What is Head and Neck Cancer?

This term is used to refer to cancer that develops around the throat, larynx, nose, sinuses, ears, salivary glands and the mouth. Most of these tumours start in the tissues that line the mouth, throat and nose. These cancers are more common in men than women.

Types of Head and Neck Cancers

The 5 main types of head and neck cancers are:

  1. Oral and Oropharyngeal Cancer: This is cancer that affects the oral cavity; the mouth, tongue, the middle of the throat and tonsils to the tip of the voice box.
  2. Laryngeal and Hypopharyngeal Cancer: This cancer affects the voice box and the gullet which is the lower part of the throat that surrounds the voice box.
  3. Nasal cavity and Paranasal sinus cancer: This cancer develops in the nasal cavity which is the space behind the nose that allows air to pass to the throat. It can also start in the sinus especially the maxillary sinus.
  4. Nasopharyngeal cancer: It affects the passageway of the upper part of the throat behind the nose.
  5. Salivary gland cancer: It develops in the salivary gland which produces saliva.

Symptoms of Head and Neck Cancers

The symptoms for these cancers vary depending on the part that is affected. Below are the some of the common symptoms that a person with cancer in the above-mentioned areas, may experience:

  • Problem swallowing
  • Pain when swallowing
  • Lump or sore that does not go away
  • Change in voice or hoarseness
  • Having a sore throat that does not go away

Causes of Head and Neck Cancers

The exact causes of cancers of the head and neck are not known, however the risk factors for these cancers include:

  • Excessive alcohol intake
  • Smoking
  • Prolonged exposure to the sun: This could also increase the risk for cancer in other areas, especially in the lip area.
  • Low immunity: A person with low immunity, especially due to health conditions such as HIV/AIDs, has a higher risk of developing these cancers.
  • HPV: The human papilloma virus which is mainly transmitted through sex with an infected person is another risk factor for head and neck cancers.
  • Epstein-Barr virus (EBV): Exposure to this virus increases the risk for nasopharyngeal cancer.
  • Certain health conditions: Conditions like Gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux disease (LPRD) can increase the risk for cancer due to the stomach acid that is released into the upper airway and throat.
  • Poor diet: Eating foods that are low in vitamin A and B also increase the risk for head and neck cancers. High intake of certain preserved or salted foods, especially during childhood increases the risk for nasopharyngeal cancer.
  • Radiation exposure: Exposure to radiation to the head and neck to treat either noncancerous conditions or cancer increases neck and head cancer risk.
  • Exposure to certain industrial substances: Being exposed to certain chemicals or other workplace materials such as asbestos, paint fumes and wood dust may increase the risk for these cancers.
  • Poor oral and dental hygiene: Not taking good care of the mouth and teeth is another risk factor for head and neck cancers.
  • Age: The risk for head and neck cancers increases with an increase in age; people above the age of 40 are at a higher risk of developing these cancers.
  • Gender: Men are 2-3 times more likely to develop these cancers than women.

Diagnosis of Head and Neck Cancers

The process of diagnosis depends on the symptoms one is experiencing, one’s medical history and the type of cancer one is suspected to have. Diagnosis can be done through:

  • A physical exam: During a physical exam, the doctor finds out the patient’s history and feels for any lumps on the cheeks, gums and neck after which he can order other tests.
  • Biopsy: This involves taking a sample of tissue from the tumour and checking it under a microscope to determine whether the tumour is cancerous or not.
  • Endoscopy: This test is done using an endoscope which is a thin flexible tube fitted with a camera. It is inserted through the nose to the oesophagus to examine the head and neck for any abnormalities such as tumour.
  • Imaging tests: The use of MRI, CT, panoramic radiograph or ultrasound tests to give images of the affected area and identify any tumours present.
  • Barium swallow: It is an x-ray that involves swallowing a small amount of barium that aids in identifying abnormalities along the passage of the barium which after swallowing, coats the lining of the oesophagus, stomach and intestines making it more visible to the doctor to detect abnormalities.

Treatments

The treatments for these cancers depend on the type and stage of the cancer and the possible side effects that may be caused by the treatment. Treatment options for head and neck cancers are:

  • Surgery: It is done to remove the cancerous tumour and some of the surrounding healthy tissues during an operation. The different surgeries include:

1. Vocal cord stripping which is a technique used to remove the outer layer of tissue on the vocal cords. It is commonly used when carrying out a biopsy to treat cancer in its very early stage and it rarely affects speech.

2. Cordectomy on the other hand, involves removing part or all the vocal cords and it may affect speech. However, if both vocal cords are removed speech is lost completely.

3. Laser technology can be used mostly in the removal of early stage tumour in the larynx.

4. Partial Laryngectomy is done to remove the portion of the voice box affected by cancer.

5. Total laryngectomy on the other hand, is done to remove the entire voice box after which the windpipe is moved toward a hole in the neck to assist in breathing, through a process known as tracheostomy.

6. Lymph node dissection or neck dissection is surgery done to remove lymph nodes in the neck that the doctor suspects the cancer has spread to.

7. Reconstructive surgery is done to restore the appearance and functionality of the area that has been operated on for someone who has gone through surgery that has changed the appearance of the particular area or left it not functioning properly.

  • Chemotherapy: Using a combination of anti-cancer drugs to kill the cancer cells and thereby stop their growth and division.
  • Radiotherapy: It involves using high energy beams to destroy the cancer cells and prevent them from growing and spreading further.
  • Targeted therapy: This treatment option targets the specific cancer cells blocking their growth and spread without causing any damage to the normal cells around the tumour.
  • Immunotherapy: This treatment boosts the body’s immune system by making it aware of the presence of cancer cells in the body and therefore making it possible for it fight the cancer.

Prevention of Head and Neck Cancers

There is no proven way to completely prevent these cancers, however, you can lower your risk of developing any of them by reducing the risk factors that increase the chance of getting any cancer associated with head and neck cancers. You can do this through:

  • Not smoking and avoiding second hand smoking
  • Avoiding excessive alcohol intake
  • Using sunscreen regularly
  • Protecting yourself from HPV infection by getting immunised against it, reducing your number of sexual partners and practising safe sex
  • Eating a well-balanced diet rich in fruits and vegetables
  • Practising good oral and dental hygiene and making sure you see a dentist at least once a year
  • Avoiding exposure to radiation and harmful substances especially in the workplace that can increase head and neck cancer risk
  • Getting treatment or managing certain health conditions such as gastroesophageal reflux that can increase the risk for these cancers
  • Getting regular check-ups especially if you are above 40 and/or you have a history with head and neck cancers

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