Table of ContentsView AllTable of ContentsSubtypesStagesSymptomsRate of SpreadCausesDiagnosisTreatmentPrognosisCoping
Table of ContentsView All
View All
Table of Contents
Subtypes
Stages
Symptoms
Rate of Spread
Causes
Diagnosis
Treatment
Prognosis
Coping
Squamous cell carcinoma(SCC) in the lung is one form ofnon-small cell lung cancer. Non-small cell lung cancers account for about 85% of lung cancers, many of them associated with smoking. Of these, roughly 30% aresquamous cellcarcinomas.
Squamous cell carcinoma begins in the tissues that line the air passages in the lungs. It is also known as epidermoid carcinoma. Most squamous cell carcinomas of the lungs are located centrally, usually in the largerbronchithat join thetracheato the lung.
What Are Squamous Cell Subtypes?
Survival rates vary significantly between the subtypes, with basaloid squamous cell carcinoma having a better survival rate than the others, according to research study results.The subtypes are also important in terms of how cancer responds to a specific type of drug treatment.
What Are the Stages of Squamous Cell Carcinoma?
Squamous cell carcinoma of the lungs is broken down into four stages:
What Are the Symptoms of Squamous Cell Carcinoma?
Common signs and symptomsof squamous cell carcinoma of the lung are not unlike those of other lung cancers. Symptoms typically include:
But there’s also a difference that distinguishes this form of cancer from others. Squamous cell carcinoma tends to cause symptoms earlier because it affects the larger airways of the lungs, as opposed toadenocarcinoma, which affects the edges.
This translates to higher rates of early detection, but 75% of cases are still only diagnosed after the cancer has spread.
This can cause dehydration, constipation, and kidney problems. It also can lead to mental confusion.
Paraneoplastic Syndrome: Common Types and Symptoms
How Fast Does Squamous Cell Carcinoma Spread?
Metastasis(the spreading to another part of the body) with a squamous cell carcinoma of the lung depends on a number of factors, including your overall health and smoking history. The amount of time it takes to spread will vary with the individual and the stage of the cancer.
What Is Metastasis?
What Are the Causes of Squamous Cell Carcinoma?
Squamous cell carcinomas are linked more strongly withsmokingthan other forms of non-small cell lung cancers. Overall, about 80% of all lung cancer cases in people assigned male at birth and 90% of those assigned female are associated with smoking.
While squamous cell carcinomas are intrinsically linked to smoking, other causes can contribute.
Secondhand Smoke
Secondhand smokepresents a health risk to non-smokers. In addition to lung cancer, it can be the cause of other lung diseases including chronic obstructive pulmonary disease (COPD) andasthma.
Secondhand smoke contains at least 70 toxins known to be carcinogenic (cancer-causing) and it can lead to other types of cancer too, including head and neck cancers.
Radon
Radonexposure in the home is the second leading cause of lung cancer overall. Radon gas can break down into tiny particles that lodge in the lungs and damage cells.
The Environmental Protection Agency estimates that about 21,000 people die each year as a result of radon-related lung disease, including squamous cell lung cancers.Radon also is a risk factor in certain occupations, including uranium miners.
Occupational Exposures
Asbestos exposure contributes to squamous cell lung cancer risk. Overall, the non-small cell lung cancer (NSCLC) subtypes account for at least 80% of these cases.Researchers continue to study the specific pathways in these asbestos-related lung cancers in the hopes of finding new treatment options.
Other occupational hazards that contribute to squamous cell lung cancer risk include heavy metals exposure. Toxins include:
Air Pollution
There is increasing recognition of the role that air pollution plays in lung cancer risk; the International Agency for Research on Cancer (IARC) defined it as a human carcinogen in 2013.
Still, more studies are needed to better understand the specific impacts of particulate matter (PM2.5, PM10) on squamous cell carcinomas. The results have been mixed, with some studies suggesting a greater risk of adenocarcinoma lung cancers.
Lung Disease
There’s increasing evidence that COPD is, in and of itself, a risk factor for developing lung cancer. Both have some common features, like inflammation and long-term genetic damage.An underlying lung disease also may change how the disease progresses in someone who is diagnosed with squamous cell carcinoma.
Genetics itself may also play a role, given that the lung cancer risk is statistically increased in people who have other family members with lung cancer.
Smoking and AdenocarcinomasCases of squamous cell carcinoma of the lungs have decreased in recent years but the rate of adenocarcinoma is up. The addition of filters to cigarettes allows smoke to be inhaled more deeply into the lungs where adenocarcinomas tend to develop.These cancers can, however, occur even in people who have never smoked.
Smoking and Adenocarcinomas
Cases of squamous cell carcinoma of the lungs have decreased in recent years but the rate of adenocarcinoma is up. The addition of filters to cigarettes allows smoke to be inhaled more deeply into the lungs where adenocarcinomas tend to develop.These cancers can, however, occur even in people who have never smoked.
How Is Squamous Cell Carcinoma Diagnosed?
Squamous cell carcinoma of the lungs is often first suspected when abnormalities are seen on an X-ray. Further evaluation may include:
Depending on the results, your healthcare provider may want to obtain a sample of tissue (lung biopsy) to confirm the diagnosis and will order further tests to check to see if your cancer has spread.
How Is Squamous Cell Carcinoma Treated?
Depending upon the stage of squamous cell carcinoma of the lungs, treatment may include:
Manyclinical trialsare in progress looking for new ways to treat this cancer and to help decide which treatments are most effective.
Oftentimes in the past, these different categories of treatment were used separately. For example, with metastatic squamous cell tumors, first-line therapy usually included either an immunotherapy drug or chemotherapy, but combination therapy may prove most beneficial.
