Squamous cell carcinomas may be treated in several different ways, depending on their size, location, and depth.
If the cancer is superficial, it may be treated with a topical medication, such as imiquimod. This is a form of chemotherapy, but unlike many other types of chemotherapy, the medicine is applied to the skin rather than being taken orally or injected.
Another type of topical treatment is photodynamic therapy, in which the doctor applies a topical medication that is activated by strong light. This technique is useful for treating squamous cell carcinomas on the face or scalp.
Some squamous cell carcinomas are treated by curettage and electrodessication, which means that the doctor scrapes off the growth and then dries the site with an electrocautery needle. This technique is commonly used for small squamous cell carcinomas but is not recommended for larger ones.
In another technique, called cryosurgery, liquid nitrogen is applied to the tumor to freeze it. The tumor becomes dry and crusty-looking, and it eventually falls off. The procedure may need to be repeated several times until all of the abnormal tissue is gone. This procedure is used for relatively small tumors, but it is not used for tumors on the nose, eyelids, scalp, ears, or legs. It is not recommended for use on large tumors.
Sometimes, squamous cell carcinomas are treated by excisional surgery, in which a surgeon removes the tumor along with an area of normal skin around it. The tissue that has been removed is sent to a laboratory for examination to make sure that the cancer has been removed completely.
In another type of surgery, called micrographic surgery, the doctor removes the tumor and then removes surrounding skin one layer at a time, checking each layer under a microscope to make sure that all the cancer has been removed. This technique works very well, and it is often used for cancers on parts of the body where it is important to save as much healthy tissue as possible, such as the fingers. Micrographic surgery is particularly useful for treating squamous cell carcinomas larger than 4/5 inch (2 cm) in size, for those that have come back after previous treatment, for those that have spread along the nerves under the skin, and for those on certain areas of the face or genitals.
Laser surgery is often used to treat squamous cell carcinomas that are located on the lips, face, or scalp.
Radiation therapy is considered a good form of treatment for older patients with large squamous cell carcinomas, especially if the cancer is located in an area where it is difficult to perform surgery, such as the eyelids, ear, or nose. Radiation may also be used if the doctor is unsure that all of the cancer cells were removed during surgery, if a squamous cell carcinoma recurs, or if a cancer has become too large or too deep to be removed by surgery.
Lymph node dissection (surgery to remove lymph nodes near the tumor) is sometimes recommended for patients with squamous cell carcinoma if the doctor suspects that cancer may have spread to the lymph nodes. If squamous cell carcinoma has spread to the lymph nodes or to other parts of the body, systemic chemotherapy (chemotherapy given as an oral or injected medicine that travels to all parts of the body through the bloodstream) may also be used.
It is a good idea for patients to discuss treatment options for squamous cell carcinoma with their doctors to find out why a particular treatment is recommended, what its pros and cons are, and what side effects there might be. Some patients may want to get a second opinion before agreeing to a particular type of treatment.