Metastasis of cutaneous squamous cell carcinoma (cSCC) is rare. However, certain tumor and patient characteristics increase the risk of metastasis. Prior studies have demonstrated metastasis rates of 3-9%, occurring, on average, one to two years after initial diagnosis [6].
Signs and symptoms of metastatic squamous neck cancer with occult primary include a lump or pain in the neck or throat. Check with your doctor if you have a lump or pain in your neck or throat that doesn't go away. These and other signs and symptoms may be caused by metastatic squamous neck cancer with occult primary.
Squamous cell carcinoma rarely metastasizes (spreads to other areas of the body), and when spreading does occur, it typically happens slowly. Indeed, most squamous cell carcinoma cases are diagnosed before the cancer has progressed beyond the upper layer of skin.
Recurrence of cSCC indicates an aggressive tumor, and metastatic rates for these tumors are 25–30%. Of cSCC that metastasize, 80% of cases spread to regional lymph nodes, but it has also been found to go to the lungs, liver, brain, bones, and skin. Proper evaluation of cSCC is therefore vital for good patient outcomes.
Hanke: The first place SCCs metastasize to is the regional lymph nodes. So if you have a squamous cell carcinoma on your cheek, for example, it would metastasize to the nodes in the neck. But there are treatments for that. Patients can have surgery, radiation and, in some advanced cases, immunotherapy medication.
In general, the squamous cell carcinoma survival rate is very high—when detected early, the five-year survival rate is 99 percent. Even if squamous cell carcinoma has spread to nearby lymph nodes, the cancer may be effectively treated through a combination of surgery and radiation treatment.
Treatment should happen as soon as possible after diagnosis, since more advanced SCCs of the skin are more difficult to treat and can become dangerous, spreading to local lymph nodes, distant tissues and organs.
Although squamous cell carcinoma can be more aggressive than basal cell cancer, the risk of this type of cancer spreading is low—as long as the cancer is treated early, Dr. Leffell says. He notes that the lesions must be treated with respect because they may grow rapidly and invade deeply.
Death from basal and squamous cell skin cancers is uncommon. It's thought that about 2,000 people in the US die each year from these cancers, and that this rate has been dropping in recent years.
Untreated squamous cell carcinoma of the skin can destroy nearby healthy tissue, spread to the lymph nodes or other organs, and may be fatal, although this is uncommon.
Most (95% to 98%) of squamous cell carcinomas can be cured if they are treated early. Once squamous cell carcinoma has spread beyond the skin, though, less than half of people live five years, even with aggressive treatment. There are many ways to treat squamous cell carcinoma that has not spread.
Most malignant tumors that metastasize do so within five years after the primary tumor has been detected, so this raises the question of how one can explain “dormancy” among tumor cells for decades.
Stage 1 squamous cell carcinoma
In stage 1, the cancer is less than 2 centimeters, about 4/5 of an inch across, has not spread to nearby lymph nodes or organs, and has one or fewer high-risk features.
For a patient with stage IV cancer, age must also be considered to prognose survival. For a patient who is 67 years or older, the expected median survival is a little more than 1 year. If this patient were younger than 67 years, then the expected median survival would be about 2 years.
Squamous cell carcinoma is considered curable when caught early. Stage 3 skin cancer has spread to nearby tissues and lymph nodes and, thus, is more difficult to treat. This type of cancer is treatable with surgery and other treatment options, like chemotherapy and radiation therapy.
Diane Keaton
Several years ago, she was diagnosed with the second most common form of the disease, squamous cell carcinoma. Keaton encourages her fans to practice proper sun protection and has spoken openly about her family's history with the disease (both her father and brother have had BCCs removed).
Most cases of squamous cell carcinoma have a positive prognosis and an excellent survival rate if you receive an early diagnosis. Early detection and treatment prevent the tumor from growing and damaging other parts of your body.
Age over 50: Most SCCs appear in people over age 50. Fair skin: People with fair skin are at an increased risk for SCC. Gender: Men are more likely to develop SCC. Sun-sensitive conditions including xeroderma pigmentosum.
Epidemiological studies suggest that individuals with basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the skin are more likely to develop other malignancies; however, the factors responsible for this are unknown.
About 60 percent of people who have had one skin cancer will be diagnosed with a second one within 10 years, says a 2015 study in JAMA Dermatology. Your odds increase dramatically if you've been diagnosed with a second BCC or SCC (or third, or any other number beyond first).
If squamous cell carcinoma has spread, chemo might be an option, although an immunotherapy drug might be used first. If chemo is used, drugs such as cisplatin and 5-fluorouracil (5-FU) might be options. These drugs are given into a vein (intravenously, or IV), usually once every few weeks.
Conclusion: A dietary pattern characterized by high meat and fat intakes increases SCC tumor risk, particularly in persons with a skin cancer history.
Treatment overview
In June 2020, pembrolizumab (Keytruda®) was approved by the FDA for the treatment of recurrent or metastatic SCC that is not curable by radiation or surgery. In July 2021, the FDA expanded this approval to include SCC that is locally advanced and not curable by radiation or surgery.