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If you're worried about a spot, lump, flaky patch or blemish on your skin, you should see your doctor.

It can be hard to diagnose squamous cell skin cancer just by looking at it. Sometimes it's hard to tell the difference between this type of skin cancer and another type of damage caused by the sun (called a solar keratosis).¹

If your doctor thinks you might have squamous cell skin cancer, they can do a simple operation to remove some skin cells so that a laboratory can check them for cancer under a microscope.¹ This operation is called a biopsy.

During a biopsy, your doctor removes part or all of the spot on your skin. Before the biopsy, your doctor will probably give you a shot that numbs the area so you won't feel any pain.

During the biopsy your doctor may:

• Remove part of the spot and send it to a laboratory to check for cancer
• Remove all of the spot and send it to a laboratory to check for cancer.

Your doctor will probably want to remove all of the spot. This is because there may be just a few cancer cells in one part of the spot, and if your doctor takes out just a part of it, these cells could be missed.

But if your spot is very big or is on your face, your doctor probably won't take out all of it until they know for sure that it's cancer. This is so you don't get a big scar if you don't need to.²

You'll need to go back to your doctor to find out the results of your biopsy. Your doctor will tell you one of three things.

• Your skin sample didn't contain any cancer cells.
• Your skin sample had some cancer cells in it, but they were all removed during the biopsy. You won't need to have any more surgery. (When the laboratory technician checks a skin sample, they look at how much healthy tissue there is around the cancer. If enough healthy tissue was removed, it means that all the cancer cells have been taken out. If there were any cancer cells left behind, they could spread to other parts of the body.)
• Your skin sample had some cancer cells in it, and some other cells may have spread. You will need to have surgery to remove all the cancer. You will also have some more tests to see if your cancer has spread. See the sections below for what happens next.

If you do have cancer, your doctor will need to find out if it has spread and how far it has spread. This is called staging. Staging helps your doctor tell how serious your cancer is and decide what treatment you might need. There's a greater chance that your cancer has spread if you've had the spot on your skin for a long time or it's large.

Your doctor may check for cancer in the lymph nodes near the spot on your skin. And if your doctor thinks your cancer has spread further, you may need other tests, such as X-rays.³ The test results will help you and your doctor decide which treatment is best for you.

To learn more, see What stage is my cancer?

Your doctor may do tests to see if your cancer has spread to other parts of your body, especially if the spot on your skin is large. (If your cancer has spread, your doctor may say that it has metastasized.)

Your doctor might:²

• Feel the area around your abdomen
• Listen to your lungs
• Take an X-ray of your chest
• Do a blood test
• Check the levels of chemicals in your blood (levels of some chemicals in your blood go up if your cancer has spread).

But most people don't need these tests.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.