Head and Neck Cancer
Head and Neck carcinomas are a varied
group of malignancies of the upper airway and neck. With modern treatments, disease control is often obtainable, with fewer
side effects then in previous years. With the advent of Intensity Modulated Radiation Therapy (IMRT), we can often decrease
side effects, such as permanent dry mouth. Furthermore, with IMRT we can deliver exquisitely accurate doses to difficult regions,
while avoiding excessive dosage to critical nearby organs.
Treatment of head and neck cancers varies
depending on the type of head and neck cancer, the location of the cancer, stage of the cancer, general physical health and
age of the patient. The most frequently used treatments are surgery, radiation therapy, and chemotherapy. Many times, a combination
of therapies are suggested.
Head and Neck Cancer
Head and neck cancer
usually begins in the mouth, nose or throat. These areas are moist, hollow and may be directly exposed to cancer causing agents.
Cancers of this region are defined by where they begin. Cancers often can spread to lymph nodes. The location of the cancer
determines which lymph nodes would likely be involved and which lymph nodes need to be treated.
Oral
cavity — includes the lips, most of the front of the tongue, the gums, cheek lining, under the tongue, the roof
of the mouth and the space behind the back teeth.
Salivary glands — The glands that
make saliva. These include the parotid glands in front of the ears, submandibular glands under the lower jaw, and sublingual
glands under the tongue. The lining of the mouth also contains minor salivary glands.
Paranasal
sinuses and nasal cavity — the hollow spaces around the nose in the skull and the nose.
Pharynx
— a tube that starts behind the nose and is attached to the esophagus and the trachea. The pharynx has three parts:
the nasopharynx, the oropharynx, and hypopharynx.
Larynx — The larynx is the voice box.
It’s made of cartilage and contains the vocal cords and the epiglottis.
Risk Factors
Use of Tobacco — (cigarette smoking, cigar smoking, and chewing tobacco) increases the chances
of developing head and neck cancer.
Use of Alcohol — Excessive alcohol consumption
can increase the risk of Head and Neck carcinoma. People who drink and smoke have a marked increased chance of developing
a head and neck malignancy.
Other contributing agents:
- Human Papillomavirus
- Inhaling industrial grade wood or nickel dust
- Epstein-Barr virus infection
- Consumption of certain
preservatives or salted foods
- Plummer–Vinson syndrome
- Asbestos exposure
Symptoms
Symptoms of head and neck carcinoma can include lumps in the oral cavity or pharynx, neck lumps, bleeding, constant sore throat,
hoarse voice, difficulty swallowing, sores that won’t heal, and neck pain. Other symptoms may include the following:
- Oral cavity — Unusual bleeding, swollen jaw, tenderness, red and white patches on gums, tongue or
mouth lining.
- Nasal cavity and sinuses — Constantly blocked sinuses, sinusitis that does not go away
with antibiotic use, nose bleeds, headaches, pain in jaw and teeth, swelling around the eyes.
- Salivary glands
— Swelling in the jawbone, facial paralysis or numbness, constant pain in face, chin or neck.
- Oropharynx
and hypopharynx — Discomfort in the ear.
- Nasopharynx — Difficulty breathing or speaking,
headaches, ear discomfort, difficulty hearing.
- Larynx — hoarseness, pain in throat.
Diagnosis
To diagnose head and neck cancer the doctor thoroughly examines the oral cavity, pharynx and larynx. A
direct laryngoscopy is performed. In this procedure, a tube is placed through the nose and the pharynx and larynx are examined
via a magnified light source. Biopsies are taken of suspicious regions.
Staging
Work
up for staging usually includes a CT of the Head/ Neck and PET/CT. For certain malignancies, an MRI is ordered as well.
HEAD AND NECK CANCER
