As my ENT explained, in situ refers to the location of the cancer in the pathologists examination. In situ, in short, means the cancer was only in the upper layer of cells or the epithelium (surface cells) and is called cancer in situ or cancer in place. This is typically the first stage of carcinomas. However, this does not indicate the cancer has not spread. Squamous Cell Carcinoma sends out thousands of cells throughout the body in the lymph fluid and the blood. For whatever reasons, some of the cells tend to attach and immediately start reproducing versus flushing out of the body through normal processing. I had a biopsy of SCC in situ for the tumor at the base of my tongue. However, and this is very important to know, I had metastatic cancer appear in 2 lymph nodes that then put me in Stage IV. One lymph node was the size of my thumb for 6-8 months while I went from doctor to doctor trying to bend an ear. I eventually went to a plastic surgeon on my own and asked to have it removed. It was so liquid filled and full of what he thought was puss that he just biopsied it and sewed me back up. His initial guess was that I had TB. It came back with a pathology of metastatic Squamous Cell Carcinoma. I then went to an ENT and the PET/CT scan showed not only the tumor on the base of my tongue but also two lymph nodes indicating metastatic cancer.

The ENT was still baffled by the second biopsy he performed when they placed my mediport, feeding tube and pulled my back molars in preparation of treatment. The pathologist report came back as Squamous Cell Carcinoma in situ. He made it a point to tell me that most people believe in situ to indicate an early stage cancer when in fact this is not always the case, especially with Squamous Cell Carcinoma. Even though I had a somewhat slow growing version of SCC, I am lucky to have found it before it spread more.

Ed