Head and Neck Cancer
Head and Neck Cancer is a common form of cancer in India and other developing countries. More than one lakh Head and Neck Cancer cases are diagnosed in India, every year. Head and neck cancer types include ear cancers, nose cancers, throat cancers, tongue cancers, thyroid cancer, oral cancers as well as cancer of the larynx. Typically, the cells lining these organs experience a cancerous growth and affect the entire organ.
Most head and neck cancers are squamous cell carcinomas, which are cancerous growths that begin in the flat squamous cells, that form the inner lining of many parts of the head and neck. Invasive squamous cell carcinoma is a tumour that moves into deeper tissues and adenocarcinomas arise in the glandular cells, such as those found in the salivary glands. Alcohol and tobacco are the key etiological factors and their use increases the risk of developing Head and Neck Cancers.
The signs and symptoms vary with the location of the primary site and the stage of the cancer. The early warning signs of head and neck cancer could lead to an early diagnosis and a high probability of better outcome in many cases. For example, hoarseness frequently occurs in the earliest stage of voice box cancers. Persistent sore throat for longer than two weeks is a possible symptom of cancer in the voice box and/or the pharynx. Though not limited to, other symptoms often are:
Pain and changes in the fit of dentures (if the patient is using one) in case of cancer in the oral cavity
A non-healing ulcer, difficulty in swallowing or nasal blockage could also be warning signs of potential carcinomas
Although not an early sign, a neck mass may be the first presenting symptom
Nasal problems may also indicate possibility of nasopharyngeal cancer
Red or white patch in the mouth
Foul mouth odour not explained by hygiene
Hoarseness or change in voice
Difficulty in breathing
Double or weak vision
Numbness or weakness in the head and neck region
Pain or difficulty in chewing, swallowing, or moving the jaw or tongue
Blood in the saliva or phlegm, discharged via the mucus into the mouth from respiratory passages
Loosening of teeth
Ear pain or infection
Oral cancer is the uncontrolled multiplication of cancerous cells in the mouth and surrounding regions. They are most commonly seen in people who chew tobacco, but it is also seen in smokers. In addition to tobacco, trauma due to sharp teeth and Human Papilloma Virus are emerging as causes of these cancers. This type of cancer may affect the tongue, lips, palate, floor of the mouth, pharynx, minor salivary glands and sinuses. If not treated when the disease is at an early stage, it can potentially be life threatening.
Throat cancer refers to cancerous tumours that develop in the throat. Throat cancer includes cancers of the air pipe, food pipe and those arising from the glands in the neck. Throat cancer includes cancer of the nasopharynx (the upper part of the throat behind the nose), the oropharynx (the middle part of the pharynx) and the hypopharynx (the bottom part of the pharynx). Cancer of the larynx (voice box) may also be included as a type of throat cancer.
Different cancers can develop from each kind of cell in the paranasal sinuses and nasal cavity. The nasal cavity and paranasal sinuses are lined by a layer of mucus-producing tissue with the following cell types: squamous epithelial cells, minor salivary gland cells, nerve cells, infection-fighting cells and blood vessel cells. Symptoms may include nasal blockage, nosebleed, swelling in the eyes and partial or complete loss of vision.
Cancers of the ear usually begin as skin cancers on the outer ear, ear canal or skin around the outer ear. The most common types are squamous cell carcinoma and basal cell carcinoma. If they are neglected, they may grow into the:
Deep into the temporal bone, which consists of the ear canal
Organs for hearing and balance
Head and neck cancer treatment is dependent on the stage of the cancer. While there is a different staging system for each type of head and neck cancer, the doctors use the diagnostic tests to answer the following aspects in the staging system:
Tumor: How large is the primary tumour and where is it located
Node: Has the tumour spread to any of the lymph nodes? If so, where and how many
Metastasis: Has the cancer metastasized to other parts of the body? If so where and how much?
The combined result of the above determines the stage of the cancer basis which a treatment plan is determined for each patient. Many cancers of the head and neck can be overcome, especially if they are detected early. Although eliminating the cancer is the primary goal, preserving the function of the nearby nerves, organs, and tissues is also equally crucial. When planning the treatment, how it might affect a person’s quality of life needs to be considered, such as how a person feels, looks, talks, eats, and breathes.
Multi-disciplinary approach is known to have improved the quality of cancer care and ensure that the patient has access to the best current thinking on cancer management. Surgery or radiation therapy by themselves or a combination of these therapies may be part of the treatment plan.