Worried about skin cancer?

Squamous cell carcinoma (SCC) is a type of skin cancer associated with lifetime exposure to ultraviolet light on fair skin. It therefore typically occurs on skin exposed regularly to sunlight such as the face, arms or lower legs. 

It tends to present as a lump on the skin which develops over a few months and is often sore or painful to touch or when knocked. In some cases, the skin might break down leaving an ulcer in the centre with raised edges. Bleeding is also common. 

If you are concerned you might have a squamous cell carcinoma developing on your skin, you should see a Consultant Dermatologist for assessment with a dermatoscope. 

Treatment for squamous cell  carcinoma may involve the following:

• A biopsy may first be considered to check the diagnosis. This involves taking a small sample from the lesion and sending it for urgent analysis under the microscope by a histopathologist. 
• In some cases, your Dermatologist will advise that you proceed straight to an excision where the lesion is removed with a margin to try and ensure it is fully removed. The skin is then brought back together with stitches. In most cases, this will result in a line scar about three times as long as the lesion you had removed. The sample will be sent for urgent analysis and you will be informed of the result as soon as it is available. 
• Radiotherapy may also be considered. This is a painless treatment where x-rays are used to treat the lesion. You typically need to attend on numerous occasions to provide the full course. This is often not considered first line treatment as there is a higher risk of future recurrence although in most cases it will still be successful. It may be necessary to have radiotherapy if there is a reason you cannot have surgery or if this is your preference. 
• In some cases, you will be advised to have radiotherapy after your surgery, particularly if the margins are close or where there are certain high risk features which increase the chance of recurrence. 

In most cases, once a squamous cell carcinoma has been removed it does not cause any further problems in the future. 

The risk of SCC coming back at the scar site or spreading to the glands (lymph nodes) will depend on the features seen under the microscope. You will be informed whether the SCC is low risk (unlikely to come back) or high risk (higher chance of coming back). 

If the lesion has any higher risk features, you may be advised to have your skin and lymph glands monitored for a 2-3 year period. At each appointment, your Dermatologist can examine any lesions of concern and check there is no sign of recurrence. 

You will receive contact details for the Consultant or Skin Cancer Nurse specialist so that you can contact if you have any questions or concerns between appointments.