SCC on scalp - waiting for surgical excision

Just had an eraser-sized growth on scalp removed and biopsy revealed a SCC. Didnt notice it untiil it was raised about 5 months ago so no idea how long it may have been there as a flat spot. Im olive skinned, dark eyes and hair so not typical candidate for UVA cause. Appt for surgical excision is 3 more weeks and im freaking out worrying about possibility of metastis. in the last year i had a 4mm lung nodule carefully monitored that has now disappeared and nodules in my thyroid which was deteremined benign after needle biopsy and 2 ultrasounds. could this have been caused by too much radiation from x-rays and ct scans ( 3 of each in the past 18 months)? what are the chances of metastis to internal organs? freaking out with worry  and unsure if waiting a month for the surgery is risky? thanks!

[Bhupinder Kaur, MD]

Hello,
It is true that excessive radiations in medical treatments can predispose to squamous cell carcinoma, but it is alone not the causative factor for it. Squamous cell carcinoma is capable of locally infiltrative growth, spread to regional lymph nodes, and distant metastasis, most often to the lungs.

Apart from the surgical excision of the malignancy, topical chemotherapy, topical immune response modifiers, photodynamic therapy (PDT), radiotherapy, and systemic chemotherapy can also be used. For this we have to see the metastasis and staging of the carcinoma. Usually surgery is followed by radiotherapy and chemotherapy.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your dermatologist. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[jc5632]

thank you! but since ive had my lungs carefully monitored for teh past year and half and had ultrasounds on thryoid that includes most of teh neck, wouldnt that increase chances that there is no spread to internal organs and thus a better chance that this is localized and surgical excision will be therapeutic in itself? also, does the biopsy report from teh initial "shave" biopsy provide much detail as to tumor attributes that allow the dermatologist to determine with at least some confidence the risk of spread?