Your Biopsy Result
Your skin biopsy has shown Squamous Cell Carcinoma (SCC), one of the most common types of skin cancer.
Although hearing the word “cancer” is understandably frightening, it is important to know that most squamous cell carcinomas can be completely cured when they are diagnosed and treated early.
The purpose of this handout is to explain:
- What SCC is
- Why it develops
- How serious it is
- Why surgery is needed
- What your treatment options are
- How to reduce your risk of developing additional skin cancers
What is Squamous Cell Carcinoma?
Your skin is made up of several layers.
The outer layer of the skin (called the epidermis) contains flat skin cells known as squamous cells.
These cells constantly replace older skin cells throughout your life.
When years of sun damage permanently injure the DNA inside these cells, they may begin growing abnormally.
Over time, some of these abnormal cells become Squamous Cell Carcinoma (SCC).
SCC is the second most common type of skin cancer, after basal cell carcinoma.
Is Squamous Cell Carcinoma Dangerous?
Yes—but in most cases it is highly treatable.
Unlike basal cell carcinoma, SCC has the ability to spread to:
- nearby lymph nodes
- surrounding tissues
- other organs (in uncommon cases)
Fortunately, the vast majority of SCCs are cured completely when treated early.
The risk of spread depends on several factors, including:
- the size of the tumour
- how deeply it has grown
- where it is located
- whether it has returned after previous treatment
- whether the immune system is weakened
- certain microscopic features seen by the pathologist
Why Did I Develop SCC?
The Main Cause: Years of Sun Exposure
The most common cause is long-term exposure to ultraviolet (UV) radiation.
This includes:
- sunlight
- tanning beds
UV radiation damages the DNA inside skin cells.
Although your body repairs much of this damage, repeated exposure over many years causes permanent mutations.
Eventually, these damaged cells may become cancerous.
SCC usually develops after many years of accumulated sun damage, which is why it is more common later in life.
Common Areas Where SCC Occurs
SCC usually develops on skin that has received the most sun exposure throughout life.
These include:
- Face
- Nose
- Lips
- Ears
- Scalp (especially in people with thinning hair)
- Neck
- Forearms
- Hands
- Lower legs
However, SCC can develop anywhere on the body.
Other Risk Factors
You are more likely to develop SCC if you have:
- Fair skin
- Blue or green eyes
- Blond or red hair
- A history of severe sunburns
- Frequent outdoor work or hobbies
- A weakened immune system
- Previous radiation treatment
- Chronic wounds or scars
- Previous skin cancers
- Numerous actinic keratoses (sun-damaged precancerous spots)
What is an Actinic Keratosis?
Many SCCs begin as Actinic Keratoses (AKs).
An actinic keratosis is a precancerous lesion caused by years of sun damage.
Most AKs never become cancer.
However, some gradually develop into SCC.
This is why dermatologists often recommend treating actinic keratoses before they have the opportunity to progress.
What Symptoms Can SCC Cause?
Some SCCs are painless.
Others may:
- grow quickly
- become tender
- bleed easily
- form a crust
- fail to heal
- ulcerate
- become painful
Any skin lesion that continues to grow or fails to heal should be examined promptly.
What Did My Biopsy Show?
Your biopsy confirmed that the abnormal skin lesion is a Squamous Cell Carcinoma.
The biopsy establishes the diagnosis, but in most cases additional treatment is still required.
This is because microscopic cancer cells may remain beyond the visible lesion or biopsy site.
Why Do I Need More Surgery?
Even if most of the visible lesion was removed during the biopsy, cancer cells may still remain around the edges or deeper in the skin.
To make sure all cancer cells are removed, your dermatologist or surgeon will usually recommend a complete surgical excision.
During surgery:
- the biopsy scar is removed
- the cancer is removed
- a small margin of normal-looking skin around the cancer is also removed
This greatly reduces the chance of the cancer returning.
Is This Surgery Urgent?
Yes.
Although SCC usually grows more slowly than melanoma, it should not be left untreated.
Without treatment, SCC may:
- continue growing
- destroy nearby skin and tissue
- invade nerves, cartilage, muscle, or bone
- spread to nearby lymph nodes
- rarely spread to other organs
For this reason, surgery should be arranged as soon as reasonably possible, based on your dermatologist’s and surgeon’s recommendations.
What Type of Surgery Will I Need?
The type of surgery depends on:
- the size of the tumour
- its location
- its microscopic features
- whether it has returned previously
- your overall health
Standard Surgical Excision
This is the most common treatment.
The cancer is removed together with a margin of healthy skin.
The specimen is examined under a microscope to confirm that all cancer has been removed.
Mohs Micrographic Surgery
Some patients are referred for Mohs surgery, especially if the SCC is located on:
- the nose
- eyelids
- lips
- ears
- fingers
- areas where preserving as much healthy skin as possible is important
Mohs surgery removes the cancer layer by layer while each layer is examined immediately under the microscope.
