Head and Neck Cancer

Head and neck cancer is a wide term that encompasses a variety of cancers that develop in the head and neck region. The majority begin in the squamous cells that comprise the wet tissue that borders the mouth, throat (pharynx), larynx, and nasal passages. Doctors refer to this as head and neck squamous cell carcinoma (HNSCC). Most head and neck malignancies begin in squamous cells.

About 9 in 10 head and neck cancers (90%) start in squamous cells.

If you have head and neck cancer, your oncologist will consult with you to establish the best treatment options. The idea is to battle the disease while protecting your body’s organ that allows you to speak, eat, and create facial emotions. The earlier you detect and treat the disease, the better your chances of recovery.

Head and neck cancer is not a diagnosis. Rather, it is a category of cancer that has some similarities. For example, many head and neck cancers share the same risk factors and treatments.

Types of Head and Neck Cancer

There are several types of head and neck cancer. Here’s a summary of the types of cancer and the areas they affect:

  • Hypopharyngeal cancer

Cancer cells are found in tissues in the lower part of the throat behind the larynx.

  • Nasopharyngeal cancer

Cancer cells are found in tissues in the upper part of the throat behind the nose.

  • Oropharyngeal cancer

Cancer cells are found at the back of the oropharynx.

  • Sinus and nasal cavity cancer

Cancer cells are found in tissues in the small cavities around the nose called the sinuses and nasal cavities. The nasal cavity is located just behind the nose.

  • Cancer of the salivary glands

Cancer cells are present in the salivary glands.. These glands are located just under the tongue, on the sides of the face in front of the ears, and under the jawbone. Salivary glands are also found in various parts of the upper digestive tract.

  • Oral cavity cancer

Cancer cells are present in the mouth cavity. These areas include the lips, teeth, gums, the front two-thirds of the tongue, the inside of the lips and cheeks, the area under the tongue, the palate, and a small area behind the wisdom teeth.

  • Laryngeal cancer

Cancer cells are found in the larynx. Most cancer cells start in the mucosal surface and are also called squamous cell carcinoma (SCC). Other less common forms include salivary gland cancer or cancer that starts in muscle, cartilage, or other structural tissues (sarcoma).

  • Skin cancer

Cancer cells are found in tissues that form on the surface of the skin.

  • Melanoma of the head and neck

Melanoma is a cancer that begins in melanocytes, the cells that give skin its pigment or color.

  • Basal cell carcinoma of the head and neck

Basal cell carcinoma is a type of non-melanoma malignant tumor that begins in abnormal basal cells of the skin.

  • Squamous cell carcinoma of the head and neck

This is a type of non-melanoma malignant tumor. This is the second most frequent kind of skin cancer. It is more aggressive and may require extensive surgery depending on the location and nerve involvement.

  • Sarcoma of the head and neck

Cancer cells are present in the soft tissues of the body such as muscles, connective tissue (tendons), blood or lymphatic vessels, joints, and fat.

  • Head and neck cancer with unknown primary tumor

This type of cancer usually appears as a lump in the neck. This indicates that the cancer has spread to one or more lymph nodes in the neck.

How common is head and neck cancer?

Head and neck cancer account for around 4.5% of all cancer diagnoses globally. Most head and neck cancers occur in men over the age of 50. However, this may be because this group is more likely to have risk factors associated with these cancers, such as: B. History of tobacco use.

 

In India, HNC accounts for about one-quarter of all cancers in men and one-tenth of all cancers in women.

  • The incidence of HNC is highest in Northeast India.
  • The most common HNC in India is oral cancer.
  • Recently, the incidence of HNC has increased, especially for oropharyngeal cancer.

Risk Factors

There are numerous known risk factors for head and neck cancer. These include tobacco consumption and alcohol consumption. Other risk factors vary depending on where the cancer begins. Cancers of the mouth, throat, sinuses, and salivary glands are all types of head and neck cancer.

 

In general, the following factors increase the risk of head and neck cancer:

  • Tobacco use

Consuming any type of tobacco increases the risk of many types of head and neck cancer. Examples of tobacco types include cigarettes, cigars, pipes, chewing tobacco, and snuff.

  • Alcohol consumption

Frequent and heavy alcohol consumption increases the risk of many types of head and neck cancer.

  • Exposure to HPV

Exposure to the human papillomavirus, also known as HPV. HPV is a common sexually transmitted virus. In most people, it goes away on its own without any problems, but in some, it can cause cell changes that can lead to many types of cancer. Many throat cancers are thought to be caused by HPV.

  • Inhalation of airborne chemicals

Exposure to airborne chemicals may increase the risk of cancer of the nose and sinuses. Chemicals in the home or workplace can increase your risk.

  • Exposure to sunlight or tanning lamps

The sun’s ultraviolet radiation raise the risk of head and neck skin cancer. UV rays also come from tanning bed lamps.

What are the signs of head and neck cancer?

