Treatment for metastatic squamous neck cancer with occult primary varies. Some methods are considered standard and some are still under study. These clinical trials are designed to improve current treatment options or to test new ones. The treatment methods developed in these trials may become standard treatments for patients with squamous neck cancer. However, these trials may only be available to people who have not begun treatment yet. Some of these treatments may involve neck dissection.
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Although the exact nature of the disease is unknown, squamous cell carcinomas in the neck are highly aggressive and may spread to distant locations. Patients may develop precancerous growths. The care team may notice precancerous growths before cancer has even begun. Treatment options for metastatic squamous neck cancer depend on whether the cancer has spread beyond the primary tumor. Once the cancer has spread to the lymph nodes, it may be difficult to treat the patient.
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Head and neck cancers originate from mucosal epithelium of the larynx, pharynx, and oral cavity. These cancers are associated with alcohol use and tobacco use, although there are no definitive links between HPV infection and head and neck cancers. However, cancers in these areas are often associated with HPV-16 infection. Although a patient has to be tested cytologically for HPV DNA to be diagnosed with HPV-related head and neck cancer, a false negative p16 result is possible.
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The next step in diagnosing squamous neck cancer is performing a biopsy. The biopsy is performed under ultrasound guidance and should yield 80% positive results. Repeated FNA is usually recommended if a solid neck mass is suspected to harbor squamous cell cancer. If the diagnosis is unclear, doctors can then proceed with treatment. The best treatment for metastatic squamous neck cancer is surgical removal of the tumor.
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Advanced minimally invasive techniques may be used to treat the disease. In addition to traditional surgical techniques, patients undergoing resection of tumors lasting at least two hours may benefit from a procedure known as transoral robotic surgery. A more recent development in radiation therapy may include the use of positron emission tomography. The radiation therapy for metastatic squamous neck cancer may affect the thyroid gland. As a result, blood tests may be done to determine the amount of thyroid hormone in the body.
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To become metastatic, HNSCC tumour cells must detach from the basement membrane. When this occurs, normal epithelial cells lose access to key survival factors and undergo a form of programmed cell death called anoikis. By suppressing anoikis, HNSCC tumour cells have a greater chance of metastasis. Tumour cells also express growth factors, which activate the signalling pathways of tumour cells and suppress anoikis.
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Metastatic squamous neck cancer is composed of abnormal squamous cells that have spread from an identified primary organ. In some cases, the cancer may originate from an occult organ, such as the mouth. Once it has spread to the neck, symptoms can include a pain in the neck or throat. Patients with metastatic squamous neck cancer may experience a lump in the throat or other symptoms.
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A biopsy of the tumor will confirm the diagnosis. This process involves the removal of a small piece of the affected skin and sending it to a laboratory for testing. However, the cancer may return if the condition is left untreated. It is therefore crucial to visit your doctor periodically for follow-up checks. If you notice precancerous areas on your skin, you may have SCC. Besides, you should avoid sun exposure during the hottest hours of the day.
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Radiation is one of the common treatment options for metastatic squamous cell cancer. Treatment options include hyperfractionated radiation therapy and chemotherapy. Patients may also be enrolled in a clinical trial to learn about new treatments. If you have metastatic squamous neck cancer, your doctor can recommend chemotherapy and radiation. Your oncologist will discuss which treatment options would be best for your specific type of squamous cell cancer.
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Most invasive HNSCCs are caused by mutations of a gene called p63. p63 is a p53-related transcription factor that regulates proliferative potential in stratified epithelia. The gene is found at its highest level in basal epithelial cells, where it inhibits NOTCH1 expression. However, during terminal differentiation, p63 expression is downregulated and it is reactivated in the suprabasal layers. Furthermore, p63 is associated with genomic amplification in most invasive HNSCCs.
