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Cancer of unknown primary

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Treatment of squamous cell carcinoma in cervical lymph nodes

Squamous cell carcinoma accounts for a small number of cases of cancer of unknown primary (CUP). People with a squamous cell carcinoma of unknown primary in lymph nodes in the neck (cervical lymph nodes) may be treated as if they have a head and neck cancer.

Surgery

Surgery may be offered to treat squamous cell carcinoma in lymph nodes in the neck. Lymph nodes in the neck are removed (neck dissection). Different types of neck dissection may be done depending on the number of lymph nodes and tissue removed.

  • partial or selective neck dissection
    • Only a few lymph nodes are removed.
  • modified radical neck dissection
    • Most lymph nodes on one side of the neck are removed (between the jawbone and collarbone). Some muscle and nerve tissue is also removed.
  • radical neck dissection
    • Nearly all the lymph nodes on one side of the neck are removed. More muscle, nerves and veins are removed than in a modified radical neck dissection.

Surgery may be used alone if cancer is only in one neck lymph node.

Radiation therapy

Radiation therapy may be used instead of surgery when a larger area needs to be treated. Radiation therapy is usually given to lymph nodes on both sides of the neck and areas of the neck (such as the pharynx) where doctors think the cancer may have started or that may contain cancer.

Some people may be treated with both surgery and radiation therapy. Radiation therapy may be given before or after surgery.

Chemoradiation

Chemotherapy may be combined with radiation therapy (chemoradiation). This may be an option for larger cancers or if cancer is present on both sides of the neck. Chemotherapy drugs used for squamous cell carcinoma may include cisplatin (Platinol AQ), 5-fluorouracil (Adrucil, 5-FU) and a taxane drug.

Clinical trials

People with CUP may be offered the opportunity to participate in clinical trials. For more information, go to clinical trials.

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