Metastatic squamous neck cancera disease where abnormal cells split without control and spread to other nearby body tissue and/or organs with occult primary is a very rare type of carcinomacancer arising from tissues that line organs that develops in the neck. It is a type of secondary cancercancer that has spread from another part of the body, also known as metastasis or mets that forms from the squamous cellsthe basic structural and functional unit of all living things lining the neck that have spread from an unknown (or occult) point of origin in the body. Cancer/s that have spread from an unknown point of origin in the body are known as cancers of unknown primary (CUP).
CUPs are often considered advancedat a late stage, far along cancers as they have already metastasised (spread). Your doctor will try to find the primary cancer to decide treatment options, however if it can’t be found the cancer cells can be tested to give some indication on what the primary cancer is likely to be.
Treatment
If metastatic squamous neck cancer with occult primary is detected, it will be staged and graded based on size and how the cancer cells look under the microscope. Stagingthe process of determining how big the cancer is, where it started and if it has spread to other areas and grading helps your doctors determine the best treatment for you.
Cancers may be staged using the TNM staging system:
- T (tumoura tissue mass that forms from groups of unhealthy cells) indicates the size and depth of the tumour.
- N (nodea small lump or mass of tissue in your body) indicates whether the cancer has spread to nearby lymph nodessmall bean-shaped structures that filters harmful substances from lymph fluid.
- M (metastasiswhen the cancer has spread to other parts of the body, also known as mets) indicates whether the cancer has spread to other parts of the body.
This system can also be used in combination with a numerical value, from stage 0-IV:
- Stage 0: this stage describes cancer cells in the place of origin (or ‘in situ’) that have not spread to nearby tissuea group of cells that work together to perform a function.
- Stage I: cancer cells have begun to spread to nearby tissue. It is not deeply embedded into nearby tissue and had not spread to lymph nodes. This stage is also known as early-stage cancer.
- Stage II: cancer cells have grown deeper into nearby tissue. Lymph nodes may or may not be affected. This is also known as localisedaffecting only one area of body cancer.
- Stage III: the cancer has become larger and has grown deeper into nearby tissue. Lymph nodes are generally affected at this stage. This is also known as localised cancer.
- Stage IV: the cancer has spread to other tissues and organs in the body. This is also known as advanced or metastatic cancer.
Cancers can also be graded based on the rate of growth and how likely they are to spread:
- Gradea description of how abnormal cancer cells and tissue look under a microscope when compared to healthy cells I: cancer cells present as slightly abnormal and are usually slow growing. This is also known as a low-grade tumour.
- Grade II: cancer cells present as abnormal and grow faster than grade-I tumours. This is also known as an intermediate-grade tumour.
- Grade III: cancer cells present as very abnormal and grow quickly. This is also known as a high-grade tumour.
Once your tumour has been staged and graded, your doctor may recommend genetic testinga procedure that analyses DNA to identify changes in genes, chromosomes and proteins, which can be used to analyse tumour DNA to help determine which treatment has the greatest chance of success, which analyses your tumour DNA and can help determine which treatment has the greatest chance of success. They will then discuss the most appropriate treatment option for you.
Treatment is dependent on several factors, including location, stage of disease and overall health.
Treatment options for this disease may include:
- Surgerytreatment involving removal of cancerous tissue and/or tumours and a margin of healthy tissue around it to reduce recurrence, potentially including:
- Radical neck dissectionremoval of tissues in one or both sides of the neck from the jawbone to the collarbone, including all lymph nodes, sternocleidomastoid muscle, submandibular gland, internal jugular vein and spinal accessory nerve.
- Modified radical neck dissectionremoval of tissues in one or both sides of the neck from the jawbone to the collarbone, including all lymph nodes and potentially other structures.
- Selective neck dissectionremoval of some of the lymph nodes in the neck region while preserving other tissues and structures, also known as partial neck dissection.
- Radiation therapya treatment that uses controlled doses of radiation to damage or kill cancer cells.
- Chemotherapya cancer treatment that uses drugs to kill or slow the growth of cancer cells, while minimising damage to healthy cells.
- Clinical trialsresearch studies performed to test new treatments, tests or procedures and evaluate their effectiveness on various diseases.
- Palliative carea variety of practices and exercises used to provide pain relief and improve quality of life without curing the disease.
Risk factors
Because of how rare metastatic squamous neck cancer with occult primary is, there has been limited research done into the riskthe possibility that something bad will happen factors of this disease. However, a potential link of being infected with the human papilloma virus (HPV) has been observed.
Symptoms
Due to the rarity of this disease, there have been few symptoms reported. The only symptom that has been linked to this disease is a persistent lump or pain in the neck and/or throat.
Not everyone with the symptoms above will have cancer but see your general practitioner (GP) if you are concerned.
Diagnosis
If your doctor suspects you have a metastatic squamous neck cancer with occult primary, they may order the following tests to confirm the diagnosisthe process of identifying a disease based on signs and symptoms, patient history and medical test results and refer you to a specialist for treatment:
- Physical examinationan examination of your current symptoms, affected area(s) and overall medical history.
- Imagingtests that create detailed images of areas inside the body tests, potentially including:
- MRI (magnetic resonance imaging)a type of medical imaging that uses radiowaves, a strong magnet and computer technology to create detailed images of the body.
- CT (computed tomography) scana type of medical imaging that uses x-rays and computer technology to create detailed images of the body.
- PET (positron emission tomography) scana type of medical imaging that uses radioactive tracers to create detailed images of the body.
- Ultrasounda type of medical imaging that uses soundwaves to create detailed images of the body .
- Blood teststesting done to measure the levels of certain substances in the blood.
- Biopsyremoval of a section of tissue to analyse for cancer cells.
