Head and neck cancers
Cancer is a disease in which the body's cells proliferate uncontrollably. Cancers of the head and neck include cancers that begin in multiple locations in the head and throat, but do not include brain or eye cancers.
These cancers can begin —
- Within the sinuses (the spaces around the nose on the inside of the skull).
- Inside the nose and behind it.
- Within the mouth, as well as the tongue, gums, cheek and roof of the mouth.
- The pharynx (back of the mouth and throat) is divided into three sections: the nasopharynx, oropharynx, and hypopharynx.
- Within the larynx (voice box).
- In the glands that produce saliva for the mouth, these are uncommon.
To reduce your risk of head and neck cancer, avoid using tobacco products, limit your alcohol consumption, minimize indoor tanning, and discuss HPV vaccination with your doctor.
Men and people directed male at birth (AMAB) are up to three times more likely than women and people assigned female at birth to be diagnosed (AFAB). Age also plays a role. The majority of people are diagnosed after the age of 50.
Certain factors, particularly tobacco and alcohol use, as well as HPV infection, increase your cancer risk.
Sign & Symptoms
Head and neck cancer can be difficult to detect because symptoms are frequently mild and can mimic less serious conditions such as a cold or sore throat. The most common sign of head and neck cancer is a persistent non healing ulcer.
Among the symptoms are:
- A non-healing ulcer/ lesion in the mouth.
- Hoarseness or changes in voice.
- When you chew or swallow, you may experience pain.
- Spontaneous loosening of teeth.
- Persistent pain in mouth or throat.
- Numbness or pain in the face.
- Neck ache that will not go away.
- Having difficulty breathing or speaking.
- You have a lump in your throat, mouth, or neck.
- Earaches or infections that persist.
- Nosebleeds, bloody saliva or phlegm are all symptoms.
- Sinus infections do not respond to antibiotics on a regular basis.
- A white or red patch on your gums, tongue, or the interior of your mouth.
- Jaw, neck, or side of the face swelling (that may cause your dentures to fit poorly).
- Unexplained weight loss
If you notice any of these symptoms, contact your doctor right away. They could be symptoms of something less serious, but only a thorough examination can tell.
The importance of early detection in cancer treatment cannot be overstated. Most head and neck cancers can be detected with routine exams. A medical professional will examine you and order diagnostic tests.
These examinations and tests may include:
- A physical exam is performed in which your provider examines your oral and nasal cavities, neck, throat, and tongue. They may feel like lumps on your neck, lips, gums, and cheeks.
- An endoscopy is a procedure in which your provider uses a thin, lighted tube called an endoscope to examine your nasal cavity, throat, voice box, or other areas where you're experiencing symptoms. The name of an endoscopy varies depending on the body part being examined. A nasal endoscopy, for example, allows your provider to see inside your nasal cavity. A laryngoscopy allows your doctor to examine your voice box (larynx).
- Head and neck X-rays, CT scans, MRIs, and PET scans all produce images of the inside of your head and neck. Your doctor will determine which tests will be most helpful in making a diagnosis.
- Your provider may request a blood sample for testing. They may, for example, look for viruses such as HPV or EBV. They may use biomarker testing (molecular testing) to look for proteins that are common in certain head and neck cancers. This information could assist your provider in determining treatment options.
- A biopsy is a procedure in which your provider eliminates tissue for examination under a microscope by a pathologist. They will examine the sample for cancer cells. Cancer can only be diagnosed through a biopsy.
Staging of Cancer:
Cancer staging assists healthcare providers in determining the stage of cancer and planning treatment. To stage head and neck cancers, doctors use the TNM (tumor, node, metastasis) system.
They take into account factors such as the size and location of a tumor (T), whether cancer has spread to lymph nodes (N), and whether cancer has spread to other parts of your body (metastasized) (M). They assign a number ranging from I to IV based on this information, with higher numbers indicating more advanced disease.
Staging differs depending on the location of the cancer and the stage of cancer.
Your treatment plan will be determined by the stage of your cancer, as well as your age and general health.
There are several ways to reduce your risk of developing head and neck cancer—
- You should not smoke. Quit smoking if you smoke. Quitting smoking reduces the risk of developing cancer.
- Use no smokeless tobacco products.
- Limit your alcohol consumption.
- Discuss HPV vaccination with your doctor. The HPV vaccine can protect against new infections with the types of HPV that are most commonly associated with oropharyngeal and other cancers. Vaccination is only advised for people of certain ages.
- Use condoms and dental dams consistently and correctly during oral sex to reduce the chances of transmitting or receiving HPV.
- Avoid excessive sun exposure. Use sunscreen outdoors as well as indoors.
- Visit the dentist on a regular basis. Checkups can often detect head and neck cancers at an early stage when they are highly treatable.
- Surgery, radiation therapy, and chemotherapy are the three main treatments. Your doctor may also recommend newer treatments such as targeted therapy and immunotherapy, or you may be asked to participate in a clinical trial.
Surgeons may remove the tumor as well as a margin of healthy tissue surrounding it. If cancer has spread to the lymph nodes in your neck, the surgeon may remove them as well.
- Radiation therapy: The most common type of radiation therapy for head and neck cancers involves the use of a machine that directs high-energy X-rays at your tumor (EBRT). Radiation can be used alone or in conjunction with other treatments such as surgery and chemotherapy. Radiation therapy can also help relieve symptoms.
- Chemotherapy: To kill cancer cells, a single drug or a combination of drugs is used. It is typically used for advanced-stage head and neck cancers.
- Targeted therapy: These drugs are designed to target specific types of cancer. They are typically used in conjunction with other therapies to treat advanced head and neck cancers. Cetuximab (Erbitux®) is a drug that targets a tumor protein called epidermal growth factor (EGFR) and is FDA-approved to treat certain head and neck cancers. The FDA has approved treatments for genetic changes, such as larotrectinib (Vitrakvi®), which is used to treat people who have mutations in their NTRK gene.
- Immunotherapy drugs activate (or boost) your immune system, allowing it to identify and destroy cancer cells more quickly. Pembrolizumab (Keytruda®) and nivolumab (Opdivo®) are two FDA-approved immunotherapy drugs for the treatment of certain head and neck cancers that have spread or returned after treatment.
- A clinical trial is a study that evaluates the safety and efficacy of new treatments. New immunotherapy drugs and radiation therapy techniques are being tested in current research on head and neck cancer treatments. The search for the best treatments for different types of cancer is ongoing. Consult your doctor to see if a clinical trial is right for your treatment plan.
If detected early, many head and neck cancers can be treated with surgery and radiation. If you experience any symptoms of head and neck cancer, see a doctor right away, especially if you engage in high-risk activities such as smoking or using tobacco. Once you've been diagnosed with cancer, the best way to fight it is through early detection and treatment. Inquire with your doctor about the best treatment options based on your health and cancer stage.