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What is squamous cell carcinoma and how does it differ from BCC?
Both BCC and SCC are non-melanoma skin cancers arising from keratinocytes. BCC is more common and almost never spreads beyond the skin. SCC grows more rapidly and carries a small but real risk — typically around 3–5% for lower risk lesions — of spreading to lymph nodes. High-risk SCC (large, poorly differentiated, or arising in immunosuppressed patients) carries a higher risk and requires more aggressive management.
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What does squamous cell carcinoma look like?
SCC commonly presents as a firm, red or skin-coloured nodule, a non-healing wound or ulcer, a crusty or scaly plaque, or a wart-like growth on sun-exposed skin. It often develops in areas of pre-existing sun damage or within actinic keratoses. Any persistent, growing, or non-healing skin lesion should be assessed by a dermatologist.
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Is surgery always necessary?
For most SCCs, surgical excision is the treatment of choice and offers the highest cure rate. For certain superficial, low-risk tumours — particularly in patients who are not suitable candidates for surgery — topical treatments, curettage, or radiotherapy may be considered. Your surgeon will recommend the most appropriate approach based on your specific tumour type and circumstances.
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What happens if the lymph nodes are affected?
If lymph node involvement is confirmed on examination or imaging, surgical removal of the affected lymph nodes (lymphadenectomy) may be recommended. This may be followed by adjuvant radiotherapy and discussed with oncology colleagues. For inoperable disease, systemic immunotherapy is now available and has significantly improved outcomes.
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Will I need radiotherapy after surgery?
Adjuvant radiotherapy following surgical excision is recommended for high-risk SCC — particularly those with involved or very close margins, perineural (nerve) invasion, large tumour size, or specific anatomical locations. Your surgeon will review the histology results and discuss with the oncology team whether adjuvant treatment is indicated.
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How often should I have skin checks after SCC treatment?
Following SCC treatment, regular clinical skin examinations are recommended — typically every 3–6 months for the first 2 years, and then reduced thereafter. Patients with a history of SCC have a substantially increased risk of developing further skin cancers. Sun protection, self-examination, and prompt reporting of any new or changing lesions are important components of long-term follow-up.
Your Patient Journey
1. Your
Consultation
Your surgeon will review any existing biopsy report, examine the lesion and regional lymph nodes, and perform a whole body skin check. They will arrange any required scans / imaging if indicated. The surgical plan — including excision margins, closure technique or reconstruction, and any requirement for further treatment such as radiotherapy— is explained fully. A personalised treatment plan is agreed before consent is obtained.