Usually seen Head and neck cancer symptoms are often mild. They may resemble less serious illnesses, such as a cold or sore throat. A sore throat that doesn’t get better is the most common sign of head and neck cancer. Depending on the type of head and neck cancer, symptoms may include:

  • A persistent sore throat.
  • Persistent ear pain or symptoms of an ear infection (especially if your doctor determines your ear condition is normal).
  • Frequent headaches.
  • Pain in the face or neck that does not go away.
  • Pain in the upper teeth.
  • Pain when chewing or swallowing.
  • Hoarseness or changes in your voice.
  • Problems breathing or speaking.
  • A lump in your throat, mouth, or neck.
  • A nosebleed that doesn't go away.
  • Frequent nosebleeds or blood in the saliva or mucus.
  • White or red spots on the gums, tongue, or inside the mouth.
  • Swelling in the jaw, neck, or sides of the face (which can cause dentures to not fit properly.

If you observe any of these symptoms, call your doctor immediately.  These could also be signs of something less serious, but a thorough exam is needed to know for sure.

Diagnosis and Tests How is Head and Neck Cancer Diagnosed?

 Diagnosis usually starts with a physical exam. During the exam, your doctor will examine your mouth, sinuses, throat, and neck. This includes feeling your neck, lips, gums, and cheeks for lumps. Depending on your doctor’s findings, you may need the following test:

  • Endoscopy

 This test uses a thin, lighted tube to allow your doctor to look into your nasal passages, throat, or larynx. This procedure is usually performed in the office

  • Imaging tests

X-rays of the head and neck, CT scans, MRIs, and PET scans can reveal tumors inside the body.

  • Lab tests

If the results are concerning, your doctor may perform an HPV test to see if the HPV virus is causing your cancer.

  • Biopsy

Only a biopsy can confirm that a tumor is cancerous. A doctor removes tissue from the tumor to be examined by a pathologist for the presence of cancer cells. 

Staging of Head and Neck Cancer

Staging of head and neck cancer helps medical professionals determine how advanced the cancer is. Doctors use the TNM (Tumor, Node, Metastasis) system to stage head and neck cancer. This system takes into account the following:

  • The size and location of the tumor (T)
  • Whether the cancer has spread to lymph nodes (N)
  • Whether the cancer has spread, or metastasized, to other parts of the body (M) With this information, doctors give you a number from I to IV.

The details of the stage vary depending on the type of head and neck cancer. But generally, lower numbers (I and II) mean the cancer is in the early stages. 

Head and neck cancer has the highest success rate in treating the early stages.

Treatment

  • Surgery

Surgery removes cancerous tissue while preserving as much function of the head and neck area as possible, such as breathing, swallowing, and speaking. The type of operation is determined by the Head and neck cancer. As the emergence of new technologies like Minimally Invasive -Surger , Robotic Surgery, the success rates and results are outstanding with less cuts, early recovery, low side effects.

  • Radiation Therapy (Radiotherapy)

Radiation therapy uses controlled amounts of radiation to damage or kill cancer cells. It may be used alone as the main treatment for head and neck cancer. Radiation treatment can also be used after surgery (adjuvant therapy) or in conjunction with chemotherapy.

  • Chemotherapy

Chemotherapy uses certain drugs to kill cancer cells or slow their growth. The medications are often administered by injection into a vein.

  • Immunotherapy

Immunotherapy is a type of treatment that uses the body’s immune system to fight cancer and may used to treat head and neck cancer.

  • Targeted Therapy

Targeted therapy drugs work on certain properties of cancer cells to stop them from growing

  • Palliative Care

If you have head and neck cancer, your health care team may discuss palliative care with you. The goal of palliative care is to improve your quality of life by relieving the symptoms of cancer. Palliative care not only slows the progression of head and neck cancer, but also helps relieve pain and manage other symptoms.

Treatment may include radiation therapy, chemotherapy, and other drug therapies. 

Prevention

To prevent head and neck cancer, you should refrain from smoking and limit your alcohol intake. Other measures you can take depend on the type of cancer you have. Head and neck cancer includes cancers that develop in the mouth, throat, sinuses, and salivary glands. 

 

To reduce your risk of head and neck cancer, you should:

  • Don't smoke cigarettes. If you don't smoke or smoke other types of tobacco, don't start. If you smoke cigarettes, make plans to quit. Speak with your doctor about strategies to quit smoking.
  • If you drink alcohol, do it in moderation. For healthy adults, limit one drink per day for women and two drinks per day for men.
  • Ask about the HPV vaccine Getting vaccinated to prevent HPV infection can reduce your risk of HPV-related cancers Ask your doctor if the HPV vaccination is suitable for you.
  • Protect your head and neck from the sun. Wear a wide-brimmed hat to shade your head and neck. Use a broad-spectrum sunscreen with at least SPF 30, even on cloudy days. Apply sunscreen liberally. Reapply every 2 hours, or more often if you swim or sweat.

Notes from Surgical Oncology Solutions

Many head and neck cancers can be treated with surgery or radiation therapy if caught early. If you experience symptoms of head and neck cancer, see a doctor right away, especially if you smoke or use tobacco. Early detection and treatment are the best way to fight cancer. Talk to your doctor about t best treatment for you based on your health and how advanced the cancer is.