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Squamous Cell Carcinoma

What is a squamous cell carcinoma?

A squamous cell carcinoma is a type of skin cancer that can occur in any part of the body. 

What causes squamous cell carcinoma?

Many squamous cell carcinomas arise as a result of excessive exposure to sunlight, chronic irritation or at the site of a previous unhealed ulcer, which has been present for a long time.

What are the features of a squamous cell carcinoma?

Squamous cell carcinomas usually present as a nodule or an ulcer that grows rapidly, weeps, bleeds or gets infected. 

How is a squamous cell carcinoma treated?

The treatment for a squamous cell carcinoma usually involves surgical excision.  For small lesions this can be carried out under local anaesthetic. Larger lesions may require either a skin graft or a skin flap to heal the area that results from removal of the squamous cell carcinoma. Unless the lesion is very large and requires a significant-sized skin graft these procedures are usually carried out as day cases.

Very occasionally for small or superficial lesions it may be appropriate to treat the lesion with a cream applied to the skin or radiotherapy. 

What is the aftercare following surgery for a squamous cell carcinoma?

Following your surgery you will be asked to attend a dressing clinic where the specialist Plastic Surgery  Nurses will remove your sutures approximately one week following the operation. You will have an appointment to come and see me approximately two weeks following your surgery when he will be able to discuss the histology result with you.  In most cases I will see you at the end of three months to ensure that the scar has healed well and that there is no sign of recurrence of the original lesion. 

Can a squamous cell carcinoma spread to other parts of the body?

There are different types of squamous cell carcinomas and they are graded on the basis of the aggressiveness of the tumour.  Small and well-differentiated squamous cell carcinomas are unlikely to spread.  Very large lesions which have been present for a long time and are poorly differentiated have a greater potential to metastasise (spread) to other parts of the body.  The most likely mode of spread is via the lymphatic system to the lymph nodes which drain the area in which the original squamous cell carcinoma is located.  In very advanced or longstanding lesions one may see a spread of the squamous cell carcinoma to other parts of the body via the blood stream such as the lungs. 

Do I need any further investigations following my surgery?

Depending upon the size of the squamous cell carcinoma and the degree of differentiation I will discuss the need for further investigations, such as a scan of the lymph nodes, an x-ray or a CT scan of the chest and/or abdomen. In the vast majority of cases patients do not need further investigations but are followed clinically.

How will I be followed up after surgery?

I will see you for a follow-up appointment approximately a fortnight after your initial operation. Depending on the nature of the lesion, further appointments will be scheduled, either on a monthly or bi-monthly basis initially and then subsequently every three months in the third year and every six months in the fourth and fifth years after your initial surgery. In small and well-differentiated lesions the period of follow up may be shorter and the intervals may be spaced out further. 

Where can I get further information about a squamous cell carcinoma?

A sensible site to visit is www.cancerbackup.org.uk. This site is written by doctors, nurses and patients and presents the available information on skin cancer in a readable and non-sensationalised format. It will provide you with useful background information as to why certain treatments or tests are being carried out and what you can expect during the course of your treatment.

The MacMillian Cancer Trust page on squamous cell carcinoma is also worth visiting.

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After some research I contacted Mr Sood at the Roding Hospital about the possibility of surgery and the outcome I could expect, I found his approach optimistic and professional with a real understanding of the problem.

Tony

Sincere thanks go to all patients that grant their permissions for us to display their photographs.


Excision and local flap for keratoaicanthoma


Squamous Cell Carcinoma

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