Dr. Karthik Chandra VallaM
(MBBS, M.S, M.Ch, D.N.B Surgical Oncology)
Head and neck cancer is a term used to describe a collection of cancers that form in the tissues of the head and neck area. This includes the mouth, throat (pharynx), voice box (larynx), sinuses, nose, and salivary glands. These types of cancers usually start in the squamous cells that line the mucosal surfaces of these regions.
Types of head and neck cancer
Oral cavity cancer:
This type of cancer can develop in various areas of your mouth, including your lips, tongue, gums, the inner lining of your cheeks and lips, the upper and lower parts of your mouth, or even behind your wisdom teeth.
This type of cancer develops in the central area of the throat, which includes the tonsils, the base of the tongue, the soft palate, and the rear wall of the throat.
This type of cancer starts in the nasopharynx, which is the upper part of the throat located behind the nose.
This cancer develops in the hypopharynx, the lower part of the throat just above the esophagus and windpipe.
This cancer occurs in the larynx, or voice box, which includes the vocal cords and surrounding tissues
Salivary gland cancer:
Salivary gland tumors can develop in any of the salivary glands, including the parotid, submandibular, and sublingual glands.
Other types of cancers such as brain tumors, esophageal cancer, eye cancer, parathyroid cancer, sarcoma, and thyroid cancer can also be located in the head and neck region, but the diagnosis and treatment are much different.
What are the symptoms of head and neck cancer?
Head and neck cancer can be hard to diagnose because symptoms are often mild and can mimic less serious conditions like a cold or sore throat. A sore throat that doesn’t get better is the most common symptom of head and neck cancer.
- Persistent sore throat
- Difficulty swallowing
- Changes in voice or hoarseness
- Swelling or lumps in the neck
- Ear pain
- Unexplained weight loss
- Persistent cough or coughing up blood
- Mouth sores that don't heal
- Pain or difficulty chewing, swallowing, or moving the jaw or tongue
- Frequent nose bleeds and/or unusual nasal discharge
- Numbness or weakness of a body part in the head and neck region
- Red or white patch in the mouth
- Swelling in your jaw, neck, or side of your face (that may cause your dentures to fit poorly).
- Ear pain or infection
- Trouble breathing or speaking.
Causes of Neck and Head Cancers
- Tobacco: Smoking cigarettes, cigars, pipes, or using smokeless tobacco (such as chewing tobacco or snuff) is one of the most significant risk factors for head and neck cancers. Tobacco contains various cancer-causing substances that gradually harm the cells in the head and neck area.
- Alcohol consumption: Drinking alcohol regularly and in large amounts increases the chances of developing cancer in the mouth, throat, voice box, and food pipe.
- Human papillomavirus (HPV) infection: Head and neck cancers linked to HPV infection are becoming more common, particularly among younger adults. Around 75% of oropharyngeal cancers are connected to HPV infection.
- Prolonged sun exposure: Excessive sun exposure or using tanning beds significantly raises the chances of developing skin cancers, such as melanoma and squamous cell carcinoma, which can appear on the head, neck, and even the lips.
- Poor oral hygiene: Neglecting proper oral hygiene can elevate your susceptibility to periodontal disease and oral cancer.
- Poor Diet: Having a diet that lacks vitamins A and B can increase the chances of developing head and neck cancer.
- Genetic factors: Genetic predisposition and inherited genetic mutations can sometimes raise the likelihood of developing particular types of head and neck cancers, such as familial variations of thyroid cancer.
- Having a weak immune system: A weakened immune system can raise a person’s risk of head and neck cancer.
- Epstein-Barr virus (EBV): EBV, also known as the virus responsible for mononucleosis or "mono," plays a role in the development of nasopharyngeal cancer.
Typically, diagnosing head and neck cancer involves a mix of checking the patient physically, conducting imaging tests like CT scans or MRI, and performing a biopsy. The treatment options for this type of cancer vary depending on factors such as the location, stage, and overall health of the patient. They may include surgery, radiation therapy, chemotherapy, targeted therapy, or a combination of these methods.
Treatment for head and neck cancers typically depends on various factors including the type, location, and stage of the cancer, as well as the patient's overall health and preferences. Common treatment options may include:
Surgery: Surgery is often advised for early-stage or localized head and neck cancers, involving the removal of the tumor and adjacent tissues. Depending on the cancer's extent, reconstructive surgery may be required to restore both appearance and function.
Radiation Therapy: High-energy beams like X-rays or protons are utilized to eliminate cancer cells in radiation therapy. It can be the main treatment or used alongside surgery or chemotherapy, often to target hard-to-reach tumors or shrink them before surgery.
Chemotherapy: Chemotherapy is a treatment that involves using either one drug or a mix of drugs to eliminate cancer cells. It is frequently used for head and neck cancers that have reached an advanced stage.
Targeted Therapy: Targeted therapy drugs, which aim at particular molecules or pathways in cancer growth, can be employed alone or with other treatments. They're especially useful for cancers with specific genetic changes or biomarkers.
Immunotherapy: Immunotherapy drugs work by helping the body's immune system recognize and attack cancer cells. This treatment approach has shown promising results in some patients with head and neck cancers, particularly those with recurrent or metastatic disease.
Palliative Care: Palliative care focuses on relieving symptoms and improving the quality of life for patients with advanced or terminal cancer. It may include pain management, supportive care, and counseling services. Palliative care can improve your quality of life, no matter your cancer stage.
Doctors create personalized treatment plans for each person's cancer and health needs. They work with different healthcare experts like cancer doctors, surgeons, and radiation specialists to make sure the treatment works well and doesn't cause too many problems.
Preventing head and neck cancers involves avoiding tobacco and moderating alcohol intake. Practicing safe sex, maintaining good oral hygiene, and protecting the skin from sun exposure are important. Eating a balanced diet and getting vaccinated against HPV can further reduce risk. Regular screenings with healthcare providers help detect issues early. Incorporating these measures into daily life lowers the risk of developing head and neck cancers.
Early-stage head and neck cancers are often manageable through a combination of surgery and radiation therapy. If you notice any symptoms of head and neck cancer, particularly if you are a smoker or use tobacco, seek medical attention promptly. Detecting and treating cancer early significantly improves outcomes. Consult your healthcare provider to discuss the most suitable treatment options based on your health and the stage of your cancer.