After Treatment Ends

What Happens After Treatment Ends?

When initial treatment for squamous cell skin cancer (SCSC) is finished, it typically means there is no evidence of disease remaining. But because cancers can return and you are predisposed to skin cancer, some steps will be necessary for the rest of your life to stay vigilant against recurrences.

Within five years of treatment, an estimated 13-50% of patients with SCSC will develop another SCSC. The risk for SCSC is highest within two years of treatment ending. You are also at risk for developing other types of skin cancers, such as melanoma and basal cell carcinoma (BCC).

Follow Up Appointments

If you had low-risk SCSC, follow-up appointments should occur every three to 12 months for the first 2 years, then every six to 12 months for three years, and then annually for life. If you had high-risk SCSC, follow-up appointments should occur every three to six months for the first two years, then every six to 12 months for three years, and then annually for life. If you had very high-risk SCSC, follow-up appointments should occur every three to six months for the first two years, then every six months for three years, and then every six to 12 months for life.

If your SCSC spread beyond the skin, the schedule for follow-up appointments is more frequent. Regional or metastatic SCSC survivors should have an appointment every two to three months for the first year, then every two to four months for the second year, then every four to six months for the third through fifth years, and then every six to 12 months for life. Imaging may be a part of some exams.

Checking Your Lymph Nodes

If you had SCSC that spread, your healthcare provider will need to regularly examine your lymph nodes.  You can also check your lymph nodes at home: Use your fingertips in a gentle circular motion to evaluate the areas containing lymph nodes. Feel for unusual changes, enlargements beyond a pea size, hard lumps, or differences between one side and the other. Check lymph nodes in your neck, armpits, and groin.

Sun Protection

It is vital that you protect your skin from exposure to UV radiation. Avoid excessive exposure to the sun and do not use indoor tanning equipment. If you are outdoors, seek shade, wear a broad-spectrum sunscreen with SPF 30 or higher or use an umbrella or parasol to block the sun. Wear protective clothing, sunglasses, and a wide-brimmed hat.

Prescription Therapies for Prevention

Your clinician may prescribe additional therapies, particularly if actinic keratoses develop or your SCSC was categorized as high-risk or very-high-risk. Topical fluorouracil, imiquimod, or photodynamic therapy could be recommended and prescribed for precancerous changes. Oral retinoids, acitretin, and isotretinoin may be effective against the development of actinic keratoses and SCSC among patients with high-risk and very high-risk SCSC. Topical 5-fluorouracil with or without calcipotriol, topical imiquimod, and topical tirbanibulin may be prescribed to treat precancers on your skin.

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