This allows the surgeon to remove all cancer while preserving as much normal tissue as possible.
What Happens After Surgery?
The removed tissue is examined carefully by a pathologist.
The pathology report confirms:
- whether all cancer has been removed
- whether the margins are clear
- whether any additional treatment is necessary
Most patients require no further treatment after complete surgical removal.
Can SCC Spread?
Most SCCs never spread.
However, some SCCs have a higher risk than others.
The risk is higher if the tumour:
- is large
- grows deeply into the skin
- involves nerves (perineural invasion)
- is poorly differentiated (more aggressive under the microscope)
- occurs on the lip or ear
- has returned after previous treatment
- develops in someone with a weakened immune system
Your dermatologist will discuss whether your SCC has any of these high-risk features.
Will I Need Additional Tests?
Most patients with SCC do not need CT scans, MRI scans, PET scans, or blood tests.
Additional imaging is considered only if there are signs that the cancer may have spread or if the tumour has particularly high-risk features.
Will I Need Radiation or Chemotherapy?
For the majority of patients, no.
Complete surgical removal is all that is needed.
Additional treatments such as radiation therapy, immunotherapy, or other medications are reserved for selected patients with advanced, recurrent, or metastatic SCC.
Can SCC Come Back?
Yes.
Even after successful treatment, SCC can occasionally recur in the same area.
The risk is much lower when the cancer has been completely removed with clear margins.
Having one SCC also means you have a greater chance of developing another new SCC or other skin cancers in the future because your skin has already experienced significant sun damage.
How Often Should I Be Checked?
After an SCC diagnosis, regular skin examination will be recommended
The frequency depends on your individual risk factors, but many patients are seen every 3 to 12 months initially.
Regular follow-up allows your doctor to detect:
- new SCCs
- basal cell carcinomas
- melanoma
- precancerous lesions (actinic keratoses)
at an early stage.
How Can I Reduce My Risk?
Protect Your Skin Every Day
Sun protection is one of the most important ways to reduce your future risk.
Use Sunscreen
- Broad-spectrum SPF 30 or higher
- Apply daily to exposed skin
- Reapply every 2 hours when outdoors and after swimming or sweating
Wear Protective Clothing
- Wide-brimmed hat
- Long sleeves
- Long pants when practical
- UV-protective sunglasses
Avoid Peak Sun Hours
Try to stay out of direct sunlight between:
10:00 AM and 4:00 PM
when UV radiation is strongest.
Never Use Tanning Beds
Artificial UV radiation significantly increases the risk of skin cancer.
Examine Your Skin Every Month
Become familiar with your own skin.
Look for:
- new growths
- sores that do not heal
- rough or scaly patches
- rapidly growing bumps
- bleeding lesions
- changing moles
Report any suspicious lesions to your family doctor promptly.
Frequently Asked Questions
Did I do something wrong?
No.
SCC usually develops after decades of accumulated sun exposure. It is very common, especially in fair-skinned individuals and older adults.
Can SCC be cured?
Yes.
Most squamous cell carcinomas are completely cured with appropriate surgical treatment.
Will I get another skin cancer?
Possibly.
Patients who have had one SCC have a higher chance of developing additional SCCs, basal cell carcinomas, actinic keratoses, or melanoma later in life.
This is why lifelong skin surveillance is important.
Can SCC spread to my family?
No.
Squamous cell carcinoma is not contagious and cannot be passed from one person to another.
When Should I Contact My Family Doctor Immediately?
Contact your family doctor promptly if you notice:
- a new rapidly growing skin lesion
- a sore that does not heal
- persistent bleeding from a skin lesion
- increasing pain around the surgical scar
- numbness or tingling near the tumour site
- a new lump in the nearby neck, armpit, or groin (depending on the tumour location)
Do not wait until your next scheduled visit if you notice these changes.
Key Take-Home Messages
- Squamous Cell Carcinoma (SCC) is the second most common type of skin cancer.
- It develops after many years of accumulated sun damage.
- Most SCCs are completely curable when treated early.
- Surgery is recommended because microscopic cancer cells may remain after the biopsy, and complete removal offers the best chance of cure.
- Although SCC has a greater ability to spread than basal cell carcinoma, the overall risk is low for most patients, particularly when treated promptly.
- Lifelong sun protection, monthly self-examinations, and regular dermatology follow-up are essential because people who have had one SCC are at increased risk of developing additional skin cancers.
A Final Reassurance
A diagnosis of squamous cell carcinoma can be upsetting, but the outlook is excellent for most patients.
With timely treatment, careful follow-up, and good sun protection, the vast majority of patients are cured and continue to live healthy, active lives.
Disclaimer
This handout provides general educational information and is not a substitute for personalized medical advice.
Treatment recommendations vary depending on the size, location, pathology findings, and risk features of your tumour.
Always follow the advice of your dermatologist and surgeon regarding your specific treatment and follow-up plan.