what tests will I have?

If you think you may have SCC, you will need to see your GP. Your GP will ask you questions about your symptoms and your lifestyle. She or he may check your medical history to see what illnesses you have had in the past. Your GP may want to look at other areas of your skin.

If your GP decides the condition is suspicious, you will be referred to see a dermatologist (specialist skin doctor) at a nearby hospital. There are cancer referral guidelines to help GPs decide who needs to see a specialist, and how quickly.

At hospital
At hospital you will be seen in the appropriate specialist department. This may be a dermatology, plastic surgery, clinical oncology, or other appropriate clinic, supervised by a consultant.

The area of your skin with the sore or lump will be examined. In some cases, your nearby lymph glands may be felt too. As you may have more than one SCC, other areas of you skin may be examined too. You may need a biopsy to confirm the diagnosis.

Your consent
Before any doctor, nurse or therapist examines or treats you, they must seek your consent. We have more information about informed consent.

Biopsy
A biopsy is a way of getting a sample of cells or body tissue to be looked at under a microscope. It is usually carried out at a day surgery unit. Sometimes an in-patient stay is required, depending on where your SCC is.

There are three ways a biopsy for suspected SCC may be taken. First, a local anaesthetic is injected to numb the area of the operation:

• excision biopsy
  In this procedure the area around the spot is swabbed with antiseptic and injected with a local anaesthetic. An oval cut is made with a scalpel and the whole of the abnormal area, plus a margin of healthy cells around it, are removed. The wound is stitched up. Small areas take about 10-15 minutes to do. The stitches will have to be taken out in about a week, or later, depending on the site of the excision.
  
• incision biopsy
  This procedure is similar to excision biopsy, except that only a portion of the suspect area is cut out for examination.

• curettage and cautery
  In this procedure the abnormal cells are scraped off with a spoon-shaped instrument with a sharp edge (a curette). The raw area this leaves is heat-sealed (cautery), sometimes more than once. This leaves a scab that heals in the same way as a graze. Some types of small SCC may be adequately removed by curettage as well as providing a laboratory specimen to confirm the diagnosis.

Whatever method is used, the removed tissue is sent to a laboratory to be examined under a microscope for cancer cells.

For more general information, see our page on biopsy.

The biopsy that has been taken is processed to confirm the diagnosis. Even if the area has been removed by excision biopsy, you will need some follow-up. Your biopsy results and details of follow-up and further treatment may be given to you at a hospital appointment, via your GP or by a letter from your consultant. This may be arranged before you leave hospital or arrangements may be delayed until the results are known to your consultant.

Your doctor or clinical nurse specialist will discuss them with you. If SCC is diagnosed, a clear plan of investigation and treatment will then be explained to you.

A cancer diagnosis can be shocking. You may want emotional and practical support and advice for yourself and your family. You will find more information in the following sections What will life be like after treatment? and Where can I get more information?.

Further tests
If cancer is detected, you may need further tests, to find out whether the cancer has spread. The most likely test you will have is a chest x-ray.