SCC Skin Cancer Surgery

Getting diagnosed with skin cancer can be a highly stressful and unsettling experience. One of the most effective ways to treat this disease, particularly Squamous Cell Carcinoma (SCC), is through skin cancer surgery. This detailed guide will provide you with all the necessary information about SCC skin cancer surgery, covering everything from the procedure itself, its benefits, the ideal candidates, different types, recovery period, and potential risks. With this knowledge, you will be better equipped to make informed decisions about your health and treatment options.

Anca Breahna is a highly respected and experienced consultant plastic surgeon with an outstanding track record in the treatment of skin cancers, including Squamous Cell Carcinoma (SCC).

What is SCC Skin Cancer Surgery?

SCC skin cancer surgery is a medical procedure designed to remove squamous cell carcinomas, a type of skin cancer. These are malignant tumours that develop in the squamous cells, which make up the middle and outer layers of your skin. Squamous cell carcinoma is the second most common type of skin cancer in the UK, right after basal cell carcinoma.

Squamous cell carcinomas can form on any part of your body, but they’re often found on areas exposed to the sun, such as the face, ears, and hands. They usually appear as firm red nodules or flat lesions with a scaly or crusty surface. SCC skin cancer surgery aims to remove these carcinomas completely to prevent them from spreading to other parts of your body.

Who Needs SCC Skin Cancer Surgery?

As mentioned before, the need for SCC skin cancer surgery is largely determined by specific factors relating to your diagnosis and overall health. Let’s take a more in-depth look at each:

Size, Depth, and Location of the Carcinoma

• Size and Depth: Larger and deeper squamous cell carcinomas are more likely to spread to the surrounding tissues or even to the lymph nodes. For such carcinomas, surgery is often the most effective treatment option to ensure complete removal of the cancerous cells
• Location: Carcinomas located on areas of the body like the face, ears, hands, or feet are often best treated with surgery. These areas are more sensitive and more visible, so the precision of surgical removal is beneficial

High-Risk Features

• Nerve Involvement: If the carcinoma involves nerves (referred to as perineural invasion), it’s considered high-risk. The involvement of nerves can lead to a higher risk of recurrence and spread; hence, surgical intervention becomes necessary
• Unclear Margins: Sometimes it can be difficult to establish the exact boundaries of the carcinoma. In such cases, surgical removal can ensure that no cancerous cells are left behind
• Rapid Growth: A rapidly growing squamous cell carcinoma indicates aggressive behaviour and poses a higher risk of spread, therefore, necessitating surgery

Weakened Immune System: If your immune system is compromised due to conditions like HIV or treatments like chemotherapy, your body may struggle to fight off cancer cells. In such cases, surgery can be a valuable option to prevent further spread of the carcinoma

Ineffectiveness of Other Treatments: If you have previously tried other treatments such as cryotherapy, radiation, or topical medications and these have not been effective, or if they’re unsuitable for your situation, then surgery would be recommended

Benefits of SCC Skin Cancer Surgery

SCC skin cancer surgery brings numerous benefits, playing an essential role in skin cancer management:

• Effective Removal: The primary aim of this surgery is to fully remove the squamous cell carcinoma. By extracting the cancer cells, you significantly reduce the risk of the cancer spreading to other areas of your body
• Preserves Healthy Skin: These procedures are designed to minimise damage to your healthy skin. Anca uses precise methods to target only the cancerous cells, leaving your healthy skin intact
• Decreases Recurrence: Surgery reduces the likelihood of the cancer recurring, leading to better long-term outcomes
• Immediate Results: Unlike other treatments that take time to show results, surgery provides an immediate solution to the problem

Types of SCC Skin Cancer Surgery

There are several surgical procedures available to treat squamous cell carcinoma, each with distinct characteristics. Let’s look more in-depth at each of these types:

Excisional Surgery

• Description: Excisional surgery involves using a scalpel to remove the cancerous growth along with a border of healthy skin, known as the margin, to ensure complete removal of the cancer
• Suitability: This is often the first choice for small and well-defined squamous cell carcinomas. It can be performed in almost any location on the body
• Considerations: The size of the excised area can lead to a noticeable wound. If the wound is large, it might need to be covered with a skin graft or skin flap

Mohs Surgery

• Description: In Mohs surgery, the surgeon removes the cancer layer by layer, examining each layer under a microscope until no cancer cells are detected. This approach maximises the preservation of healthy skin while ensuring complete cancer removal
• Suitability: Mohs surgery is beneficial for larger cancers, those with unclear boundaries, or in cosmetically sensitive areas. It’s also used for cancers that have recurred after previous treatment
• Considerations: It can be a time-consuming procedure as your plastic surgeon needs to examine each layer of skin during the operation. However, it has a high cure rate and typically leaves the smallest possible scar

Curettage and Electrodessication

• Description: Anca scrapes away the cancer with a curette, a sharp, spoon-shaped instrument, then uses an electric needle (electrodesiccation) to destroy any remaining cancer cells and control bleeding
• Suitability: This is typically used for small, well-defined squamous cell carcinomas
• Considerations: The procedure may need to be repeated during the same session to ensure all cancer cells are removed. It’s generally less effective for aggressive squamous cell carcinomas or those in high-risk areas

Laser Surgery

• Description: Laser surgery uses a powerful beam of light to vaporise the cancer cells. It’s a non-invasive procedure that doesn’t involve any cuts or stitches
• Suitability: This can be used for superficial squamous cell carcinomas that are limited to the outermost layer of skin
• Considerations: Laser surgery might not be suitable for larger, deeper tumours or those in certain locations. It also requires a high level of expertise to ensure the precise targeting of cancer cells

How is the SCC Skin Cancer Surgery Performed?

The specific process depends on the type of surgery you’re having, but generally, here’s what you can expect:

• The area around the cancer will be cleaned and marked
• You’ll receive a local anaesthetic to numb the area
• Using the appropriate surgical method, Anca will remove the cancer
• Once all the cancer is removed, the wound will be closed with stitches or covered with a skin graft or flap, if necessary
• The removed tissue will be sent to a laboratory to ensure all the cancer has been eliminated

Recovery after SCC Skin Cancer Surgery

The recovery process following SCC skin cancer surgery will depend on several factors, such as the type of surgery performed, the size and location of the removed carcinoma, and your general health. Here, we’ll delve into the various aspects of recovery and what you might expect:

Bandaging and Wound Care

• Immediately after surgery, the wound will be covered with a bandage or dressing, which serves to protect the area and aid in healing. Your plastic surgeon will instruct you on how often and when to change this dressing
• It’s crucial to keep the wound clean and dry to prevent infections. Anca will provide guidelines on how to clean the wound, and when it’s safe to resume bathing or showering

Pain Management

• Some level of pain or discomfort can be expected following surgery. This can usually be managed with over-the-counter pain relievers such as paracetamol. If the pain is severe, your surgeon might prescribe stronger medication
• Ice packs can be used to reduce swelling and provide some pain relief. However, ensure you wrap the ice pack in a cloth to prevent direct contact with your skin

Follow-Up Visits

• You’ll have follow-up appointments with Anca to monitor your healing process and to address any concerns you might have
• If stitches were used during surgery, they may need to be removed during one of these appointments. This is typically done 1-2 weeks after the surgery

Activity Levels

• You can resume your regular activities within a week or two. Your plastic surgeon may advise you to avoid strenuous activities for a specific period to avoid putting pressure on the surgical wound
• It’s also advised to avoid direct sunlight on the surgical site as your skin will be more sensitive and susceptible to sunburn. If you need to go out in the sun, use a broad-spectrum sunscreen with at least SPF 30 and wear protective clothing

Emotional Recovery

• The emotional recovery after skin cancer surgery is as important as physical recovery. It’s normal to feel a range of emotions, from relief to worry. You might find it beneficial to talk to a mental health professional or a support group if you’re finding it difficult to cope

Risks of SCC Skin Cancer Surgery

While SCC skin cancer surgery is generally safe, no surgery is without risks. Here are some potential complications associated with SCC skin cancer surgery:

• Scarring: Any form of surgery can leave a scar. Depending on the size and location of the carcinoma, this scar may be more or less visible
• Infection: As with any surgery, there’s a small risk of infection. It’s important to keep the wound clean and follow your plastic surgeon’s instructions to minimise this risk
• Nerve damage: If the carcinoma is near nerves, there’s a risk of nerve damage during surgery. This could lead to numbness or weakness in the area
• Recurrence: There’s always a chance that the cancer could come back, even after successful surgery. Regular follow-up appointments will help your plastic surgeon catch any signs of recurrence early

 Medical References about SCC Skin Cancer

• Skin Cancer: Squamous and Basal Cell – American Cancer Society
• Squamous Cell Carcinoma of the Skin – Mayo Clinic
• Squamous Cell Carcinoma – British Association of Dermatologists
• Squamous Cell Carcinoma of the Skin – Medscape
• Squamous Cell Carcinoma: Symptoms, Causes & Treatment – Cleveland Clinic