Squamous Cell Carcinoma of the Lung

What Is It?

Squamous cell carcinoma of the lung accounts for about 30% of cases of non-small cell lung cancer. Most squamous cell carcinoma starts in the central areas of the lungs. These tumors may cause symptoms of coughing up blood at an earlier stage than tumors located on the edges of the lungs, such as adenocarcinoma. The proportion of lung cancers labeled squamous has been steadily decreasing, possibly because people began inhaling smoke more deeply into more peripheral areas of the lung after the advent of filtered cigarettes.

Squamous cell carcinoma often spreads (metastasizes) to other parts of the body because of the constant flow of fluids (blood and lymph) through the lungs. The fluids can carry cancer cells to nearby areas, such as the chest wall, neck, esophagus or heart. Unless the cancer is diagnosed and treated early, it frequently spreads throughout the body. Outside the chest, this lung cancer commonly spreads to the bones, brain, liver and adrenal glands.

Symptoms

Although some cancers initially have no symptoms, others are diagnosed during an evaluation for any of the following:

• A persistent cough
• Coughing up of blood (hemoptysis)
• Unexplained weight loss or loss of appetite
• Shortness of breath or wheezing
• Fatigue
• Increased mucus secretions or phlegm coughed from the lungs
• Difficulty swallowing
• Pain in the chest, shoulder or arm
• Recurrent pneumonias in the same place
• Bone pain
• Hoarseness
• Headaches, confusion or seizures
• Swelling of the face, neck or upper extremities
• Enlargement of the ends of fingers and toes (digital clubbing)

Diagnosis

Squamous cell carcinoma often is discovered on a chest X-ray, where it appears as a dark, shaded area. Other imaging studies, such as computed tomography (CT) or magnetic resonance imaging (MRI), may be used to further determine the size, shape and location of the tumor. This helps to find the best place to obtain a sample of the tumor to determine whether it is a type of lung cancer or whether the cancer spread to the lung from another place outside the chest. The type of cancer affects what treatment you should get.

Other tests that can be used to diagnose this type of cancer include:

• Thoracentesis A needle is used to remove pleural fluid, the fluid between the lung and the chest wall. This fluid is examined for cancer cells.
• Mediastinoscopy This is a surgical procedure that lets the doctor remove lymph nodes from the lungs through very small incisions to test them for cancer.
• Needle biopsy or fine-needle aspiration In this procedure, a needle is used to remove (aspirate) fluid or tissue for testing from lymph nodes, a lung mass or from an area in the bone marrow or other organ where the tumor may have spread.
• Bronchoscopy A fiber-optic viewing instrument is passed through the airway into the lung. The instrument allows the doctor to examine the tumor directly and to remove cells for examination.

Your doctor will choose a therapy based on size and location of the tumor or the presence of cancer cells. Squamous cell lung cancer is classified by stages defined by size and how far the tumor has spread. Stages I through III are further divided into "A" and "B" categories. Stage I tumors are small and have not invaded the surrounding tissue or organs. Stage II and III tumors have invaded surrounding tissue and/or organs and have spread to lymph nodes. Stage IV tumors have spread outside the chest area.

Expected Duration

Without treatment, cancer will continue to grow. As with any cancer, even if squamous cell lung cancer disappears (goes into remission) after treatment, there is a chance it can come back again.

Prevention

To prevent squamous cell lung cancer, quit smoking and avoid secondhand smoke. Tobacco smoke is the main risk factor for most types of lung cancer. Approximately 90% of all lung cancers are linked to smoking. Although studies are looking for screening tests to diagnose lung cancer earlier, no test has been proven effective yet.

Treatment

Surgery is the primary treatment for all non-small cell lung cancers. For small, localized tumors, it might be possible to remove only a small section of lung. More extensive carcinoma might require removal of a lobe of a lung or the entire lung. Radiation therapy and chemotherapy (the use of strong medications) may be combined with surgery to help prevent the cancer from recurring.

People with severe medical problems that make it difficult for them to withstand surgery may receive radiation therapy to shrink the tumor or a combination of radiation and chemotherapy.

When the tumor has spread significantly, chemotherapy drugs may be recommended to slow the growth of the cancer even if it cannot provide a cure. Chemotherapy has been shown to decrease symptoms and prolong life in advanced cases of lung cancer.

When To Call A Professional

If you experience the symptoms of squamous cell lung cancer, make an appointment to see your health care professional.

Prognosis

Squamous cell carcinoma usually is diagnosed after the disease has spread. The overall prognosis for all non-small cell lung cancers is poor, with a five-year survival rate of about 15%. The survival rate is higher (close to 50%) when the cancer is detected and treated early. Survival rates after surgery vary. For those with stage I disease, the five-year survival rate is about 47%. For those with stage III disease, the five-year survival rate is 8%.

Even when surgery and other therapies are initially successful, there is a high risk of the cancer coming back. This reflects the fact that squamous cell carcinoma is rarely restricted to just one area. It readily spreads to other parts of the body.

Additional Info

National Cancer Institute (NCI)

U.S. National Institutes of Health

Public Inquiries Office

Building 31, Room 10A03

31 Center Drive, MSC 8322

Bethesda, MD 20892-2580

Phone: (301) 435-3848

Toll-Free: (800) 422-6237

TTY: (800) 332-8615

E-Mail: cancergovstaff@mail.nih.gov

http://www.nci.nih.gov/

American Cancer Society (ACS)

1599 Clifton Road, NE

Atlanta, GA 30329-4251

Toll-Free: (800) 227-2345

http://www.cancer.org/

American Lung Association

61 Broadway, 6th Floor

New York, NY 10006br />Phone: (212) 315-8700

Toll-Free: (800) 548-8252E-Mail: info@lungusa.org

http://www.lungusa.org/

National Heart, Lung, and Blood Institute (NHLBI)

P.O. Box 30105

Bethesda, MD 20824-0105

Phone: (301) 592-8573

TTY: (240) 629-3255

Fax: (301) 592-8563

E-Mail: nhlbiinfo@rover.nhlbi.nih.gov

http://www.nhlbi.nih.gov/

U.S. Environmental Protection Agency (EPA)

Ariel Rios Building

1200 Pennsylvania Ave., N.W.

Washington, DC 20460

Phone: (202) 272-0167

http://www.epa.gov/

U.S. Department of Labor's Occupational Safety & Health Administration (OSHA)

200 Constitution Ave.

Washington, D.C. 20210

Phone: (202) 693-1999

Toll-Free: (800) 321-6742

TTY: (877) 889-5627

http://www.osha.gov/