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Head and Neck Cancers

 

Most head and neck cancers begin in the cells that line the mucosal surfaces (moist tissues lining hollow organs and cavities of the body open to the environment) in the head and neck area, e.g., mouth, nose, and throat. Normal mucosal cells look like scales (squamous) under the microscope, so head and neck cancers are often referred to as squamous cell carcinomas.

Causes  

  • Tobacco, including cigarettes, snuff, chewing tobacco, betel leaf, lime, areca nut, paan and gutka.
  • Alcohol
  • Viruses (herpes simplex virus, Epstein-Barr virus and the human papilloma viruses)
  • Occupation (workers in nickel refining, asbestos and wood- and leather-working industries)
  • Radiation exposure (radium watch dial painting and thorotrast ingestion). This exposure can come from diagnostic x-rays or from radiation therapy for noncancerous conditions or cancer.

Possible but not proven causes:

  • Poor oral hygiene,
  • use of mouthwash that has high alcohol content,
  • diet deficient in Vitamin A and beta-carotene

Symptoms

  • A sore on the lip or in the mouth that does not heal for more than 3 weeks
  • A lump on the lip or in the mouth or throat that persist for more than 3 weeks
  • A white (leukoplakia) or red patch on the gums, tongue or lining of the mouth
  • Unusual bleeding, pain or numbness in the mouth
  • A sore throat or a feeling that something is caught in the throat that lasts for more than a month or that does not respond to antibiotics
  • Difficulty or pain with chewing or swallowing
  • Swelling of the jaw that causes dentures to fit poorly or become uncomfortable
  • A change in the voice or hoarseness lasting more than 3 weeks
  • Pain in the ear without evidence of local ear problems
  • Slurred speech
  • Loose teeth not associated with any gum problems
  • Unintended weight loss
  • Swelling, numbness, paralysis of the muscles in the face or pain that does not go away in the face, chin, or neck.
  • Chronic sinus infections that do not respond to treatment with antibiotics
  • Bleeding through the nose, frequent headaches, swelling or other trouble with the eyes.

These symptoms may be caused by cancer or by other, less serious conditions. Sometimes there are no warning signs.

Treatment
The treatment plan for an individual depends on a number of factors, including the exact location of the tumor, the stage of the cancer, and the person’s age and general health. The patient and the doctor should consider treatment options carefully.

  • Surgery is a good way to remove the cancer especially if it has been diagnosed early. Reconstruction may be part of the treatment plan. The surgeon may remove the cancer and some of the healthy tissue around it. Lymph nodes in the neck may also be removed (lymph node dissection), if the doctor suspects that the cancer has spread.
  • Radiation therapy involves the use of high-energy x-rays to kill cancer cells. Radiation may come from a machine outside the body (external radiation therapy) or from radioactive materials placed directly into or near the area where the cancer cells are found (internal radiation therapy or radiation implant).
  • Chemotherapy is used to kill cancer cells throughout the body. In general, anticancer drugs affect rapidly growing cells, including blood cells that fight infection. Patients should talk with their doctor or nurse about the side effects they are experiencing, and how to handle them.
Regular follow-up care is very important after treatment to make sure the cancer has not returned, or that a second primary (new) cancer has not developed. From time to time, the doctor may perform a complete physical exam, blood tests and CT, PET, or MRI scans. The doctor may continue to monitor thyroid function, especially if the head or neck was treated with radiation.