My husband was diagnosed in December with stage III SCC with an unknown primary. After a CT, PET scan, tongue biopsy, and tonsillectomy, he still has an unknown primary. The tumor they found is a 3cm tumor on the right side of his neck. He elected to have radiation and chemo over a neck dissection and radiation. He will begin radiation and chemo next week. We were told it would be best to determine the primary source--what is the difference? He is an otherwise healthy 52 year old, social drinker and non-smoker.
Also, they found a 6mm lesion on his right lung in the PET scan, and the ENT said all they can do is have a pulmonologist keep an eye on it. Does anyone have any experience with SCCUP presenting only in a lymph node, then spreading to the lung?
The relatively long time between diagnosis and treatment happened because we had to wait to get in with the cancer center here--he was diagnosed just before the holidays, so getting an appointment there took 3 weeks.

Hi MQC,

Sorry to had to find this site but consider yourself lucky. This is a wonderul site with great people and information.

My diagnosis is a little bit different than your husbands but they did find a nodule on my right lung. My scc is on my right tongue. My cancer has been treated surgically. I do see see a pulminary doctor and I get a chest CT every 6 months. After I do that for 2 years and there are no changes they won't need to see me anymore.

I wish you and your husband much luck and feel free to ask as many questions as you can think of. There are so many great people who can help.

Suzanne

Hello and welcome. When I was diagnosed I had a 4.5 cm tumor on my right neck. They had a hard time finding the primary and the ent said it was possible but unlikely that that was the whole thing. Then he went in and took samples from several areas of my throat and found the primary on my right tonsil. The difference is, once they find the primary they can aim the radiation at both, nodes and primary, to do a more thorough job. Best of luck to you both.

Hi, and thank you for your reply. Did they treat the nodule on the lung surgically, or just the cancer on the tongue? Does SCC usually spread to the lung? My stepfather is a doctor, but not an oncologist, and he said it usually does not go to the lungs.

The usual path for SCC is to start in the OC, the Primary, then it can spread to the nodes and from there normally to the lungs or brain. Most of the time it's stopped before spreading past the nodes but it is more common than not that it's found already in the nodes.

My question is without the Primary and without a ND, how did they determine it's SCC? Did they do a FNA on the node?

Hi. Thank you for the information. I don't know what a FNA is, but they did a needle biopsy to determine that it was SCC.

FNA=fine needle aspiration biopsy (what you had).

Suzanne,

Sorry you are here, but I know you will get a lot of help, advice and support here. I couldn't do this journey alone and am so grateful I stumbled on this site.

When I was first diagnosed it was as a CUP. I had a lump on the left side of my neck which was needle biopsied (FNA) and it came back suspicious. I had a left neck disection surgery which removed a 3cm node along with several other items like tonsils, salivary glands, nodes etc... The only thing that came back positive initially was the one 3cm node. In addition while I was under GA they did a whole lot of biopsies on other areas, but couldn't locate a primary.

After my surgery I had a pet scan that lit up the entire back of my throat, but they attributed most of that to healing/trauma from my tonsilectomy and biopsies. I was uncomfortable with the local hospital so I traveled to a differnt facility. Once there I went under GA again with a different ENT, she was was able to locate a small malignancy at the left BOT. In addition another set of eyes on the original CT/PET scan also read it differently.

I was relieved that they found the primary because before I went for 2nd opinions my 1st RO wanted to use an older linear RT and radiate the entire oral cavity and both sides of the neck. Once the primary was discovered it allowed for a more focused IMRT and subsequently less collateral damage.

We are all differnet and present differently, this was just my circumstances. You don't say what facility your husband is scheduled to get his treatment at. The only advice I would give you is; get a 2nd opinion from a comprehensive cancer center if he isn't being treated at one now.

God Speed
Tim

[quote=mqc]Hi, and thank you for your reply. Did they treat the nodule on the lung surgically, or just the cancer on the tongue? Does SCC usually spread to the lung? My stepfather is a doctor, but not an oncologist, and he said it usually does not go to the lungs. [/quote]

MQC,

I think this question was a response to what I had posted. They only treated my tongue b/c that is where the cancer is/was. They found a lung nodule during a PET scan. Since then they just check it every 6 months with a CT scan. As long as there are no changes to the nodule over a 2 year time period they consider it not cancer and they won't worry about it. I have one year under my belt so far.

David responded to where oral cancer usually spreads to and I have been told it's not unusual for it to spread to the lung.

I hope this answers your questions.

Suzanne

mqc, My husband's cancer was on the base on his tongue with spread to his neck and lymph nodes. After he went through chemo and radiation another positive node popped out on his neck and the preadmission testing showed a lesion on his chest which proved to be a metastasis from the original SCC from his mouth. He did eventually have mets to both his lungs. Is there any talk about having the spot biopsied? My husband's initial chest metastasis was done with a scope down into the chest.

Sue