Squamous Cell Carcinoma (SCC)

Serving Hamilton, Stoney Creek, Grimsby and surrounding areas

Squamous Cell Carcinoma – Chest

Ulcerated Squamous Cell Carcinoma (SCC) – Temple

Ulcerated Squamous Cell Carcinoma (SCC) – Lip

Ulcerated Squamous Cell Carcinoma (SCC) – Scalp

Squamous Cell Carcinoma arising in Bowen’s Disease – Trunk

Ulcerated Squamous Cell Carcinoma (SCC) – Forehead

Keratoacanthoma Type of Squamous Cell Carcinoma (SCC)

Squamous Cell Carcinoma – Lip

Microdermabrasion to Prepare the Skin Before a Levulan PDT Treatment

Levulan being applied to the skin prior to PDT activation

Blue Light activation of Levulan during PDT Treatment

Blue Light used to activate Levulan

IPL Machine – Used for Levulan activation in Levulan IPL-PDT

Squamous Cell Carcinoma (SCC):

  • Is often a rough, skin coloured, or pink bump
  • May sometimes ulcerate or bleed
  • Is a skin cancer of intermediate severity
  • May be as small as a 2 to 3 mm and as large as 20 cm or more across
  • Is usually present on sun exposed areas such as the ears, lips, nose, face and tops of the hands
  • Is caused by the sun exposure that occurred 10 to 70 years before the spots appear
  • May spread internally
  • Is rarely lethal
  • Is not melanoma

Prevention of Squamous Cell Carcinoma, and other skin cancers:

  • Wear a hat with a broad brim and protective clothing (e.g. long sleeves)
  • Avoid the outdoors when the sun is strongest between the hours of 10 am to 3 pm
  • Use a sunscreen year round with an SPF of at least 30
  • Wear a sunscreen which resists water and sweating and which protects against both UVA and UVB
  • Reapply sunscreen every hour if you are in water or sweating heavily
  • Wear sunscreen even if you are in the shade, it is still possible to burn
  • Avoid tanning beds
    • The ultraviolet light tanning beds produce is known to cause skin cancer
    • This treatment combines a medication called Levulan with either

What are the advantages of Levulan PDT compared with other treatments?:

    • Unlike creams it has the advantage of being able to treat large areas in a single visit
    • Unlike liquid nitrogen, the treatment is not painful
    • It treats precancerous spots before they can be seen
      • Preventing skin cancer from developing

Levulan-IPL Photodynamic Therapy:

    • Almost any area can be treated including:
      • Face and neck
      • Arms and hands
      • Feet and legs
      • Chest and back
      • Scalp
    • The Levulan-IPL PDT treatment works with most skin types (I-IV) (from pale Caucasian to dark European and very light Asian)
    • Levulan-IPL PDT cannot be used for darker skin types (V, VI) (South Asian, African) or if you have a tan
      • In this situation  I recommend Blue Light PDT instead, which:
        • Can be used in all skin types
        • Can be used even if the skin is tanned
        • To learn more about Blue Light PDT, please click here
    • As an added bonus, Levulan PDT also treats:
      • Brown freckling
      • Enlarged pores
      • Sun damage
      • Depleted skin collagen
    • All of these lead to smoother, younger looking skin and reduced redness at the same time
    • The cost of Levulan PDT is partially covered on most private drug insurance plans
    • The cost of Levulan PDT is not covered on the Ontario ODSP (OHIP) drug plan for patients over 65 years of age
    • If you would like to learn more about Levulan PDT for the treatment of superficial basal cell carcinoma, and skin cancer prevention, please click here

Treatment:

Electrodessication and Curettage (Small Squamous Cell Carcinomas):

