF 50+ sunscreen. Avoid tanning beds and seek shade when you're outdoors.

What Should I Do if I Have a Squamous Cell Carcinoma?

If you have an SCC, make an appointment to see a dermatologist. Your dermatologist will assess your SCC and suggest the most appropriate treatment tailored for your skin cancer.