Squamous cell carcinoma is the most common form of skin cancer. It usually occurs in people who have fair skin and are in their teens or twenties, but it can also occur at any age. There are various types of squamous cell carcinoma: adenoid/pseudoglandular squamous cell carcinoma, intraepidermal squamous cell carcinoma, large cell keratinizing squamous cell carcinoma, large cell non-keratinizing squamous cell carcinoma, lymphoepithelial carcinoma, papillary squamous cell carcinoma, papillary thyroid carcinoma, small cell keratinizing squamous cell carcinoma, spindle cell squamous cell carcinoma, and verrucous squamous-cell carcinoma.
Cutaneous squamous cell carcinoma treatment usually starts with removal of the affected tissue. Treatments include, PD-1 inhibitors, radiation therapy, and photodynamic therapy, excisional surgery, Mohs surgery, cryosurgery, curettage and electrodesiccation (electrosurgery), laser surgery, and topical medications.
PD-1 Inhibitors
Nivolumab and pembrolizumab are PD-1 inhibitors approved for cutaneous squamous cell carcinoma treatment. Nivolumab is a human immunoglobulin G4 monoclonal antibody that binds to the PD-1 receptor and blocks its interaction with PD-L1 and PD-L2. This in turn releases PD-1 pathway-mediated inhibition of the immune response, including the anti-tumor immune response, thereby halting tumor growth.
Pembrolizumab binds to and blocks PD-1 located on lymphocytes. In June 2020, the U.S. FDA approved Merck’s KEYTRUDA, an anti-PD-1 therapy, as monotherapy for the treatment of patients with recurrent or metastatic cutaneous squamous cell carcinoma.
Radiation Therapy
Radiation therapy is primarily used in cutaneous squamous cell carcinoma treatment when the squamous cell carcinomas are hard to treat surgically. The therapy is a good option for those who suffer from other diseases and are not advised surgery and for people over the age of 65 and above. In RT, low-energy X-ray beams are used to eliminate cancer cells without the need for anesthesia.
Photodynamic Therapy
This cutaneous squamous cell carcinoma treatment can be used in combination with other treatments. In photodynamic therapy, a light-sensitizing topical agent is applied on the affected area and left for absorption. A laser is directed at the affected area to eliminate the cancer cells. The procedure does not affect healthy tissues. It can be used for some superficial squamous cell carcinomas on the face.
Excisional Surgery
Excisional surgery is used in cutaneous squamous cell carcinoma treatment at an early stage. At this stage, early squamous cell carcinomas are not spread extensively. In the surgery, a scalpel is used to remove the entire tumor along with some normal tissue that surrounds the affected area.
Mohs surgery
Mohs surgery is a precise surgical technique used in cutaneous squamous cell carcinoma treatment. It is used to remove and examine individual layers of cancer tissue. The tissues are examined under a microscope one at a time until all cancer tissue has been removed. The surgery is generally considered very safe. However, it has some side effects such as bleeding from the site of surgery.
Cryosurgery
Ccryosurgery is used for cutaneous squamous cell carcinoma treatment in the early stage for those who can't have surgery.
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