Head and Neck Cancer

Head and neck cancer is a broad term that contains other cancers that occur in the head and neck region. The majority of them are squamous cell carcinomas, which develop on wet parts of the mouth, throat (pharynx), and larynx, as well as the nasal passage. Medical practitioners also call these the head and neck squamous cell carcinoma (HNSCC). Squamous cells are the origin of head and neck cancer in up to 90 percent of cases.

When you are a confirmed case of head and neck cancer, your oncologist will follow you very closely and will plan the most appropriate treatment plan with you. Its key objective is to eliminate the tumour without depriving the face of useful functions such as talking, swallowing, and facial expression. In situations where a disease is caught at a tender age and treated, the recovery will be far better.

It is a set of related cancers rather than one single condition that is at risk of certain factors and treated similarly.

Types of Head and Neck Cancer

Primary Cancer Sites

  • Hypopharyngeal cancer

Occurs in the Lower part of the throat, which is behind the larynx.

  • Nasopharyngeal cancer

Its location is in the upper throat behind the cavity.

  • Oropharyngeal cancer

Cancer lies at the back of the oropharynx and thus involves the base of the tongue and tonsils.

  • Sinonasal Cancer

Cancer involves the paranasal sinuses and the cavity that is around the nose, which are small spaces filled with air.

  • Salivary Gland Cancer

Cancer progresses in the glands located underneath the tongue, in front of the ears, beneath the jawbone, and alongside the gastrointestinal tract.

  • Oral cavity cancer

Cancer includes the mouth (including lips and gums), the first two-thirds of the tongue, the inner cheeks and lips, the floor of the mouth, the hard palate, and the back of the wisdom teeth.

  • Laryngeal cancer

Cancer starts in the voice box (larynx). Majorities are squamous cell cancer originations in the mucosal surface but have secondary types such as salivary glands and muscles, cartilage, or other structural tissue sarcomas.

Skin Cancers of the Head and Neck

  • Melanoma Cancer

Cancer starts growing in melanocytes, which are cells involved in pigmentation of the skin.

  • Basal Cell Carcinoma

It is the most common of non-melanoma skin cancer and they are formed of abnormal basal cells.

  • Squamous Cell Carcinoma

This is the second type of skin cancer; it may be more threatening because of its extension and complexity of treatment needs, due to the site of development and coverage of the nervous tissue.

Other Types

  • Sarcoma

Affects soft tissues including muscles, connective tissue, blood vessels, lymphatic vessels, joints, and fat.

  • Cancer of Unknown Primary

Typically presents as neck lumps, indicating cancer spread to cervical lymph nodes from an unidentified primary source.

Epidemiology

Close to 4.5 percent of all cancer cases reported are head and neck cancers. They are mainly cancers that occur in men more than 50 years old most likely because of exposure to risk factors (mostly the causes are tobacco).

Indian Statistics

Cancer of the head and neck causes approximately 25 percent of all the cancers associated with men and 10 percent of the cancers associated with women.

  • The disease is the highest in Northeast India
  • The most common is oral cancer
  • Recent years revealed rising rates, especially among oropharyngeal cancer

Risk Factors

The risk of getting head and neck cancer is rather high when classified by several factors:

The Top Risk Factors

  • Tobacco use

All types of tobacco smoking consumption such as cigarettes, cigars, pipes, chewing tobacco, and snuff are known to contribute significantly to cancer development.

  • Alcohol Use

Heavier and regular usage of alcohol greatly increases the chances of several types of cancers in the head and neck.

  • Human Papillomavirus (HPV) Exposure

This is a highly contagious sexually transmitted virus that could cause cell alteration leading to cancer. HPV is gradually becoming out as one of the major perpetrators of oropharyngeal cancers.

Occupational and Environmental Elements

  • Exposure to Chemicals

Some of the airborne chemicals might put someone at risk of sinonasal cancer when inhaled at home or workplace.

  • References to Ultraviolet Radiation

Exposure to the sun and indoor tanning beds are risk factors for skin cancers on the head and neck skin.

Signs and Symptoms

Symptoms of head and neck cancer are usually not obvious and they can be confused with milder infections such as a cold, or sore throat. The most common of them is the relentless sore throat which fails to relieve.

