Head and Neck Cancer: Types and Treatment

Overview

Head and neck cancer is a group of cancers that develops in or near the throat, voice box, nose, sinuses, or mouth. All these cancers start when cells in part of the head or neck grow out of control and crowd out normal cells. This makes it hard for the body to function normally. Cancer cells in the head or neck can spread to other parts of the body, sometimes travel to the lungs and grow there. The main causes of head and neck cancers include tobacco, and alcohol. Worldwide, head and neck cancer accounts for more than 550,000 cases and 380,000 deaths annually.

Types

There are five main types of head and neck cancer. They are named for the affected part of the head or neck and have different symptoms.

• Nasal cavity cancer. It starts in the opening behind the nose, a space that runs along the top of the roof of the mouth and then turns downward to join the back of the mouth and the throat.

• Paranasal sinus cancer. It starts in the openings around or near the nose called sinuses.

• Nasopharyngeal cancer. It starts in the upper part of the throat behind the nose.

• Laryngeal cancer. It starts in the voice box. It caps over your larynx when you eat or drink to keep food and liquid from getting in.

• Hypopharyngeal cancer. It starts in the lower part of the throat beside and behind the voice box.

Causes

The two main causes of head and neck cancer are tobacco and alcohol. Smoking, secondhand smoke, chewing tobacco and using snuff can raise the risk of getting head and neck cancer. Drinking any type of alcohol, such as beer, wine, or liquor, also leads to a higher risk of getting cancers of the mouth, throat, and voice box. At least 75% of head and neck cancers are caused by tobacco and alcohol use.

Besides, infection with cancer-causing types of human papillomavirus (HPV), especially HPV type 16, is also a risk factor for some types of head and neck cancers, especially oropharyngeal cancer. An infection with the Epstein-Barr virus, a cause of infectious mononucleosis, can raise the risk of cancers in the nose, behind the nose, and cancers of the salivary glands.

Occupational exposures can increase the risk of getting cancers in the nasopharynx. Working in the construction, textile, ceramic, logging, and food processing industries can cause people to be exposed to substances like wood dust, formaldehyde, asbestos, nickel, and other harmful chemicals.

Radiation treatments to the head and neck can potentially cause head and neck cancers.

Symptoms

Head and neck cancer can most often affect the ears, nose and throat. Symptoms of head and neck cancer vary depending on where the cancer develops and how it spreads.

Some common symptoms of head and neck cancer tumors include:

• A lump in the nose, neck or throat
• A persistent sore throat
• Difficulty swallowing
• Weight loss
• Frequent coughing
• Change in voice or hoarseness
• Ear pain
• Difficulty hearing
• Headaches
• A red or white patch in the mouth
• Trouble breathing
• Nasal obstruction or persistent congestion
• Frequent nose bleeds or unusual discharge

Diagnosis

If you have symptoms of a head or neck cancer or the doctor suspects you have a head or neck cancer, the doctor might perform a few tests. These include:

• Complete head and neck exam. The doctor will check the head and neck area, looking for any abnormal areas. The lymph nodes in the neck may be the sign of cancer. The doctor may use mirrors, lights, and special fiber-optic scopes to look at these areas.

• Panendoscopy. It is done in an operating room after the patient is given drugs to sleep. The doctor will look inside the nose, mouth and throat through thin tubes called scopes and may take out some pieces of tissue to be checked under a microscope.

• Biopsy. In this test, the doctor will take out a small piece of affected tissue. The tissue is checked for cancer cells. This is the best way to know for sure if you have a cancer.

• CT scan. It is a special kind of x-ray that shows detailed pictures to see if the cancer spreads to the lymph nodes, lungs, or other organs.

• MRI scan. An MRI uses radio waves and strong magnets to take detailed pictures. It can be used to learn more about the size of the cancer.

• X-rays. It is used to see whether the cancer spreads to the lungs.

• Blood tests. Certain blood tests can tell the doctor more about your overall health.

Treatment

Treatment for head and neck cancer depends on a lot of factors, including the location of the tumor, the stage of the cancer, and the person’s age and general health. The common treatment options are as follows:

• Surgery

The doctor might eliminate the cancer with a laser or take out the tumor and some of the healthy tissue around it. Surgery may be used to take out lymph nodes in the neck that does not get better with other treatments. If the surgery changes your face a lot, or it makes it hard to eat and breathe, you might need another surgery.

• Radiation treatments

The doctor will use X-rays or other energy particles to kill cancer cells.

There are two main radiation treatments. External beam radiation is most often aimed at the cancer from a machine outside the body. Brachytherapy puts radioactive seeds right into the body near the cancer.

• Chemotherapy (Chemo)

The patient is given drugs to stop the cancer cells from growing and dividing, which should destroy cancer cells. The drugs may be given into a vein or taken as pills. Chemo is given in cycles or rounds. Each round of treatment is followed by a break. It often lasts for many months. Chemo is often given along with radiation.

• Targeted therapy

The doctor will prescribe some medications that work on the genes, proteins, and other parts of the cancer cells. Side effects of target therapy often include problems with the skin, hair, nails, or eyes.

• Immunotherapy

The procedure uses parts of your immune system to help fight cancer. Doctors can stimulate your immune system to attack cancer cells, or they can give you man-made proteins to strengthen your immune system.

Before taking any treatment options, please consult with the doctor for better advice.

Keywords: Head and neck cancer