Head and neck cancer

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at May 25, 2016
StartDiseasesHead and neck cancer

Head and neck cancer can dramatically affect the lives of those afflicted, and they are typically categorized by the area where the cancer began. Symptoms may be subtle or not exist at all, and visiting a health care professional is the best means by which to obtain a diagnosis. Head and neck cancers are not very common, and they account for only 3 to 5 percent of all cancers in the United States.

Contents

Definition & Facts 

Cancers of the head and neck usually begin inside the mouth, nose, or throat. In some extremely rare cases, the cancer can start in the salivary glands. Cancer can then spread to other parts of the body if left untreated. These cancers are twice as common in men and are also most common in individuals over 50 years of age. Many of these cancers are preventable.

The main areas of the head and neck that can be affected include the mouth, throat, larynx, and nasal cavity. The main types of cancer include hypopharyngeal cancer, laryngeal cancer, cancer of the lip and oral cavity (oral cancer), metastatic squamous neck cancer with occult primary, nasopharynx cancer, oropharyngeal cancer, paranasal sinus cancer and nasal cavity cancer, and salivary gland cancer.

Symptoms & Complaints

Depending on the area of the cancer, the symptoms may vary. For throat cancers, an individual could experience something as subtle as a lump in the throat or a sore throat that never heals. Difficulty swallowing is another common symptom. Voice hoarseness may also indicate that something is wrong. It's important to realize these symptoms are not necessarily an indication of cancer, and they can be caused by many conditions that are less serious.

Symptoms of cancer of the oral cavity may include red or white patches on the gums, tongue, or mouth lining. Breathing problems can also be a symptom of cancer as well as pain while swallowing, neck pain, headaches, ringing in the ears, and difficulty hearing.

Additionally, symptoms of head and neck cancer could include swelling in the area under the chin or swollen sinuses. Pain in the area around the face, chin, neck, and eyes that doesn't go away may also be a symptom of head and neck cancer. People who have dentures may also experience problems with their functionality. Any of these symptoms that don't go away after a prolonged period of time should be checked by a doctor.

Causes

The primary causes of head and neck cancer include alcohol abuse and tobacco use. In addition to cigarette smoking, chewing tobacco, hookah use, and any other means by which people use tobacco can contribute to the onset of head and neck cancer. It's estimated that 75 percent of head and neck cancers are caused by people who use tobacco and alcohol. However, this doesn't apply to people who have cancer of the salivary glands.

Infection with human papilloma virus is also a common cause of head and neck cancers. This is a sexually transmitted infection and the kind that contributes to head and neck cancers is transmitted via oral sex specifically. Individuals who have Epstein-Barr virus infections should be monitored closely as the virus has been linked to an increased risk of cancer. Additionally, people of Chinese or Asian descent are at a greater risk for head and neck cancers.

While some of the causes of cancer may be genetic or hereditary, environmental factors and diet also play a major role in the development of head and throat cancers. Areca nut, mate, some salted foods and even mouthwash with alcohol in it have been shown to increase the risk of cancer. People who are in occupations that require exposure to wood dust, asbestos and synthetic fibers are also at risk. Radiation exposure may also cause cancers of the salivary glands.

Diagnosis & Tests 

Determining whether an individual has a cancer of the head and neck involves a series of tests and questions designed to evaluate the patient's medical history and current physical health. Doctors may take X-rays, review medical history, and perform a physical examination. The exact tests will be based on the symptoms and individual circumstances surrounding the patient.

Patients will require a sample of tissue (biopsy) that can be reviewed under a microscope to confirm a diagnosis of cancer. Without the biopsy, it would be very difficult to say with certainty if an individual has cancer. The next step is to determine the stage of the cancer by determining if and where the cancer has spread or metastasized. By doing so, the doctor can better determine what types of treatment options are available. 

Treatment & Therapy 

Treatment will be different for each individual and depend largely on the stage and physical health of the patient. The location of the tumor or tumors may also affect what treatment options are available. Treatment options may include surgery, chemotherapy, radiation, targeted therapy, or any combination of treatment modalities. It's important to discuss any treatment options with a doctor to understand the side effects and the pros and cons of each method.

Additionally, people who have a human papilloma virus (HPV)-positive type of cancer may require different types of treatments from those who have an HPV-negative diagnosis. Those with an HPV-positive diagnosis often have better odds for treatment and can undergo treatments that aren't as invasive.

Many treatments may affect the patient's ability to chew, swallow liquids or talk. Speech-language pathology, physical therapy, and occupational therapy may all be necessary parts of treatment and recovery. Counseling, psychotherapy, and participation in support groups may also be an integral part of the healing process.

Prevention & Prophylaxis 

The best way to prevent head and neck cancers is to reduce or cease alcohol consumption and to quit smoking and all other tobacco products (pipes, snuff, chewing tobacco, hookah, cigars). Because certain head and neck cancers such as oropharyngeal cancer can be caused by the HPV virus, getting vaccinated with the HPV vaccine can help protect one and one's sexual partners from developing these kinds of cancer.

For those who have already been diagnosed with head and neck cancers and have undergone treatment, regular follow-up care is necessary for the healing process and to ensure that the cancer doesn't come back. Blood tests, physical exams, X-rays and various imaging technologies may be employed to check the status of the cancer.