About Head & Neck Cancers
The head and neck region is an anatomically diverse area of the body that is composed of soft tissue, bones, skin, and a variety of glands and organs. Head and neck cancer encompasses a wide range of tumors that can develop in several areas of the head and neck.
Types of Head & Neck Cancer
Cancer can develop in several different parts of the head and neck. Some of the most common include the following:
- Oral Cancer
- Laryngeal Cancer
- Pharyngeal (Throat) Cancer
- Nasal Cavity & Paranasal Sinus Cancers
- Thyroid Cancer
- Parathyroid Tumors
Below are some general symptoms and warning signs of head and neck cancer. Each type of head and neck cancer may be associated with a more specific group of symptoms. Many of these symptoms can also be caused by other health conditions. See your doctor if you notice:
- a lump or swelling in the neck
- a sore in the mouth that won’t heal (the most common symptom) or that bleeds easily
- a red or white patch in the mouth that doesn’t go away
- frequent nosebleeds, ongoing nasal congestion, or chronic sinus infections that do not respond to treatment
- persistent sore throat
- persistent hoarseness or a change in the voice
- persistent pain in the neck, throat, or ears
- blood in the sputum
- difficulty chewing, swallowing, or moving the jaws or tongue
- numbness in the tongue or other areas
- loosening of teeth
- dentures that no longer fit
- changes or discoloration in a mole; a skin sore that is crusting or ulcerated, or that fails to heal (these are also signs of skin cancer)
Causes of head and neck cancer
Alcohol and tobacco consumption are the biggest risk factors for head and neck cancers with the exception of salivary gland cancer. Some head and neck cancers are related to human papilloma virus infection. Other risk factors include:
- Age – head and neck cancer is more common in people over 40 years old
- Sex – men are three times more likely than women in Australia to develop head and neck cancer
- Oral hygiene – poor oral health including gum disease have been linked to cancers of the oral cavity
How is head & neck cancer diagnosed?
The most important test to diagnose or rule out any head and neck tumor is a “Surgical Biopsy”. Other investigations which your oncologist might advise are to know the exact location and spread of the tumor. This may include some scans like CT or MRI scan and endoscopies like direct laryngoscopy, nasopharyngoscopy or bronchoscopy.
Treatment and care of people with cancer is usually provided by a team of health professionals called a multidisciplinary team. This is especially important for people affected by head and neck cancer.
Treatment for head and neck cancer depends on:
- the stage of the disease
- the location of the cancer
- the severity of symptoms
- your general health and wishes.
Treatment may involve the following.
Surgery is a common treatment for all stages of head and neck cancer in early stages. Depending on what part of the head and neck is affected, it may involve removal of all or part of the affected part, along with lymph node clearance of the draining area. This is usually followed by plastic surgery reconstruction at the same time. Care is usually taken to achieve as normal a body appearance and function as possible.
Chemotherapy is most often delivered at the same time as radiation treatment, as concurrent chemoradiation. In some instances, it may be given both before and during radiation treatment.
Chemotherapy may be used to shrink the tumour before surgery or radiation therapy.It may also be used after surgery to kill any remaining cancer cells (this would be very uncommon).It can be used to relieve symptoms of advanced cancer.
Radiotherapy: Along with surgery, some people may receive radiotherapy.
For some types of head and neck cancer, radiation therapy may be the main treatment. Chemotherapy may be given at the same time to enhance the effect of radiation treatment.
Targeted therapy: Targeted therapy refers to treatment with medicines that are designed to specifically attack cancer cells without harming normal cells. These types of medicines affect the way that cancer cells grow, divide, repair themselves or interact with other cells and have minimal side effects.
What rehabilitation or support options are available for patients with head and neck cancers?
Rehabilitation is a very important part of treatment for patients with head and neck cancer. The goals of rehabilitation depend on the extent of the disease and the treatment a patient has received. The health care team makes every effort to help the patient return to normal activities as soon as possible.
Depending on the location of the cancer and the type of treatment, rehabilitation may include physical therapy, dietary counseling, speech therapy, and/or learning how to care for a stoma after a laryngectomy. A stoma is an opening into the windpipe through which a patient breathes after a laryngectomy.
Sometimes, especially with cancer of the oral cavity, a patient may need reconstructive and plastic surgery to rebuild the bones or tissues of the mouth. If this is not possible, a prosthodontist may be able to make a prosthesis (an artificial dental and/or facial part) to restore satisfactory swallowing and speech. Patients will receive special training to use the device.
Patients who have trouble speaking after treatment, or who have lost their ability to speak, may need speech therapy. Often, a specialist called a speech-language pathologist will visit the patient in the hospital to plan therapy and teach speech exercises or alternative methods of speaking. Speech therapy usually continues after the patient returns home.
Eating may be difficult after treatment for head and neck cancer. Some patients receive nutrients directly into a vein (IV) after surgery, or need a feeding tube until they can eat on their own. A feeding tube is a flexible plastic tube that is passed into the stomach through the nose or an incision (cut) in the abdomen. A nurse or speech-language pathologist can help patients learn how to swallow again after surgery.
Prevention of Head and Neck Cancers
There are two simple ways to prevent oral cancer and other types of head and neck cancer – quit using tobacco products (cigarettes, cigars, pipes, chewing tobacco or snuff) and reduce or eliminate alcohol consumption. Although typically associated with lung cancer, tobacco is also the most common cause of cancerous oral lesions, and nicotine is most likely the culprit. High levels of nicotine in chewing tobacco damage the inner lining of the cheeks, giving nicotine and other toxic chemicals easy access to the bloodstream and other parts of the body. Seventy-five percent of all cancerous mouth and throat tumors are related to tobacco and alcohol use. Heavy smokers (more than two packs a day) and heavy drinkers (more than four alcoholic drinks a day) have a seven-times greater chance of developing oral cancer than non smokers and non drinkers.