About Head and Neck Cancers

Overview

Head and neck cancer is a term used to describe a group of malignant tumors that develop in the mouth, throat, larynx (voice box), and other parts of the head. These tumors typically arise from the epithelial lining of these structures. The most common type of head and neck cancer is squamous cell carcinoma, accounting for 85%-95% of cases. They can affect vital functions such as speech, swallowing, hearing, and breathing, which can have a profound impact on patients' quality of life.

Types of head and neck cancers include:

Oral cancer: Cancer that develops in the lips, tongue, gums, buccal mucosa (lining of the cheeks), and top or bottom of the mouth
Oropharyngeal cancer: Cancer that develops in the middle section of the throat (the oropharynx)
Hypopharyngeal cancer: Cancer that develops in the bottom section of the throat
Laryngeal cancer: Cancer that develops in the larynx, including the vocal cords
Nasopharyngeal cancer: Cancer that develops in the upper part of the throat (the nasopharynx)
Salivary gland cancer: Cancer that develops in the salivary glands. The salivary glands produce saliva.
Nasal cavity cancer: Cancer that develops in the hollow area inside the nose
Paranasal sinus cancer: Cancer that develops in the hollow spaces around the nose (the paranasal sinuses)

The incidence, prevalence, and mortality rates of head and neck cancers are high globally. Ongoing research aims to better understand the molecular pathways involved in head and neck cancer development and identify potential targets for treatment.

Causes and Risk Factors

Head and neck cancers are causes by changes in the DNA in cells of the head and neck area. These mutations cause cells to abnormally multiply, causing masses or tumors. The exact reason that DNA mutates is not known. There are several risk factors that can contribute to the development of head and neck cancers.

Non-modifiable risk factors for head and neck cancers cannot be changed or controlled. These include:

Age: The risk increases with age.
Gender: Men may be more commonly affected than women.
Genetic predisposition: Certain genetic mutations may be inherited and increase risk of some head and neck cancers.

Modifiable risk factors for head and neck cancers can be influenced or changed. These include:

Tobacco use: Smoking cigarettes, cigars, or pipes, as well as using smokeless or chewing tobacco, increases the risk.
Alcohol consumption: Heavy and prolonged alcohol use is a known risk factor.
Human papillomavirus (HPV) infection: Particularly for oropharyngeal cancer, HPV infection is a significant risk factor.
Exposure to chemical fumes: Some chemical fumes, such as paint fumes, increase the risk of nasal and paranasal cancer.
Exposure to ultraviolet light: UV light from the
Poor oral hygiene: Neglecting oral hygiene can contribute to the development of oral cancers.

It's important to note that these are general risk factors and individual cases may vary. Consult with a healthcare professional for personalized advice.

Symptoms

The most common early symptoms of head and neck cancers include:

A lump in the neck
Persistent sore throat
Limited mobility of the tongue
Chronic hoarseness or changes in voice
Difficulty swallowing
Pain when chewing or swallowing
Presence of non-healing ulcers in the mouth or throat
Erythro- and/or leukoplakia (abnormal patches in the mouth)
Epistaxis (nosebleeds) or nasal blockage on one side

As the cancer progresses or reaches a higher severity, additional symptoms may occur, such as:

Pain in the neck or throat that does not go away
Pain or ringing in the ears
Trouble hearing
Trouble breathing or speaking
Swelling under the chin or around the jawbone
Numbness or paralysis of facial muscles
Problems with dentures fitting properly

It's important to note that these symptoms can also be caused by other, less serious conditions. If you experience any of these symptoms, it's crucial to consult with a doctor or dentist for a proper evaluation.

Diagnosis

To diagnose head and neck cancer, doctors may perform the following examinations, tests, and procedures:

Medical history review: The doctor will gather information about your medical history, including any previous diagnoses.
Physical examination: The doctor will conduct a physical exam to look for physical signs of a medical problem, such as pain, swelling, or masses in the head and neck area.
Lab tests: Blood samples may be taken and sent to the lab for analysis. In addition to general health, blood tests may look for signs of infection, inflammation, or other causes of symptoms.
Biopsy: A biopsy involves taking a small tissue sample from the affected area for further analysis. This helps determine if cancer cells are present.
Imaging scans: Various imaging scans may be used to assess the extent of the cancer and determine its stage. These include ultrasound, PET (positron emission tomography) scan, MRI (magnetic resonance imaging) scan, and CT (computed tomography) scan.

Other examinations, test, or procedures may be performed based on initial findings or individual factors. These may include:

Lymph node biopsy: If lymph nodes are enlarged, a biopsy may be performed to check for cancer spread.
Endoscopy: An endoscope is used to examine areas like the mouth, nose, pharynx, and larynx more closely. This can be done under general anesthesia or using a transnasal flexible laryngo-esophagoscopy.
Barium swallow: This test uses X-ray or CT scan to check for cancer along the gastrointestinal tract, including the throat.
Biomarker testing: Biomarker testing analyzes tumor samples to identify specific genetic mutations or markers that can help guide treatment decisions.

These procedures help healthcare providers diagnose head and neck cancers and determine their stage or severity. It's important to follow up with your healthcare provider if any symptoms worsen or change after the initial examination.

Treatment Options

The goals of treatment for head and neck cancers include:

Eliminating tumor cells: The primary goal is to destroy or remove as many cancer cells as possible to achieve a cure or control the disease.

The treatment options for head and neck cancers include:

Surgery: The mainstay of treatment is surgery, which aims to remove the tumor with sufficient safety margins. The goal is to achieve complete healing and prevent recurrence.
Radiation therapy: High-energy ionizing radiation is used to destroy cancer cells locally. It can be used alone or in combination with other treatments.
Chemotherapy: Systemic treatment that uses drugs to destroy cancer cells or prevent their growth. It can be given before surgery (neoadjuvant), after surgery (adjuvant), or in combination with radiation therapy.
Targeted therapy: These medications specifically target certain molecules involved in cancer growth and can be used in combination with other treatments.
Immunotherapy: This treatment helps the immune system recognize and attack cancer cells more effectively.

Other recommended treatments and health behavior changes may include:

Supportive services: Physical and occupational therapy, speech and swallow therapy, and nutrition support can help manage the side effects of treatment and improve quality of life.
Lifestyle changes: Quitting smoking, reducing alcohol consumption, and adopting a healthy diet can help improve treatment outcomes and reduce the risk of recurrence.

It's important to note that specific treatment recommendations depend on factors such as the stage of the cancer, its location, and individual patient characteristics. Consultation with healthcare professionals is crucial for personalized treatment plans.

Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.