This is the fifth part of our series about the condition based on our patient booklet “Fast Facts for Patients and their Supporters: Advanced Cutaneous Squamous Cell Carcinoma”. This article lists the treatment options for cutaneous squamous cell carcinoma (cSCC).

Treatments

Surgery

Wide Local Excision

The aim of wide local excision is to remove the cancer and an area of normal skin around the cancer, and then reconstruct the skin and surrounding area.

The area of normal skin is called the margin and it is sent to the laboratory to check for signs of cancer. If the margin is clear, it is likely that all the cancer has been removed. The pathologist will also check for high-risk features in samples of the cancer.

Wide local excision

Mohs Micrographic Surgery

Mohs micrographic surgery is used for some locally advanced cancers. During surgery, layers of skin are removed and checked for cancer. This continues until all the cancer has been removed.

Mohs micrographic surgery

Radiation Therapy (Radiotherapy)

Sessions of radiation therapy might be recommended:

  • to prevent advanced cSCC from returning after it has been completely removed with surgery (adjuvant therapy), or
  • to treat any remaining cancer cells if the cancer cannot be completely removed with surgery, or
  • to treat advanced cSCC that cannot be treated with surgery (definitive therapy), or
  • if it can help relieve pain or symptoms of incurable cSCC (palliative radiation).

First, a customized mask or mold is made. This is worn during each treatment so that you are in the same position every time. Then images are taken and treatment is planned. Tiny markings or tattoos may be needed to make sure you are in the same position every time.

Radiation therapy (radiotherapy)

Side Effects

Side effects can include fatigue, loss of appetite, skin changes or hair loss. If your head or neck is involved, you may develop mouth sores, changes in taste, tooth decay or trouble swallowing.

Systemic Treatment

Systemic treatment is needed if cSCC has spread throughout the body. Your treatment will be prescribed by a specialist in medical cancer treatment (oncologist). Talk to your oncologist about your treatment options, and the risks and benefits of each choice.

Chemotherapy

This kills the cancer cells directly. Potential side effects include: nausea, vomiting, loss of appetite, hair loss, fatigue, anemia (low level of red blood cells), risk of infection, hearing changes/ringing in ears, neuropathy (numbness and tingling in hands and feet).

Targeted Molecular Inhibitors

These kill cells by blocking specific cancer behaviors. Potential side effects include: rash, eye changes, diarrhea, nausea, decreased appetite, constipation, neutropenia (low white blood cell counts), risk of infection, liver problems, lung problems.

Immunotherapy

This overcomes the way cancer hides from the body’s immune system so the body’s immune defenses work against the cancer cells. Potential side effects include: fatigue, rash, diarrhea, nausea, decreased appetite, constipation, muscle aches, autoimmune problems.

 

Please check out the other posts of our series here:

 

Information based on Fast Facts for Patients and their Supporters: Advanced Cutaneous Squamous Cell Carcinoma (Karger, 2020).

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