Pathology, Observations, and Some Research

I have squamous cell carcinoma. It's a huge category and a very general classification. It can occur anywhere on the exterior of a body and a few places internally. Chances are you either know someone (other than me) with this diagnosis or someone you know will eventually have this diagnosis.

I need to lay a bit of groundwork so you can understand some things I've learned. If you get tired of reading the techy stuff that is the background, come back later and look for my next post. I will warn you that some parts of this post are - let's say they may be more descriptive than you may care to read.

Squamous cell carcinoma occurs in squamous cells. Squamous cells exist in skin and every other body part that has exposure to the environment. In skin they are a layer just beneath the surface of the skin. This may not be medically accurate, but if you cut yourself and bleed, you're pretty much at the depth where squamous cells are located. Basal cells are located just underneath squamous cells. Basal cells are the origin of skin cancer that is associated with sun exposure and generally considered not real dangerous. Squamous cell carcinoma is most commonly another variation of skin cancer. Squamous cell carcinoma in the skin is associated with exposure to the sun, and specifically to ultraviolet exposure.

Squamous cells play an important role in keeping stuff from the outside world outside of your body. They exist in areas with exposure to the environment, such as sinuses, throat, tonsils, lungs, etc. To put this delicately, any place that something goes in or out of your body, there is an area of exposure to the environment and there are squamous cells. Any area that is considered a mucous membrane has squamous cells.

I had a lump the size of an egg in my neck. It was made up of malignant squamous cells. In the location where I had the squamous cell carcinoma, there are no naturally occurring squamous cells. So, where did the squamous cells come from and how did they become malignant? That was the question facing my doctors.

The first thought was that my lymph system had found a cancer where there were squamous cells, had latched onto some sloughed off cancer cells, and transported them to my neck where they grew. That's very bad. That would mean there was a source cancer somewhere that had spread through my lymph system, and was probably depositing cancerous cells everywhere in my body. The lymph system exists in every part of the body. Cancer that has spread into the lymph system is capable of creating tumors anywhere and everywhere in the body.

There's one more factor that needs to be known before I go into what happened during my surgery and why it had to happen that way. Squamous cell carcinoma is either fairly harmless or incredibly evil, depending on where it's located. If you get it on your ear, they will just remove the tumor and that's pretty much the end of it. When it gets to a secondary location (my diagnosis), it is incredibly aggressive and invasive. It kills about anything it touches.

When removing a malignant tumor, the rule is to remove the tumor and enough healthy tissue around the tumor to be sure that all the malignancy is removed. That rule, the invasiveness of the tumor, and the aggressive approach to controlling an apparently spreading cancer led to my losing a lot of stuff. No malignancy was found in anything other than the obvious tumor.

I lost 1 saliva gland, 23 lymph nodes, the entire lymph duct system on the right side of my neck, the right internal jugular vein, parts of a skeletal muscle, the nerve that controls my right trapezius muscle, a thyroid gland, a parathyroid gland, and a tonsil.

The saliva gland was alive and well, but being invaded and had to be removed to ensure getting everything. That's permanent and affects chewing and swallowing.

The lymph nodes are automatic with squamous cell in the neck. None were malignant or had any cancerous cells. That indicates the lymph system is not spreading the cancer. It also indicates the lymph system probably didn't spread the cancer. That's a crucial point. I'll either get to it later in this post or in a future post.

The loss of the lymph ducts and the internal jugular vein are the source of my swollen neck and hoarse voice. I've got all my arteries intact. Arteries bring blood into an area. Blood moves into capillaries and sort of oozes out so it's available to the tissues. Other capillaries attached to veins grab onto the blood components and return them to the blood system. White blood cells, blood plasma, T-cells, and some other blood components are released by capillary action, but don't rejoin the blood components returned by the veins. Those blood components not returned form the basis of the lymph system.

The internal jugular vein is the route for blood components to leave the neck. I don't have that any more. Blood components have to randomly move around until they run into a capillary system attached to a vein that works. That leaves a lot of blood components stuck in my neck. Lymph components have no way out. The duct that used to transport them is gone. That leads to a buildup of fluids in my neck that presses on my larynx and produces unsightly swelling. This is temporary. Eventually my body will rebuild ways of dealing with this.

It's getting late and this post is getting long. It's time for me to fess up to what I've lost and what I can expect to recover. And why I had to lose what I lost.

Along with what I lost, the results of testing on the stuff that's gone changed the diagnosis and prognosis completely. I've ended up with a cancer that can't exist, but I had it. I haven't even started with what it killed. It killed pretty much everything it touched.