Back in early November, my husband had a lump in the right side of his neck, with no other symptoms. It was taken out, and diagnosed as Stage 3 SCC. We were all in shock as this was very low on the list according to dr. My husband is 39 years old, and was a social smoker---less than 2 packs a week. He has finished 6 treatments of chemo and has now begun radiation for 7-8 weeks 5 days a week.

I am full of questions....does this occur in moderate smokers? He was not a heavy drinker. They never found primary tumor...would prognosis be better if they had? He has had 2 PET scans and first one showed inflammation around tonsils which was due to surgery as second was clear and dr biopsied tonsils and other parts of head and neck; cancer was only found in 1 lymph node and considered stage 3 due to size.

Sometimes when they can't find the primary they call it an "occult" tumor. Cancer in the lymph nodes is typically a symptom rather than a cause (unless it's Lymphoma). I am not a doctor and it appears that they are being cautious and conservative but I would still get a second opinion from a CCC (if you aren't already at one).

SCC is found in non-smokers and drinkers about 25% of the total cases each year. He is a little on the young side of the typical profile for this disease (typical being mid 50's) so that's another reason to exercise great caution, care and vigilence.

Needless to say, if it were me, I would stop the smoking and wait a while before "social" drinking again.

Jessica,
I had an unknown primary & mets to one lymph node back in 1997. I had right modified neck disection followed by 36 XRT treatments, no chemo. Back then they didn't feel chemo increased my chances by more than 5% and didn't think making me that sick was worth it. He definitely needs to quit smoking. Even one a day is too many, as I discovered 4 years later. The radiation will be rough but he can do it. See that he gets something to preserve the saliva function even if it is only Salagen. Also make certain he drinks as much water as possible. It helps drain the bad stuff from radiation from the body.

Take care,
Eileen

Each of us is biologically unique. While you consider 2 packs a week to just be a "social smoker", in the right person those 400 carcinogens found in tobacco at that level would be enough to cause a malignancy. Doctors seldom like to tell people that their lifestyle choices may have lead them to a particular disease, because it only adds more emotional pain to the situation as the patient beats themselves up emotionally for something that they can't go back and undo. So the anseer to your question is ALL smokers are putting themselves at risk, regardless of any subjective feeling that it was light, moderate or heavy. HPV 16/18 viruses can be a cofactor and a facilataor, as well as a causative agent in their own right. This is something that has accounted for the great increase in young non smoking oral cancer patients in the last decade.

It is obviously important that regardless of the negative PET's, which are not conclusive diagnostic mechanisms, that you should be in the hands of a GROUP of doctors of different diciplines (radiation, chemo, and surgery) at a major center that will treat the patient appropriately regardless of the ability to locate a finite primary.

Just a small correction, Salagen will not PROTECT salivary function, and only aid in the producton of saliva in some post treatment patients who have compromised salivary function from their radiation treatments.

I agree that cervical mets are seldom primary locations, and an occult primary does indeed exist somewhere else.

There are others making similar inquiries here this week. Be sure to read the responses that those folks are getting - in addition to comments here in this thread.

Many of us (all of us?) have rationalized our risk factors for this cancer. The cause is no longer relevant. The cancer is. Be sure you are getting not fewer than 2 opinions about his diagnosis, his treatment options (no, its not too late to question his tx plan) and his after care strategies. Have your doc talk to you about all the other treatment options that he isn't getting. And why.

Many, many docs do not treat this cancer aggressively enough on the first round. They want to spare the patient the difficulties of aggressive treatment. Get an opinion from specialists who are successfully treating this type of cancer. Don't just consult one group of docs. The stakes are high.

Don't trust PET scans read by docs unfamiliar with this type of cancer. Don't trust docs who trust PET scans as their primary diagnostic mechanism. Its just one of many good tools used to gather data - often conflicting data - about the diagnosis. Remember,it ain't cancer till a tissue biopsy says it is, and "clean margins" from a surgery guarantees very little.

Stage 3 cancers are the 'big leagues'. Find some experts on this disease. Choose a treatment plan from a selection of treatment plans. You can do this, but you gotta do it right the first time. Fight hard. Fight smart. Be strong. Tom