How to Examine Yourself After Treatment for a Squamous Cell Carcinoma (SCC)

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1 How to Examine Yourself After Treatment for a Squamous Cell Carcinoma (SCC) Patient Information

2 Introduction This booklet is designed to give you information about examining yourself following your treatment for a Squamous Cell Carcinoma (SCC). We hope it will answer some of the questions that you or those who care for you may have at this time. It is not meant to replace discussion between you and your surgeon, but as a guide to accompany what is discussed. Why should I self examine? There is a small chance that your cancer may return and, whilst you will be followed up in clinic or by your GP, learning how to examine yourself for any sign of the cancer coming back is probably the single most important thing you can do. If the cancer does return it may still be curable if it is caught early. This is why it is important for you to examine yourself between follow up appointments. How likely is it that the SCC will return? The risk of an SCC returning or spreading to another part of the body varies from patient to patient. However it is generally a very small risk. Your doctor will give you more information about the risks in your particular case. What do I need to look for? When skin cancers return, they usually appear as lumps on top or beneath the skin. They are often found near the original cancer was growing or further up the limb or area of the body that was affected, or as lumps in the lymph nodes. Lymph nodes are glands and include the ones you feel as a swelling in your neck when you have a sore throat. They are found throughout your body, but the main sites you can feel are in your groin, your neck and your armpits. The lumps which could indicate skin cancer do not usually look like the original cancer, and the lump will probably be the same colour as the surrounding skin. Occasionally it is blue / brown / black / red and on the skin s surface. Any recurrence will feel different from the surrounding skin; it often feels like a dried pea, or a marble, or a hard, smooth, round nodule. Where should I examine? There are 4 areas that need to be carefully checked: The scar at the original site of the skin cancer. The skin around this area. The skin between the scar and the lymph nodes. 1

3 Lymph nodes are filters along the lymphatic system. Their job is to filter out unwanted substances and to eliminate them from the body. If there is an infection in the area or cancer cells growing in the lymph nodes they can become enlarged. How often should I examine myself? You should check these areas every 4 weeks. How should I examine myself? Start by feeling carefully in and around the scar. You do this by pressing firmly on the skin, and rolling the skin against the underlying muscle. This tends to make any lumpiness easier to feel. Use the same method to check the skin between the scar and the lymph nodes, and the lymph nodes themselves. Where are the lymph nodes? Lymph nodes are found all over the body but the main ones you need to be aware of are those in the groin, armpits and neck. Which lymph nodes do I need to examine? The lymph nodes you need to examine will depend on where your skin cancer was. The table below shows you where you need to examine. Your doctor or specialist nurse will give you advice on what to look for and how to examine yourself Site of skin cancer Leg Chest, back, abdomen Arm Head and neck Lymph nodes to check Behind knees, groins. Both groins, both armpits, above both collar bones, neck. Armpits, above both collar bones, lower neck Side of the neck, under chin, above collar bones, behind and in front of your ears, back of neck. When examining your lymph nodes, it is often useful to compare one side with the other. If you are finding it difficult to examine some areas then it is a good idea to ask someone to help you. You can also ask the nurse at your GP s surgery to help examine you if you would prefer not to ask someone you know. 2

4 Lymph nodes do change in size a little for reasons other than a spread of cancer for instance the lymph nodes in your neck may become swollen and perhaps tender if you have a sore throat. If you feel swelling in one or more lymph nodes and you do not feel unwell, particularly if it is not tender or has lasted more than a couple of weeks then you should contact your hospital. If you are not shown please ask. What should I do if I am worried? If you develop problems between clinic appointments, you should consult the specialist nurse at the hospital or your family doctor who will arrange for an earlier hospital appointment if this is necessary. It is important that you make a list of all medicines you are taking and bring it with you to all your follow-up clinic appointments. If you have any questions at all, please ask your dermatologist or specialist nurse. It may help to write down questions as you think of them so that you have them ready. It may also help to bring someone with you when you attend your outpatients appointments. For details of local cancer support groups and organisations, please ask your medical team. Local sources of further information You can visit any of the health/cancer information centres listed below: Birmingham Women's NHS Foundation Trust Health Information Centre Birmingham Women's Healthcare NHS FoundationTrust Metchley Park Road Edgbaston Birmingham B15 2TG Telephone: Heart of England NHS Foundation Trust Health Information Centre Birmingham Heartlands Hospital Bordesley Green Birmingham B9 5SS Telephone:

5 Cancer Information and Support Centre Good Hope Hospital Rectory Road Sutton Coldfield B75 7RR Telephone: Sandwell and West Birmingham Hospitals NHS Trust The Courtyard Centre Sandwell General Hospital (Main Reception) Lyndon West Bromwich B71 4HJ Telephone: Fax: University Hospital Birmingham NHS Foundation Trust The Patrick Room Cancer Centre University Hospital Birmingham NHS Foundation Trust Queen Elizabeth Hospital Edgbaston Birmingham B15 2TH Telephone: Walsall Primary Care Trust Cancer Information & Support Services Challenge Building Hatherton Street Walsall WS1 1YB Freephone: About this information This guide is provided for general information only and is not a substitute for professional medical advice. Every effort is taken to ensure that this information is accurate and consistent with current knowledge and practice at the time of publication. We are constantly striving to improve the quality of our information. If you have a suggestion about how this information can be improved, please contact us via our website: This information was produced by Pan Birmingham Cancer Network and was written by Consultant Surgeons, Clinical Nurse Specialists, Allied Health Professionals, Patients and Carers from the following Trusts: 4

6 Heart of England NHS Foundation Trust Sandwell and West Birmingham Hospitals NHS Trust University Hospital Birmingham Foundation Trust Walsall Hospital NHS Trust We acknowledge the support of British Association of Dermatologists (BAD) in producing this information ( Pan Birmingham Cancer Network 2009 Publication Date: December 2009 Review Date: December