I've done quite a bit of research since I was diagnosed, but find I still don't quite understand cancer, and have some fundamental questions.

With all the bad news on the forum lately, I wonder what type of head and neck cancer is considered aggressive. Is(are) all types squamous cell-carcinoma aggressive? Is the degree of aggressiveness based on location, different types of squamous cell and/or the immunostains done on the biopsy?

Thanks
Sandy

Sandy, you are quite the thinker. I am sure there are a lot of us wondering that too. You have asked a verry good question and I for one will watch the forums for the answers that will surely come.

SCC just gives you the cell type that has gone bad. I.e. the squamous cells.
It does not tell how these cells arrived at the dark side. (There are many way screwing up a cell, it is a wonder they actually work especially if you consider the numbers and the fact that they must constantly change)
That is to say not all SCC are the same. Some respond to MAB treatments while others do not.
For example; only around 20-30% of breast cancers can respond to herceptin, were a growth factor is over expressed. .... and there are also different ways that a growth factor can get over expressed/overactive too.
Back to SCC, there are chromosomal abnormalities (translocation, detetions etc), but in cancer cells things go haywire because they are not normal anymore. Therefore it may be that some of these abnormalities are a consequence (but not the cause) of a loss of normal cellular control. Some of that you can see with FISH etc but I doubt very much that this is done routinely!
Also, this is just one side then there is also the immune system that may or may not help fighting this.

This is a gross simplification, and I will not even pretend that I am current in this. What you really need is to talk to a cancer geneticist that specializes in SCC.
On the other hand to put is bluntly: it is what it is. The treatment is essentially fairly standard, we are not at the point of (very) individualized medicine.

M

You might be interested in this:
The Journal of Laryngology & Otology (2009), 123 : 266-272 Cambridge University Press

Thanks Markus. You always did have the right answers for me and others.

Sandy

When I was first diagnosed in August 2007, I was stunned that all the internet sites and hospital web sites consistently described Head and Neck Cancer as "very aggressive" with poor survival rates. Now part of that is due to late discovery so many H&N cancers are stages III and IV - skewing the statistics. Part of the puzzle is genetic, here is a link to a news article exploring "micro-RNA": Genetic markers for Agressive H&N Cancer My wife has always been depressed by the ubiquitous 50% 5 year survival rate that appears in this article also. There was also a very informative general article in Parade magazine today in the Ask Marilyn column about fundamental cancer issue and why a cure is so elusive (it's not a foreign invader like virus or bacteria, it's your own cells gone wild; only one cell needs to survive treatment to have a recurrence; current treatment kills normal cells, etc.) Bottom line is that our cancer is one of the very worst.
One excellent source of information is the OCF feed on news plus the archived articles on the OCF board. Many times a news article that Google pulled for me is explained much better and more accurately on Brian's selection of the news.

Sandy

If you want highly technical exposition of micro RNA and the genetic component of cancer, the OCF site has this excellent article. In looking for this, I was glad to see that OCF uses the 50% survival figure also as I like to be in sync with OCF facts rather than news article distortions. OCF oncogenes and cancer
charm

I concur,
the article by Croce is an excellent starting point and it is right here at OCF.
M

Hi Sandy,
Two reasons the doctors consider my husband's cancer very aggressive (we are on #4 since 2005) are that his is poorly differentiated, which means it grows very quickly. He also has PNI or Peri-neural invasion. I don't know what the percentages are of all SCC having these characteristics, but it would be interesting to find out.
Lori

Sandy and Lori

They refer to my cancer as an agressive cancer also - it really grows quickly and did not respond to either of the chemo treatments that we tried. i'm going to quiz them about my Erbitux success this next appointment. the rash has started already though and that makes me happy. My last blood work showed a very high white blood count and that is from fighting this infection. I do know that once the biopsy was done, my tumor took on a life of it's own. right now I do not know the exact location of the cancer other than the right side of my neck as opposed to the left side and need to have some scans done so that I know what we have now so that I can tell if I am responding to the Erbitux or not. My plastic surgeon mentioned that someday they will be able to genetically identify each cancer and how to treat them differently instead of trying the same treatments on different cancers. I think that will make a huge difference in successful treatment.

Patty

Thanks Everyone:
I appreicate the technical paper, but I was hoping for a more pedestran answer. I might have good questions, but I think your giving me too much credit to be able to decipher all the technical info. LOL.

Can someone make a general statement of what the piece was stating? I think I know, but would love someone more knowledgeable than me to explain.

Thanks
Sandy