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Head and neck cancer is the cancers that develop in the tissues and organs present in the head and neck. The head and neck cancer include the larynx, salivary glands, lips, mouth, throat and nose. Most of the head and neck cancers develop in the squamous cells, which are the cells lining the moist surfaces like the mouth, throat, nose, in the head and neck region.
The areas where head and neck cancer occurs are pharynx which includes nasopharynx, oropharynx, and hypopharynx, larynx, tongue, salivary glands, oral and nasal cavity and paranasal sinuses.
The annual incidence of head and neck cancer, worldwide, is more than 50,000 cases. The men to women ratio range from 2:1 to 4:1. Among all the head and neck cancers, squamous cell carcinoma is the most common cancer which constitutes 90% of all the cancers. The annual incidence makes it the sixth leading cancer in the world. Men are 2 to 3 times at a higher risk of developing head and neck cancers when compared to women.

Types of Head and Neck Cancers

  • Pharynx cancer
  • Hypopharyngeal cancer
  • Laryngeal cancer
  • Lip and oral cavity cancer
  • Metastatic squamous neck cancer with occult primary
  • Nasopharyngeal cancer
  • Oropharngeal cancer
  • Paranasal sinus and nasal cavity cancer
  • Salivary gland cancer

Symptoms

People suffering from head and neck cancers experience the following signs and symptoms.

  • Inflammation or a sore that does not heal
  • Lump or a bump on the head and neck region, with or without pain
  • Persistent sore throat
  • Hoarseness or change in voice
  • Foul mouth odour
  • Persistent nasal congestion
  • Difficulty breathing
  • Numbness or weakness experienced from a part of the head and neck area
  • Difficulty swallowing
  • Difficulty chewing
  • Double vision
  • Ear pain
  • Blood in the saliva or phlegm
  • Fatigue
  • Unexplained weight loss
  • Loose teeth

Causes and Risk factors

  • Exposure to radiations such as x-rays and CT scan may increase the risk of developing head and neck cancer.
  • A family history of cancer can increase the risk of developing head and neck cancers. The person may have an inherited gene in the body that causes the cancer to develop in the regions of the head and neck.
  • Age is one of the most significant causes of developing the disease. As a person ages, the body and the immune cells become weak and so the body may be affected with various diseases.
  • Use of tobacco, cigarette smoking and alcohol consumption increases the risk of developing cancers from the head and neck. Smokers are at a higher risk of developing various cancers, salivary gland cancer, tongue cancer, pharynx and larynx cancer when compared to non-smokers.
  • A poor nutrition, a diet low in vitamins and nutrients increases the risk for a person to develop the head and neck cancer.
  • A person with a weak immune system is also at a risk of developing the disease.
  • Exposure to Epstein-Barr virus (EBV) may increase the risk of developing nasopharyngeal cancer.
  • Poor oral and dental hygiene also increase the risk for head and neck cancer.

Diagnosis

The following are the diagnostic tests performed in people suffering from head and neck cancers.

  • Physical examination is performed by the doctor to check for any changes in the neck. The doctor feels the patient’s jaws, neck and throat for the presence of lumps.
  • Blood and urine tests are performed to check the levels of hormones in the blood. It also helps in detecting the levels of protein in the blood.
  • HPV testing is performed to determine the presence of any type of HPV virus which is most likely to cause head and neck cancers.
  • Endoscopy uses a flexible, thin, long tube with a camera at one end called the endoscope to check for changes inside the body. The tube is inserted through the mouth.
  • X-ray barium swallow is done to identify the changes or abnormalities in the passage while swallowing the liquid. In this test, the patient is asked to swallow barium which is a liquid. As it travels through the passage, the condition of the larynx and salivary glands are known. It is reported in the form of an X-ray.
  • Panoramic radiograph is a rotating or a panoramic view of the upper and lower jaw bones to detect the presence of cancer.
  • Bone scan is performed to check the spread of cancer in the bones. A radioactive tracer is injected into the patient’s vein. The picture of the inside of the bone is detected with the help of a camera. The part of the bone that is healthy appears grey and the part that is injured appears dark.
  • PET scan or Positron emission tomography is usually combined with a CT scan. It is performed to get an image of the tissues and organs present inside the body. A small amount of radioactive sugar substance is injected into the body. This substance is taken by the cells that utilize more energy and cancer cells consume a lot of energy. Therefore, a scanner detects the cells that consume more amount of energy and an image of the inside of the body is produced.
  • Ultrasound imaging uses sound waves to produce pictures of the organs and structures inside the body. It is a safe, painless and a noninvasive procedure.
  • Magnetic Imaging Resonance (MRI) is a test that uses magnetic field and pulses of radio wave energy to create pictures of organs inside the body. MRI also helps in identifying various other problems that cannot be detected in other imaging techniques.
  • CT scan is performed to get a 3D picture of the inside of the salivary gland using x-rays. A CT scan is also used to measure the size of the tumor.
  • Biopsy is another method performed to confirm the test results. It is a sample of the tissue taken from the body to examine it more closely. A doctor usually recommends for biopsy when a part of the body tissue seems abnormal. The abnormality in a particular area may be noticed in the imaging techniques or during a physical examination.

Treatment

The following are the treatments offered to people suffering from head and neck cancers.

  • Surgeryis performed to either remove a part of the infected organ or the entire organ.
    • Laser technology is used to treat cancer at an early stage, especially cancer found in larynx.
    • Endoscopic surgery is performed to remove the cancerous cells with the help of an endoscope. It does not damage the healthy cells and only removes the cancer causing cells from the body.
    • Neck dissection helps in removing the lymph nodes from the neck.
    • Reconstructive surgery is performed to replace the tissues which were removed during dissection to eliminate cancer from the body.
  • Chemotherapyis a drug used to kill the cancer causing cells. It is either given orally or intravenously. It is usually used after a surgery to remove the presence of any left-over cancerous cells in the body. Chemotherapy can also be given to treat the cancers that spread to various other parts of the body.
  • Radiation therapy is usually given along with chemotherapy before a surgery. This therapy also kills the remains of any cancerous cells in the body.
  • Targeted therapy therapy is the use of targeted drugs to kill or destroy the cancer cells in a particular part of the head and neck region. It works by acting on the particular gene or cancer cell. 
    • Herceptin
    • Avastin
    • Lapatinib
    • Low dose aspirin

Prevention

Following a healthy diet, being physically active and regular screening will help in preventing the development of any cancer associated with head and neck.

 

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