Introduction—The Biology and Pathology of Squamous Cell Carcinomata in the Head and Neck

Newell W. Johnson

Abstract A very wide range of homeostatic processes are disturbed in cancer. These are visible at patient, lesion, tissue and cellular levels and are increasingly understood at a molecular level, providing many opportunities to research molecular therapeutic targets. This chapter introduces and contextualises most of the processes currently understood as of importance to the biology of cancer: many of these understandings are comparatively new; some are speculative. It is upon such speculations and the application of scientific method that progress in cancer prevention and management depend.


In an era of vast expansion in knowledge of cell and molecular biology, and in many technologies which enable vast datasets to be generated, it is wise to go back to basic biology: to emphasise that molecules behave only within cells; that cells interact with their neighbours of both similar type/function and with surrounding supporting and infiltrating cells; that these behave within tissues; tissues comprise organs; and the whole “maketh the man”. Further, individual human beings exist within family and community structures, the behaviour of which influences risks and resistance to disease, including cancer. There are dangers in studying molecules, cells and people in isolation.

This chapter attempts to take us back to the basics of mammalian biology with, necessarily brief, explanations of the mechanisms involved—of homeostasis—and of how these are deranged in cancer. Examples are drawn from one major type of neoplasm—squamous cell carcinomata (SCC)—as these are the major public health

N.W. Johnson (H)

CMG, FMedSci Dean Emeritus, Menzies Health Institute Queensland and Griffith University, Gold Coast Campus, QLD, Australia e-mail: This email address is being protected from spam bots, you need Javascript enabled to view it © Springer Science+Business Media B.V. 2017 S. Warnakulasuriya and Z. Khan (eds.), Squamous Cell Carcinoma, DOI 10.1007/978-94-024-1084-6_1

challenge amongst head and neck cancers (HNSCC). Many of these biological processes are explained in detail in subsequent chapters where research has reached a sufficient stage for the control pathways to be targeted in patient care, especially so in the current era of personalised cancer care.

Many modern textbooks cover these topics in greater detail than is possible here. Bernier (2011) has specific chapters dealing with most aspects of cancer biology with a focus on head and neck oncology. Other more general, and very detailed, resources are: Weinberg (2013), Mendelsohn et al. (2015) and Pelengaris and Khan (2013). Rather than summarise, or worse plagiarise, these texts, the approach taken in the present chapter has been to use information from international peer-reviewed journals, and understandings, prejudices and questions derived from this author’s experience of head and neck oncological research and patient care.

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