Multidisciplinary Approach Key to Cutaneous Squamous Cell Carcinoma Care

Updated June ‍10, 2025

Early detection and a multidisciplinary approach are⁢ critical in managing cutaneous squamous cell carcinoma (cSCC), according to Dr. Aaron S. Farberg, founder and chief medical officer of Bare Dermatology. Farberg ⁤emphasized the‍ rising prevalence of⁤ cSCC and the importance of collaborative ⁢care in a recent interview.

Often, patients notice lesions that bleed, crust, or change, prompting a visit. Farberg ⁤recommends a⁣ biopsy⁤ for any suspicious lesion,‍ followed by dermatopathologic evaluation. Routine skin exams can also identify asymptomatic lesions. Early-stage lesions often are curable with excision, but ⁤high-risk ‍features necessitate further evaluation.

Defining high-risk resectable cSCC involves balancing oncologic control with quality of life. Factors include tumor size, depth, and perineural invasion. Farberg noted that while ⁣staging systems like the american Joint Committee on Cancer and Brigham and Women’s Hospital (BWH) criteria⁢ are helpful, they aren’t thorough.Immunosuppression, for example, isn’t included in the BWH system.

Systemic‍ therapies, particularly checkpoint‍ inhibitors, are vital for locally advanced or ‍metastatic cSCC when surgery or radiation ⁢is insufficient. ⁣Farberg stresses collaborative decision-making,mirroring a multidisciplinary ⁢tumor board approach.

A multidisciplinary team includes dermatologists, Mohs surgeons, surgical and medical oncologists, and radiation oncologists.⁣ Genetics specialists and other subspecialists are consulted as needed. This comprehensive approach ensures patients receive appropriate interventions at each stage.

Building a strong multidisciplinary care model requires proactive collaboration. Farberg ‍mentors residents and colleagues on developing these networks, emphasizing early engagement ⁣with specialists to ensure seamless ‍coordination.

The⁣ biggest challenge is the time and ‍effort required, which isn’t directly reimbursed. However, Farberg said the commitment to high-quality patient care drives this effort. He added that developing these relationships requires dedication beyond routine ⁤clinical duties.

Dermatologists often serve as the patient’s advocate, guiding them through treatment. They actively participate in multidisciplinary discussions to ensure treatment plans align with clinical best practices and patient goals.

Referral to a medical oncologist is necessary when systemic therapy is considered.Farberg ‍provides patients with an overview of potential options before their oncology visit and maintains communication ⁢with both the patient and the care team.

Streamlined workflows involve rapid triage and care coordination. Urgent cases⁤ receive⁤ priority, and follow-ups can be virtual. A centralized ⁢triage system gathers patient data upfront, allowing for efficient recommendations.

Information sharing ‍relies on email,⁣ fax, and ⁢follow-up phone calls⁣ to⁢ confirm receipt and scheduling. This redundancy minimizes delays.

A recent case highlighted ‍the impact of ⁤multidisciplinary collaboration. A patient with locally advanced cSCC underwent Mohs surgery, but molecular testing revealed a high risk of metastasis. Immediate referral led to adjuvant radiation therapy and a proactive surveillance plan.

“Managing ⁢advanced cSCC is one of the most impactful and rewarding roles in dermatology… Dermatologists should take a leading role in the diagnosis, treatment, and long-term management of cSCC, ‍ensuring seamless coordination ‍with multidisciplinary teams,”

Dr. Aaron S. Farberg, Bare Dermatology

What’s next

The goal is to establish a center of excellence providing cutting-edge treatments while maintaining ‍a conservative, evidence-based approach. Farberg encourages dermatologists to take an active role in driving progress ‍in oncology care.