Pin Me

The Progression of Lung Squamous Cell Carcinoma

written by: Eric Haines • edited by: Emma Lloyd • updated: 8/18/2010

Lung cancer is the leading cause of cancer-related death worldwide. Lung squamous cell carcinoma is the second most common lung cancer with a prevalence of approximately 30%. Like most cancers, lung squamous cell is a progressive disease that can be divided into diagnostic stages: Stage I-IV.

  • slide 1 of 8

    Lung cancer is the leading cause of cancer-related death worldwide. Moreover, only 16% of patients diagnosed with lung cancer survive for at least five years. While smoking is considered the cause of approximately 90% of all diagnosed lung cancers, second-hand smoke, air pollution and lung diseases (tuberculosis and chronic obstructive pulmonary disease) can also be important risk factors.

    The two main types of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). SCLCs are less common, but their tumors are more likely to grow faster and metastasize to other organs compared to NSCLC. Lung squamous cell carcinoma, an NSCLC, is the second most common lung cancer with a prevalence of approximately 30%. It is characterized by the malignancy of the layered, squamous epithelium (surface cells) of the lungs and/or bronchi.

  • slide 2 of 8

    The Progression of Lung Squamous Cell Carcinoma

    Like most cancers, lung squamous cell carcinoma is a progressive disease that can be divided into diagnostic stages:

  • slide 3 of 8

    Stage I

    Stage I squamous cell carcinoma is characterized by a tumor that can be readily removed surgically and has yet to spread or metastasize to the lymph nodes. Patients generally present with the following:

    • New or changing cough
    • Pink/bloody sputum (mucus and/or phlegm mixed with saliva)
    • Hoarseness, a harsh or strained voice
    • Shortness of breath
    • Increased sputum
    • Recurrent lung infections
    • Weight loss
    • Fatigue

    Stage I is divided into stages IA and IB. Stage IA tumors are located only in the lung and are 3 centimeters or smaller in size, whereas, Stage IB tumors have at least one of the following:

    • Tumor size greater than 3 centimeters
    • Spreading of cancer to the main bronchus of the lung and/or the innermost layer of the membrane that covers the lung
    • Partial blockage of the bronchus or bronchioles

    At this stage, the cancer is considered highly treatable, with 50-80% of diagnosed patients surviving for at least 5 years. The most common treatment option is surgery, which generally involves the removal of the affected lung tissue/lobe.

    For patients who are not good surgical candidates due to age or overall poor health, radiation therapy can be considered as an alternative option.

  • slide 4 of 8

    Stage II

    Stage II lung cancer is characterized by the spreading of the tumor to the hilar lymph nodes, specialized immune organs in the thoracic cavity or the mediastinum. This part of the thoracic cavity is located between the lungs, and contains the heart, esophagus, trachea and thymus. Most patients have similar symptoms as in Stage I, but might also have swelling of the arm and/or face.

    Stage II is also divided into two stages, IIA and IIB. Stage IIA tumors are 3 centimeters or smaller and the involved lymph nodes are on the same side of the chest as the tumor. Whereas, Stage IIB tumors are defined by same side lymph node involvement with one or more of the following:

    • Tumor size greater than 3 centimeters
    • Spreading of cancer to the main bronchus of the lung and/or the innermost layer of the membrane that covers the lung
    • Partial blockage of the bronchus or bronchioles
    • Collapsed lung or pneumonitis

    While migration of the tumor to the lymph nodes is associated with a poorer prognosis (5 year survival in only 30-50% of patients), treatment options are still consider relatively effective. Similarly to Stage I, surgery (removal of the affected lobe) is considered the standard treatment, with radiation as a secondary option. However, it is important to note that the combination of surgery and chemotherapy has been shown to improve patient outcomes.

  • slide 5 of 8
  • slide 6 of 8

    Stage III

    Stage III squamous cell lung cancer is divided into two subtypes: Stage IIIA and Stage IIIB. Only 5-30% of diagnosed patients survive for at least 5 years (Stage IIIA, 10-30%; Stage IIIB, 5-20%). Both subtypes are similar in that they both have lymph node involvement, but differ in the ability to surgically remove the tumor; with Stage IIIB tumors being considered impossible to remove.

    Stage IIIA tumors are characterized by the spreading to the lymph nodes on the same side of the chest as the tumors with:

    • A tumor of any size.
    • Spreading to the main bronchus, chest wall, diaphragm, pleura around the lungs or the membrane around the heart
    • No spreading to the trachea
    • Part or all of the lung may have collapsed or developed pneumonitis

    Stage IIIB tumors can be any size and spread to:

    • The lymph nodes above the collarbone or in the opposite side of the chest from the tumor
    • The heart, major blood vessels, chest wall, diaphragm, trachea, esophagus, sternum (chest bone), more than one lobe of the lung or the fluid of the pleural cavity

    These tumors are usually treated with radiation and chemotherapy, surgery or a combination of chemotherapy and surgery.

  • slide 7 of 8

    Stage IV

    The final and most malignant stage (IV) is defined by the spreading of the tumor to distant sites, i.e. sites other than local lymph nodes such as the liver, brain, kidneys and bones. Survival in Stage IV patients is rare, with less than 5% of patients surviving at least 5 years. Patients present with similar symptoms described above in Stages I through III plus additionally symptoms such as:

    • Severe headaches
    • Double vision
    • Pain in bones, chest, abdomen, neck or arms

    A cocktail of chemotherapy treatments combining Platinum-based drugs such as Cisplatin or Carboplatin with other chemotherapeutic agents such as Taxol, Taxotere, Gemzar or Navelbine, has been shown to be effective in reducing tumor growth and symptoms.

  • slide 8 of 8

    References

    eMedicine Health - http://www.emedicinehealth.com/lung_cancer/article_em.htm

    Cancer supportive care programs - http://www.cancersupportivecare.com/nonsmallcell.html

    National Cancer Institute - http://www.cancer.gov/cancertopics/pdq/treatment/non-small-cell-lung/Patient/page2#Keypoint13

Share
Additional Info
Additional Info