Treatment for advanced cutaneous squamous cell carcinoma (CSCC) typically starts with surgery to remove the cancer, along with radiation or other therapies to kill any cancer cells that have spread beyond the skin. If your cancer keeps growing afterward, you may need other treatments to stop it.

It can feel overwhelming to learn that your cancer hasn’t responded to treatment, or has come back. Take comfort in knowing there are more options than ever before to treat you. Here are some steps to take if your advanced CSCC treatment stops working.

Surgery is the main treatment for advanced CSCC, but it’s far from the only one. Your doctor can also try radiation, which uses high-energy X-rays to destroy cancer cells. Or you may get chemotherapy, which uses medication to kill cancer cells all over your body.

Immunotherapy is a newer way to treat advanced CSCC. It uses your body’s immune system to target and kill the cancer.

In 2018, the FDA approved the first immunotherapy drug for advanced CSCC. Cemiplimab-rwlc (Libtayo) is a type of treatment called a checkpoint inhibitor.

Checkpoints prevent your immune system from attacking your body’s own healthy cells. Cancer cells can use these checkpoints to avoid detection and keep growing. Libtayo blocks a checkpoint called PD-1, which helps facilitate your immune system to kill the cancer.

Another drug in the same class is being studied for advanced CSCC. It’s called pembrolizumab (Keytruda). A group of drugs called EGFR inhibitors may also help slow the growth of SCC cells.

Your doctor may recommend a combination of treatments to target your cancer more effectively.

For your therapy to work, you have to stick with it. Go to all of your scheduled treatment sessions and follow-up visits. Follow the instructions your doctor gave you.

If you have any side effects or you can’t tolerate your medication, let your doctor know right away. Don’t just stop taking it. Going off your treatment could allow your cancer to grow and spread further.

Researchers are studying new treatments for CSCC in clinical trials. Joining one of these trials may give you access to a therapy that isn’t available to the public yet. The treatment may work better than ones currently available.

Ask your doctor if you’re a good fit for any clinical trials. Before you join, make sure you understand how the treatment might help you, and the risks it might have.

Treatment isn’t only aimed at curing your cancer. It can help relieve your symptoms, too.

Ask the doctor who treats your cancer about medications to ease pain and other symptoms. These are called palliative therapies. Radiation is one treatment that can help with symptoms like pain and bleeding.

Facing a cancer diagnosis can be overwhelming. Learning that your treatment has stopped working can be even more difficult to navigate. Don’t try to go through this experience alone.

Rely on friends, family, and other people in your social circle for support. You might also want to consider talking to a therapist. The doctor who treats your cancer can recommend a therapist with experience working with people who have the same type of cancer you do.

Or, you can join a support group of people with CSCC at your hospital. Support groups are also available through organizations like the American Cancer Society.

The news that your cancer is no longer responding to treatment can be difficult to hear. Remember that you’re not out of options. You can start on another approved therapy, or enroll in a clinical trial to try something new.

Be kind to yourself during this process. Treat any symptoms that make you uncomfortable, and get the emotional support you need to help you get through the next phase of treatment.