Last Modified : 2006-09-07
Squamous cells are thin, flat cells found in tissues that form the surface of the skin and the lining of body cavities such as the mouth, hollow organs such as the uterus and blood vessels, and the lining of the respiratory (breathing) and digestive tracts. Some organs with squamous cells are the esophagus, lungs, kidneys, and uterus. Cancer can begin in squamous cells anywhere in the body and metastasize (spread) through the blood or lymph system to other parts of the body.
When squamous cell cancer spreads to lymph nodes in the neck or around the collarbone, it is called metastatic squamous neck cancer. The doctor will try to find the primary tumor (the cancer that first formed in the body), because treatment for metastatic cancer is the same as treatment for the primary tumor. For example, when lung cancer spreads to the neck, the cancer cells in the neck are lung cancer cells and they are treated the same as the cancer in the lung. Sometimes doctors cannot find where in the body the cancer first began to grow. When tests cannot find a primary tumor, it is called an occult (hidden) primary tumor. In many cases, the primary tumor is never found.
Possible signs of metastatic squamous neck cancer with occult primary include a lump or pain in the neck or throat.A doctor should be seen if there is a lump or pain in the neck or throat that doesn't go away. These and other symptoms may be caused by metastatic squamous neck cancer with occult primary. Other conditions may cause the same symptoms.
Tests that examine the tissues of the neck, respiratory tract, and upper part of the digestive tract are used to detect (find) and diagnose metastatic squamous neck cancer and the primary tumor.Tests will include checking for a primary tumor in the organs and tissues of the respiratory tract, the upper part of the digestive tract (including the lips, mouth, tongue, nose, throat, vocal cords, and parts of the esophagus and trachea), and the genitourinary system. The following procedures may be used:
A diagnosis of occult primary tumor is made if the primary tumor is not found during testing or treatment.
Certain factors affect prognosis (chance of recovery) and treatment options.The prognosis (chance of recovery) and treatment options depend on the following:
Treatment options also depend on the following:
Staging is the process used to find out much cancer is in the body and how far it has spread. There is no standard staging process for metastatic squamous neck cancer with occult primary. The tumors are described as untreated or recurrent. Untreated metastatic squamous neck cancer with occult primary is cancer that is newly diagnosed and has not been treated, except to relieve symptoms caused by the cancer.
The following tests and procedures may be used to find out if the cancer has spread to other parts of the body, such as the lung or liver:
Recurrent metastatic squamous neck cancer with occult primary is cancer that has recurred (come back) after it has been treated. The cancer may come back in the neck or other parts of the body.
Different types of treatment are available for patients with metastatic squamous neck cancer with occult primary. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Before starting treatment, patients may want to think about taking part in a clinical trial. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment.
Clinical trials are taking place in many parts of the country. Information about ongoing clinical trials is available from the NCI Web site. Choosing the most appropriate cancer treatment is a decision that ideally involves the patient, family, and health care team.
Two types of standard treatment are used:Surgery may include neck dissection. There are different types of neck dissection, based on the amount of tissue that is removed.
Even if the doctor removes all the cancer that can be seen at the time of surgery, some patients may be given radiation therapy after surgery to kill any cancer cells that are left. Treatment given after surgery, to increase the chances of a cure, is called adjuvant therapy.
Radiation therapyRadiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
Radiation therapy to the neck may change the way the thyroid gland works. The gland will be tested before treatment and at regular checkups after treatment.
New types of treatment are being tested in clinical trials. These include the following:Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).
Hyperfractionated radiation therapyHyperfractionated radiation therapy is radiation treatment in which the daily dose of radiation is divided into two or more smaller doses that are usually given hours apart. This is also called superfractionated radiation therapy.
This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.
Treatment of untreated metastatic squamous neck cancer with occult primary may include the following:
This summary section refers to specific treatments under study in clinical trials, but it may not mention every new treatment being studied. Information about ongoing clinical trials is available from the NCI Web site.
Treatment of recurrent metastatic squamous neck cancer with occult primary is usually within a clinical trial. Information about ongoing clinical trials is available from the NCI Web site.