 

The most common signs include:

  • Constant sore throat
  • Symptoms of chronic pain or infection in the ear (when the medical examination of the ears appears normal)
  • Frequent headaches
  • Constant pain in the face or the neck
  • Tooth pain on the top level
  • Chew or swallowing pain
  • Voice alterations or huskiness
  • Asthma/asthma-like breathing or talking problems
  • Throat, mouth or neck lumps
  • Constant or chronic nosebleeds
  • Blood in snot or the saliva
  • White or red lesions on the gum, tongue, or lining of the mouth
  • Swelling of jaw, neck, or face (might impair denture fitting as well)

Note: If you experience any of these symptoms be sure to visit the doctor immediately. Such symptoms may exist as indicators of the existence of not severe conditions, however, a medical examination is an important step to the right diagnosis.

Diagnosis and Testing

Initial Evaluation

Diagnosis normally starts with a thorough physical examination of the mouth, sinuses, throat, and the neck, inclusive of palpation to detect lumps or any other irregularity.

Diagnostic Procedures

  • Endoscopy

An endoscopic instrument is used to examine the throat or neck, or nasal passages using a thin illuminated tube. Typically, this is done in a doctor’s office.

  • Imaging Studies
  • X-rays of the head and neck
  • CT (Computed Tomography) scans
  • MRI (Magnetic Resonance Imaging)
  • PET (Positron Emission Tomography) scans

These tests can detect tumors and assess their extent within the body.

  • Lab tests

 HPV testing may be performed to determine if viral infection is contributing to cancer development.

  • Biopsy

The definitive diagnostic procedure involving tissue removal from suspicious areas for pathological examination to confirm the presence of cancer cells.

Cancer Staging

Staging determines cancer advancement and guides treatment decisions. The TNM system evaluates:

  • T (Tumor): Size and location of the primary tumor
  • N (Nodes): Lymph node involvement
  • M (Metastasis): Spread to distant body parts

Stages are I-IV, the lower (I and II) stages being an indication of early-stage disease. The most successful rates of management of head and neck cancers are in the very initial stages.

Treatment Options

  • Surgery

Surgery is employed to make sure that the cancerous tissue is eliminated but it must be in a manner that a person can breathe, swallow, and talk. The minimally invasive, technique of robot surgery is now being regarded as the modern technique with improved outcomes, fewer cuts, less recovery process, as well as having fewer side effects.

  • Radiation Therapy (Radiotherapy)

Destroys or damages cancer cells by using controlled doses of radiation. Can be administered as a primary therapy, postoperative adjuvant therapy, or with chemotherapy.

  • Chemotherapy

Uses specialized medication to destroy or prevent the nutriment of cells of the cancer and is mostly administered intravenously.

  • Immunotherapy

Uses the body’s immune to attack cancer cells hence becoming a more significant treatment option:

  • Targeted Therapy

Drugs attack certain characteristic features of cancer cells so that the growth and transfer of the tumor are prevented.

  • Palliative Care

Concentrates on sustaining a better quality of life by attending to cancer symptoms and side effects. May consist of several treatments to alleviate pain and other symptoms with a possible progression delay of the disease.

Prevention Strategies

Primary Prevention Measures

  • Tobacco Cessation

Do not start smoking tobacco under any circumstances. If you are already using tobacco, develop a plan to quit with your medical attendant.

  • Alcohol Moderation

Take alcoholic drinks only a few times and limit them to drinking one drink a day right in the case of women, and two drinks a day, in the case of men.

  • HPV Vaccination

 Discuss with your doctor the HPV vaccine to reduce the dangers posed by HPV cancer.

  • Sun Protection
  • Cover your head with wide-brimmed hats
  • Use broad-spectrum sunscreen of higher SPF (30 and up) daily even when it is cloudy
  • Use a liberal amount of sunscreen and do it again every 2 hours or after each swimming or sweating step

Conclusion

Most head and neck cancers are easily treated after they are diagnosed early especially using surgery or radiation. When you have any signs or symptoms that could point to having head and neck cancer, particularly in case of your history of tobacco and alcohol use, immediately consult your health expert. Cancer should be detected early and treated promptly because this is the best approach to its management.

 

Discuss it with your healthcare team to when the most suitable course of treatment can be selected given your health condition and the stage of cancer. Usually, the best care for head and neck cancer patients will be a multidisciplinary approach that will include surgical oncologists, medical oncologists, radiation oncologists, and supportive care specialists.