Skin Cancer Squamous Cell Carcinoma Treatment
Small SCCs evolving from actinic keratosis are treated by electrodesiccation and curettage. Larger tumors or those on or near the vermilion border of the lips are best excised and should include the subcutaneous fat. Histologic microstaging may help to direct therapy. Tumors thinner than 4 mm can be managed by simple local removal. Patients with lesions that are between 4 and 8 mm thick or that exhibit deep dermal invasion should undergo excision.
Tumors that penetrate through the dermis are staged by the surgeon and treated with several modalities including excisional surgery and Mohs surgery, neck dissection, radiation therapy, and chemotherapy. Larger tumors or those about the nose and eyes require special consideration. When SCC metastasizes, it spreads first to local nodal groups. The combination of Mohs micrographic surgery and sentinel lymphadenectomy may be an option for management of SCCs at high risk for metastasis.
For those patients who are poor surgical candidates, radiation therapy is also a valid means of removal. Routine follow up and lymph node examination for all patients should be performed.