Combination Treatment With Chemoimmunotherapy
Surgery
Lung cancer surgery may be possible for squamous cell carcinoma in the early stages.It may be considered in combination with other treatments, like chemotherapy and radiation therapy, in some stages as well.
Sometimes, a tumor may initially be inoperable but may be reduced in size with chemotherapy and/or radiation therapy so that surgery is then possible.
When chemotherapy is done to reduce the size of a tumor prior to surgery, it is referred to as “neoadjuvant chemotherapy.” The use of immunotherapy to reduce the size of an inoperable tumor so that surgery may be performed also has proven successful.
What Is Adjuvant Therapy?
Chemotherapy
Chemotherapymay be used alone, in conjunction with radiation therapy, or before or after surgery for lung cancer. It may also be combined with immunotherapy, and this combination appears to have the most benefit on survival in those who have metastatic disease.
For example, a 5-year follow-up study on the immunotherapy drug Keytruda (pembrolizumab) suggests a survival benefit (both overall and progression-free) when it is used during and after chemotherapy to treat squamous cell lung cancers.It’s now a first-line treatment option.
Squamous cell carcinoma of the lungs responds somewhat differently to chemotherapy medications than other lung cancers, such as adenocarcinoma. The use of platinum-based drugs is more likely to achieve complete remission.
Common medications used initially for this type of cancer include:3
For those who respond to treatment, continuous (maintenance treatment) with Tarceva (erlotinib) or Alimta (pemetrexed) may be used.
Radiation Therapy
Radiation therapy may be used to treat cancer or to control symptoms related to the spread of cancer.Radiation may be given externally, including stereotactic body radiation therapy (SBRT) that targets tumors precisely. Internal (brachytherapy), in which radioactive material is delivered to a precise area of the lungs, is another method used.
Targeted Therapy
Instead of targeting EGFR mutations, anti-EGFR antibodies are a class of drugs used to bind to EGFR on the outside of cancer cells. When EGFR is thus bound, the signaling pathway which tells the cell to grow is halted.
Portrazza(necitumumab) may be used along with chemotherapy for advanced squamous cell cancers.Gilotrif (afatinib), another type of targeted therapy, is also used with chemotherapy, specifically in cases where a person is not eligible for immunotherapy. This type of treatment is most commonly prescribed for people with epidermal growth factor genetic aberrations.
Immunotherapy
Immunotherapydrugs were first approved for the treatment of lung cancer in 2015. The immunotherapy drugs have been approved for SCC of the lungs, used as monotherapy or in combination with other treatments. These immunotherapy drugs include:
These treatments enhance the immune system’s ability to fight off cancer cells.
Immunotherapeutic drugs are currently approved for people with a metastatic non-small cell lung malignancy whose cancer has progressed during or after platinum-based chemotherapy.
As noted above, for metastatic squamous cell carcinoma, the combination of Keytruda and chemotherapy greatly improved survival.
What Is the Prognosis of Squamous Cell Carcinoma?
Keep in mind that statistics describe the “average” course or survival. Ultimately, each person is different. Many factors can affect the prognosis of squamous cell lung cancer including your age at diagnosis, your sex, the condition of your general health, and how you respond to treatments.
For example, the five-year survival rate for non-small cell lung cancer is based on people who were diagnosed five years earlier. Since many significant treatments for squamous cell cancer of the lung may have been approved after those individuals were diagnosed, statistics do not necessarily indicate how someone diagnosed today will do.
Currentfive-year survival ratesfor non-small cell lung cancer diagnosed between 2012 and 2018 are 65% for localized cancer that hasn’t spread. It’s just 9% for metastatic cancers, with an overall rate of 28% across the stages.
Most lung cancers, including squamous cell carcinoma of the lung, are detected after they have spread and so are difficult to treat. The diagnosis is serious, but early detection and newer treatments are helping to extend survival for people living with lung cancer.
Coping With Squamous Cell Carcinoma
A diagnosis of squamous cell carcinoma of the lungs is frightening and you may feel very alone. This is the time to reach out and allow your friends and loved ones to support you.
Studies show that people who better understand their cancer not only feel more empowered, but that knowledge can sometimes make a difference in survival as well.
Not all oncologists may be familiar with the latest studies. Since general oncologists may not be abreast of fast-changing research, many lung cancer survivors recommend obtaining asecond opinionfrom one of the larger National Cancer Institute-designated cancer centers.
See if you can find a support group for people with lung cancer in your community or connect with alung cancer communityonline. Check out the lung cancer organizations such as LUNGevity, the American Lung Association Lung Force, and the Lung Cancer Alliance.
When searching for others with lung cancer on social media, the hashtag is#LCSMwhich stands for lung cancer social media. If you are under the age of 50, check out the Bonnie J. Addario Lung Cancer Foundation, an organization that takes a special interest inlung cancer in young adults.
Summary
Squamous cell carcinoma of the lung is commonly associated with smoking and accounts for about 30% of all non-small cell lung cancers, which constitute the majority of smoking-related cancers. Yet others can develop squamous cell carcinoma too, including people exposed to radon, asbestos, secondhand smoke, and air pollution.
The treatment choices and outlook after a squamous cell lung cancer diagnosis depend on a number of factors, including the metastasis (spread) of the cancer and a person’s overall health. Generally, though, the long-term prognosis is poor, but some studies find differences depending on the cancer subtype.
Research and treatments for squamous cell carcinoma of the lung are changing rapidly, and many survivors are currently alive because they educated themselves. It’s important to become anadvocate for your healthand learn about your disease and treatment options.
31 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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