Cancer is a disease in which certain cells begin to divide too quickly and without any order. Cancer can spread to tissues and organs near the place where it started (called the primary site). Cancer cells can also spread through the bloodstream and the lymph system to other parts of the body to form new tumors. Cancer that started in one place, but has spread to another part of the body is called metastatic cancer.
Squamous cells line the outside of many body organs, including the mouth, nose, skin, throat, and lungs. Cancer can begin in the squamous cells and spread (metastasize) from its original site to the lymph nodes in the neck or around the collarbone. Lymph nodes are small bean-shaped structures that are found throughout the body. They produce and store infection-fighting cells. When the lymph nodes in the neck are found to contain squamous cell cancer, a doctor will try to find out where the cancer started (the primary tumor). If the doctor cannot find a primary tumor, the cancer is called a metastatic cancer with unseen (occult) primary.
A doctor should be seen if there is a lump or pain in the neck or a sore throat that doesn’t go away. If tissue that is not normal is found, the doctor will need to cut out a small piece and look at it under the microscope to see if there are any cancer cells. This is called a biopsy. If the biopsy shows that a person has squamous cell cancer, the doctor will do many kinds of tests to see whether a primary site can be found. If the primary site cannot be found, the doctor will treat the cancer in the neck.
The chance of recovery (prognosis) depends on how many lymph nodes contain cancer, where the cancer is found in the neck, whether or not a primary tumor is found, and the patient’s general state of health.
Once metastaticsquamous neck cancer with occult primary is found, more tests will be done to find out how far the cancer cells have spread. This is called staging. A doctor needs to know the stage of the disease to plan treatment. The following stages are used for metastatic squamous neck cancer with occult primary:
Untreated metastaticsquamous neck cancer with occult primary means no treatment has been given for the cancer except to treat symptoms.
Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the neck or in another part of the body.
There are treatments for all patients with metastaticsquamous neck cancer with occult primary. Two kinds of treatment are used:
Surgery (taking out the cancer).
Radiation therapy (using high-dosex-rays or other high-energy rays to kill cancer cells).
Chemotherapy is being studied in clinical trials.
Surgery is a common treatment of metastatic neck cancer. A doctor may cut out the lymph nodes that contain cancer and some of the healthy lymph nodes around them (lymph node dissection).
Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors.Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes that are put into the area where the cancer cells are found (internal radiation therapy). External radiation to the thyroid or the pituitary gland may change the way the thyroid gland works. The doctor may wish to test the thyroid gland before and after therapy to make sure it is working properly.
Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in a vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells outside the neck.
Treatment of metastatic squamous neck cancer with occult primary depends on how many lymph nodes contain cancer, whether or not an original (primary) tumor is found, and the patient’s age and overall condition.
Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in some parts of the country for metastatic squamous neck cancer. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
Treatment may be one of the following:
Surgery to remove the lymph nodes in the neck (lymph node dissection).
Radiation therapy plus surgery.
A clinical trial that includes chemotherapy, radiation therapy, and/or surgery.
Treatment depends on the type of treatment the patient had before, where the cancer came back, and the patient’s health. A patient may want to take part in a clinical trial of new treatments.
The PDQcancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.
Links to the NCI Dictionary of Cancer Terms were added to this summary.
For more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing callers with TTY equipment may call 1-800-332-8615. The call is free and a trained Cancer Information Specialist is available to answer your questions.
Web sites and Organizations
The NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support and resources for cancer patients and their families. There are also many other places where people can get materials and information about cancer treatment and services. Local hospitals may have information on local and regional agencies that offer information about finances, getting to and from treatment, receiving care at home, and dealing with problems associated with cancer treatment.
The NCI has booklets and other materials for patients, health professionals, and the public. These publications discuss types of cancer, methods of cancer treatment, coping with cancer, and clinical trials. Some publications provide information on tests for cancer, cancer causes and prevention, cancer statistics, and NCI research activities. NCI materials on these and other topics may be ordered online or printed directly from the NCI Publications Locator. These materials can also be ordered by telephone from the Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.
The NCI's LiveHelp service, a program available on several of the Institute's Web sites, provides Internet users with the ability to chat online with an Information Specialist. The service is available from 9:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer.
For more information from the NCI, please write to this address:
NCI Public Inquiries Office
6116 Executive Boulevard, MSC8322
Bethesda, MD 20892-8322
PDQ is a comprehensive cancer database available on NCI's Web site.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.
PDQ also contains information on clinical trials.
Before starting treatment, patients may want to think about taking part in a clinical trial. A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about new treatments, the risks involved, and how well they do or do not work. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard."
Listings of clinical trials are included in PDQ and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.