What Is Squamous Cell Carcinoma?

Squamous cell carcinoma is a kind of small-cell lung cancer (SCLC) that constitutes nearly 20 percent of all lung cancers. As the name indicates, the small-cell lung cancers form a smaller variety of lung cells that line surfaces and cavities, and are normally located in the central airways (bronchi) that bifurcate left and right into each lung. The word squamous indicates the nature of the cells; they are thin, long, and flattened cells that are packed closely together just like fish scales.

The central location of squamous cells within the lung creates difficulty breathing, frequent coughing, and painful rattling chest, and patients may vomit blood in their sputum. An X-ray or detailed CT scan of a squamous cell carcinoma patient would show squamous cells filled with secretions or gaseous content, imparting a lighter or more hazy appearance when compared to the surrounding dark lung tissue. Squamous cell carcinomas, if detected at an early stage and removed promptly, are almost always curable causing minimal damage to the patient and their body. However, if left untreated, it eventually penetrates the underlying tissues and can become disfiguring. Therefore, any suspicious growth in the body should be reported and seen by a physician without delay. Unlike non-small cell lung cancer, squamous cell carcinoma is mostly caused by smoking. Up to 80 percent of squamous cancers are found in habitual smokers.

Accurate SCLC Diagnosis is Imperative for Successful Treatment

Generally speaking, there are three classes of diagnostic tests that help physicians zero in on the types of cancer that require immediate treatment:

• Imaging tests (digitalized screening and 3D imaging of affected tissue)
• Laboratory testing (collecting and analyzing blood and sputum samples)
• Tissue biopsies (samples of tissues that are sent for lab analysis)

Imaging tests such as x-rays, CAT scans, and PET scans help determine the precise location and size of a squamous cell tumor. It also determines whether the case is a tumor that is localized in nature or cancer that is metastasizing rapidly to other organs.  

Staging of Squamous Cell Carcinoma

The stage of a cancer describes how widespread it is. Since squamous cell skin cancers are more likely to spread (although this risk linked with it is still small), the task of determining the stage is termed to be more important, particularly for people who are at higher risk which includes people with weakened immune systems, such as those who have had organ transplants and people infected with HIV- the virus that causes AIDS. Without staging this type of cancer, it would be impossible to explore the correct treatment options for each patient. Squamous cell carcinoma typically follows an aggressive path that runs through four stages.

• Stage 1 is where the tumor grows but remains isolated within the lung tissue.
• In Stage 2, the tumor starts affecting the lymphatic system.
• In Stage 3, cancer spreads to tissues and organ systems that border the lungs.
• The cancer culminates in stage 4 where the squamous cell carcinoma that originated in the lung metastasizes to other organs such as the liver or kidney.

Treatment is very much dependent on the stage that the cancer is currently at and the path it is following. 

Treatment of Squamous Cell Carcinoma

• If detected early or in Stage 1: At this point, the cancer is confined to the epithelial (surface) cells and has not penetrated deeper, therefore being much easier to remove surgically. To avoid complications, radiation and chemotherapy might be postponed or avoided altogether. To rule out the possibility of leaving tumorous tissue behind, an entire section (wedge resection), whole lobe (lobectomy) or the entire affected lung (pneumonectomy) is removed. Because these are severe and difficult procedures for the body, a patient should be in reasonably good health and be physically fit to undergo surgery.

• If detected in Stage 2: Squamous cell carcinoma at this stage may require surgery in combination with radiation and chemotherapy to be as effective as possible. As the lymphatic system is open to attack during this stage, the surgeon will remove all lymph nodes servicing the lungs to prevent cancer from spreading. Before surgery, the doctor may prescribe a dose of controlled radiation to shrink the tumor. Chemotherapy after the surgery will help identify and destroy any cells that may remain untouched by the procedure.

• If detected in Stage 3: Detecting cancer at such a late stage, especially in older patients, usually rules out surgery as a viable option. Instead, the surgeon may prefer to combine radiation and chemotherapy to stop cancer from spreading to other organ systems. 

• If detected in Stage 4: This is undoubtedly the most difficult stage in which to treat squamous cell carcinoma, simply because it has already spread to organs far removed from the lungs. Surgery is rarely recommended at Stage 4 because removal of an organ in one are would be counterproductive because the cancer will metastasize in another system. The only options are chemotherapy, immunotherapy, and targeted therapy. However, these options provide no guarantee of success in such a serious situation.  

How to Cope with a Squamous Cell Carcinoma Diagnosis 

Squamous cell carcinomas usually remain confined to the epidermis (top layer of skin) for some time. However, the larger these tumors grow, the more extensive the treatment is needed as they eventually penetrate the underlying tissues which lead to major disfigurement, sometimes even causing the loss of a nose, eye or ear. When this happens, squamous cell carcinomas can be life-threatening.  At this point, a three-pronged strategy is typically the best method to deal with this type of cancer:

1. Contacting a Good Cancer Specialist: This is not a disease that can be addressed symptomatically; it requires thorough screening and meticulous strategizing. Unless you know the stage of the disease, it may not be possible to explore worthwhile treatment options.

2. Expanding your Resources by Getting Outside Help: Join support groups that keep you informed of the latest developments in the cancer community, and that provide advice to help manage symptoms.

3. Encouraging an Emotional Connection with Others: Confide in those closest to you and take advantage of their emotional support as you prepare for the long haul to recovery.