• The Brigham and Women's Hospital staging system, and why squamous cell carcinoma has two: The anatomical staging systems put almost every squamous cell carcinoma in one or two categories, so they cannot pick out the few that will spread.
• The subtype and grade on a cutaneous squamous cell carcinoma report: A squamous cell carcinoma report carries two separate things: a subtype, which is the shape the tumour grows in, and a grade, which is how much it still looks like normal skin.
• Skin cancer after an organ transplant: The drugs that keep a transplanted organ alive let skin cancers grow, and they grow differently: faster, in numbers, and far more likely to spread.
• Radiotherapy for skin cancer: Radiotherapy cures most skin cancers without an operation, and is chosen when surgery would take too much, when someone is too frail for it, or when they refuse it.
• How skin carcinoma is staged in Britain: UICC TNM, and why it is not the American system: UK skin carcinoma reports are staged against the UICC's system, not the American AJCC's, and the two are not the same: the American manual covers only the head and neck, while the UICC covers the whole body and includes basal cell carcinoma.
• What makes a skin cancer high risk: the UK feature lists: Low risk and high risk are the words that actually decide what happens to a keratinocyte cancer in Britain, more than any stage.
• Depth of invasion (DOI): Depth of invasion is how far down a cancer has grown from the surface it started on, measured in millimetres on the pathology slide; in mouth cancer it now sets the T stage and a depth over 4 mm means the neck nodes are treated even when they look clean, and in early stomach cancer it decides whether an endoscopic removal was enough.
• Mohs surgery: Skin cancer surgery in which the tumour is removed in thin layers, each checked under the microscope on the spot, until the edges are clear; it spares the most normal skin.
• Pathologic complete response (pCR): No invasive cancer left in the breast and lymph nodes when the surgeon removes the tissue after pre-surgery treatment.
• Tumour mutational burden (TMB): How many mutations a tumour has.

Biomarker results to ask for: Tumour mutational burden (very high; ultraviolet signature), Perineural and lymphovascular invasion, Depth of invasion and differentiation grade, Immunosuppression status (transplant, chronic lymphocytic leukaemia, HIV), PD-L1 expression (not required for treatment), Pathological response after neoadjuvant immunotherapy.

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

• Adjuvant after surgery and radiotherapy: Cemiplimab for high-risk disease (C-POST, 2025). (Cemiplimab)
• High-risk resectable disease: Excision with margin control or Mohs surgery, nodal evaluation, and postoperative radiotherapy for perineural invasion, positive margins or nodal disease; neoadjuvant cemiplimab to shrink large tumours before surgery. (Mohs surgery, IMRT / IGRT (modern external beam), Cemiplimab, Sentinel lymph node biopsy)
• Locally advanced or metastatic, first line: Cemiplimab (EMPOWER-CSCC-1), pembrolizumab (KEYNOTE-629) or cosibelimab; radiotherapy for symptomatic sites. (EMPOWER-CSCC-1, KEYNOTE-629, Cemiplimab, Pembrolizumab, Cosibelimab, IMRT / IGRT (modern external beam))
• Transplant recipients: Reduce immunosuppression and switch to sirolimus or everolimus where possible; PD-1 blockade only after weighing graft rejection risk; surgery and radiotherapy preferred. (Everolimus, Cemiplimab)
• Immunotherapy-ineligible or refractory: Cetuximab with or without radiotherapy, platinum-based chemotherapy, capecitabine; clinical trials of RP1 with cemiplimab or photoimmunotherapy. (Cetuximab, Carboplatin, Study Evaluating Cemiplimab Alone and Combined With RP1 in Treating Advanced Squamous Skin Cancer, An Open-label Study Using ASP-1929 Photoimmunotherapy in Combination With Anti-PD1 Therapy in EGFR Expressing Advanced Solid Tumors, Vusolimogene oderparepvec)

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.