  • The skin around the squamous cell carcinoma is injected with a local anesthetic to numb the area
  • The injection stings for a few seconds
    • After this, there is no pain or discomfort
  • The squamous cell carcinoma is removed from the skin in a scraping motion with an instrument called a curette
  • As the area is numb from the anesthetic, this process is not painful
  • The curetted area is then treated with electrocautery, a hot electric needle
    • This is not painful as the area is still numb
  • Electrocautery stops and bleeding and kills any residual cancer cells
  • The lesion is scraped and cauterized a total of 3 times in one visit
  • No stitches are required
  • Antibiotic and a bandage are used to cover the wound
  • The day after surgery, the bandage should be removed and a small amount of antibiotic should be be applied
    • This should occur twice daily site is healed
  • Redness, pain, swelling or a discharge from the wound may be a sign of infection
    • The doctor should be informed immediately
  • You may bathe, shower and do your normal activities unless the squamous cell carcinoma that has been removed is very large and there is a risk of the wound being damaged
    • The doctor will inform you about this
  • There is a small chance that the squamous cell carcinoma could grow back

Surgical Excision (All types of Squamous Cell Carcinoma):

  • The skin around the squamous cell carcinoma is injected with a local anesthetic to numb the area
  • The injection stings for a few seconds
    • After this, there is no pain or discomfort
  • The squamous cell carcinoma and a small amount of surrounding normal skin is cut with a scalpel and removed
  • As the area is numb from the anesthetic, this process is not painful
  • Stitches are used to close the opening
  • Antibiotic and a bandage are used to cover the wound
  • The day after surgery, the bandage should be removed and a small amount of antibiotic should be be applied
    • This should occur twice daily until the stitches are removed
  • Redness, pain, swelling or a discharge from the wound may be a sign of infection
    • The doctor should be informed immediately
  • The stitches are removed in 5 to 10 days
  • The removal of stitches is painless
  • You may bathe, shower and do your normal activities unless the squamous cell carcinoma that has been removed is very large and there is a risk of the wound being damaged
    • The doctor will inform you about this
  • There is a small chance that the squamous cell carcinoma could grow back

Radiation (All types of SCC):

  • To receive radiotherapy of a squamous cell carcinoma, the lesion must be biopsied (sampled) first
  • To do the biopsy:
    • The skin around the squamous cell carcinoma is injected with a local anesthetic to numb the area
    • The injection stings for a few seconds
      • After this, there is no pain or discomfort
    • A small portion of the squamous cell carcinoma is removed
    • As the area is numb from the anesthetic, this process is not painful
    • Stitches are usually not necessary to close the opening
    • The biopsied area is then treated with electrocautery, a hot electric needle
      • This is not painful as the area is still numb
    • The electrocautery is used to stop any bleeding
    • Antibiotic and a bandage are used to cover the wound
    • The day after surgery, the bandage should be removed and a small amount of antibiotic should be be applied for 1 week
    • Redness, pain, swelling or a discharge from the wound may be a sign of infection
      • The doctor should be informed immediately
    • If stitches were used, they are removed in 5 to 10 days
    • The removal of stitches is painless
    • You may bathe, shower and do your normal activities after the biopsy
  • Once the biopsy result is available the doctor will make a referral to a radiation specialist
  • In Hamilton, the radiation treatments and specialists are located at the Juravinski Cancer Centre next to the Henderson General Hospital
  • The first visit with the radiation specialist is for an assessment only
  • If he or she agrees with your doctor that the lesion is suitable for radiation, treatments will be arranged
  • Most squamous cell carcinomas required 10 to 15 treatments
    • These are done daily, Monday to Friday over a period of 2 to 3 weeks
  • After the radiation is complete, the spot will become red, scabby and crusted
  • This will heal over the next few weeks
  • There is a small chance that the basal cell carcinoma could grow back

Mohs Micrographic Surgery (Complicated SCC) :

  • Mohs micrographic surgery is a detailed surgical procedure to treat aggressive non-melanoma skin cancers, mainly on the face and neck
  • This treatment is usually reserved for the most complicated cases
  • For appropriate patients in the Hamilton area, referrals are made to the Mohs Centre at Women’s College Hospital in Toronto
  • Initially, the diagnosis must been confirmed with a biopsy (see above), prior to the referral being made

What if you are interested to learn more about Levulan PDT?

  • If you would like to learn more:
    • Please click on the blue text links above
    • E-Mail Us
    • Or call our aesthetic centre directly at (905) 549-7873 to book a free consultation with one of our knowledgeable technicians

Would you like to see a Video Demonstration?

  • I am pleased to offer a new section on the website with video demonstrations of various procedures
  • To watch a video-clip in which Dr. V talks about: