Why Your Dermatologist May Recommend Mohs Surgery for Squamous Cell Carcinoma (SCC)

On average, more than 5.4 million cases of nonmelanoma skin cancer are treated every year in more than 3.3 million patients, according to The Skin Cancer Foundation. This type of skin cancer comes in two main forms: basal cell carcinomas (BCC), which are the most common, and squamous cell carcinomas (SCC), slightly less common. Both forms of skin cancer are named for the skin cells they affect. Basal cells grow in the lowest layer of the epidermis while squamous cells make up the middle and upper layers of the skin.

A squamous cell carcinoma primarily develops when the skin is exposed to ultraviolet (UV) radiation for extended periods of time. The energy of these UV rays, which come from sunlight and tanning beds, can damage the DNA of skin cells, causing them to mutate and grow out of control. These mutations result in red, scaly bumps, patches, or open sores, which can continue to grow and spread, damaging more healthy tissue in the process. SCCs can occur just about anywhere on the body, whereas BCCs are typically limited to the head and neck areas. Still, most SCCs appear in sun-exposed areas, which include the face, backs of hands, lips, ears, etc.

The good news is that most SCCs are easily treated and removed, especially when detected early in their development. There is more than one way to eliminate SCCs. The main options include:

• Surgical Excision: a scalpel is used to cut out the tumor and a portion of surrounding tissue
• Electrodesiccation and Curettage: the lesion is scooped out and the wound is sealed via electrical needle
• Cryosurgery: liquid nitrogen freezes and destroys small SCCs
• Mohs Micrographic Surgery: the SCC is removed one layer at a time. Each layer is carefully examined under a microscope to determine the cancer’s location, direction, and depth, and the process repeats until the cancer has been completely removed

All four SCC treatment methods have been proven to work. However, Mohs surgery has become the most prevalent option for most patients with SCCs and BCCs. Let’s go over why your dermatologist might recommend Mohs surgery for SCCs in particular.

Lowest Recurrence Rates

With any type of cancer, there is always a risk of it coming back even after it has been eradicated. This phenomenon is known as recurrence. Of the four SCC treatment methods outlined above, Mohs surgery boasts the lowest recurrence rates. The Skin Cancer Foundation reports that the five-year recurrence rate for SCCs treated by Mohs is somewhere between 3-5%. This is one reason more dermatologists are recommending Mohs for SCCs.

Highest Cure Rates

The ultimate goal of any medical treatment or surgery is to cure the patient. In regards to Mohs surgery, the cure rate is 99% for new cases of skin cancer and 94% for a skin cancer that has recurred. These numbers easily make Mohs the most effective treatment for SCCs, which is why it’s often recommended.

Minimal Cosmetic Damage

Because nonmelanoma skin cancers like BCCs and SCCs are conspicuous (easily seen), removing them can result in cosmetic damage such as scarring which can reduce one’s self-esteem. Wide surgical excisions can lead to the most prominent scars, as a decent amount of healthy tissue can get removed in the process. The precision of the Mohs surgical procedure, on the other hand, is designed to maintain the maximum amount of healthy tissue. While most patients can expect some scarring after Mohs, it’s often less prominent than it would be following a different type of treatment.

Are You a Good Candidate for Mohs Surgery?

Despite the clear advantages of Mohs micrographic surgery for removing SCCs, your dermatologist will only recommend this option if it’s right for you. Smaller, less severe SCCs can often be removed just as well via standard surgical excision or cryosurgery. Additionally, patients who take certain medications or have health histories that might interfere with the procedure might not be eligible to undergo the Mohs procedure. In this case, your dermatologist will recommend a different option. That said, Mohs surgery is also useful for treating skin cancers other than SCCs and BCCs, such as those that lack visible borders, larger lesions in lower-risk areas, tumors that couldn’t otherwise be entirely removed, and more.

Mohs surgery is often recommended by dermatologists for a reason. Here at Premier Dermatology Partners, we’re happy to give our patients additional information regarding skin cancer, SCCs, Mohs micrographic surgery, and more. To learn more about our team and all the services we provide, contact us.