Head and Neck Cancer

by Dr. Santhosh Kumar N

Know the Symptoms, Causes & Treatment of Head & Neck Cancer

Head and neck cancer is a type of cancer that develops in the tissues of the head and neck. This area includes several vital structures, such as the oral cavity (mouth), nasal cavity, sinuses, throat (pharynx), voice box (larynx), salivary glands, and the lymph nodes in the neck.  These cancers can affect various parts of the head and neck, and they are often classified based on their specific location and the type of cells involved.

The following are the most prevalent kinds of head and neck cancer:

  • Squamous cell carcinoma: This type of cancer originates in the squamous cells, which are thin, flat cells lining the surfaces of the head and neck structures. Squamous cell carcinomas are the most prevalent type of head and neck cancer.
  • Nasopharyngeal carcinoma: This cancer develops in the nasopharynx, which is the upper part of the throat, behind the nose.
  • Oropharyngeal carcinoma: It affects the oropharynx, the middle part of the throat, including the base of the tongue, tonsils, and soft palate.
  • Laryngeal carcinoma: This cancer forms in the larynx, commonly known as the voice box.
  • Oral cavity cancer: This includes cancers of the lips, tongue, gums, floor of the mouth, and other areas within the mouth.
  • Hypopharyngeal carcinoma: It occurs in the hypopharynx, the lower part of the throat.

Several risk factors can contribute to the development of head and neck cancer, including smoking, chewing tobacco, excessive alcohol consumption, human papillomavirus (HPV) infection (linked to some oropharyngeal cancers), prolonged exposure to certain chemicals and substances (e.g. , asbestos, wood dust, formaldehyde), and a weakened immune system.

The symptoms of head and neck cancer can vary depending on the specific location of the cancer and its stage. It's important to note that these symptoms can also be caused by other non-cancerous conditions, but if you experience any of the following persistently or notice any changes, it's essential to seek medical evaluation for a proper diagnosis.

 Some common symptoms of head and neck cancer include:

  • Persistent Sore Throat: A sore throat that doesn't go away and doesn't respond to usual treatments may be a sign of cancer in the throat or larynx.
  • Difficulty Swallowing (Dysphagia): Trouble swallowing or the sensation of something being stuck in the throat could indicate cancer in the throat, esophagus, or surrounding areas. 
  • Hoarseness or Voice Changes: Persistent hoarseness or changes in the voice that last for more than two weeks may be associated with vocal cord or laryngeal cancer.
  • Lump or Swelling in the Neck: The presence of a painless lump or swelling in the neck that persists for more than two weeks could indicate enlarged lymph nodes, which might be a sign of cancer. 
  • Ear Pain: Unexplained ear pain, especially when it occurs on one side and is not associated with ear infections, can be related to certain head and neck cancers.
  • Unexplained Weight Loss: Significant and unintentional weight loss without any apparent cause may be a sign of advanced head and neck cancer.
  • Persistent Cough or Sore Throat: A chronic cough or a persistent sore throat that does not respond to treatment could be related to cancer in the larynx or pharynx.
  • Changes in the Skin: Changes in the skin on the face, neck, or lips, such as sores that do not heal, or red or white patches, may be indicative of certain types of head and neck cancer. 
  • Numbness or Weakness: Numbness or weakness in the face may occur due to nerve involvement in some types of head and neck cancer.
  • Nasal Blockage or Chronic Sinusitis: Chronic sinus problems or nasal blockages that do not improve with standard treatments may indicate a sinus or nasal cavity cancer. 

The treatment for head and neck cancer depends on various factors, including the location and stage of the cancer, the overall health of the patient, and the specific characteristics of the tumor.

The primary treatment options for head and neck cancer include:

  • Surgery: Surgery is often used to remove the cancerous tumor and surrounding tissues. The extent of surgery depends on the size and location of the tumor. In some cases, minimally invasive procedures may be used. Surgical options may include:
  • Transoral surgery: Performed through the mouth, avoiding external incisions.
  • Neck dissection: Removal of lymph nodes in the neck if they are affected.
  • Laryngectomy: Removal of the larynx (voice box) in cases of laryngeal cancer.
  • Maxillectomy or mandibulectomy: Removal of parts of the upper or lower jaw affected by cancer.
  • Radiation Therapy: Radiation therapy uses high-energy beams to kill cancer cells. It can be used as the primary treatment or in combination with surgery or chemotherapy. External beam radiation therapy and brachytherapy (internal radiation) are both routinely used to treat head and neck cancer.
  • Chemotherapy: Chemotherapy involves the use of drugs to destroy cancer cells or prevent their growth. It is sometimes used as the primary treatment for advanced cases or in combination with surgery and/or radiation therapy. Chemotherapy may also be given in conjunction with radiation therapy (chemoradiation).
  • Targeted Therapy: Targeted therapies are medications that specifically target certain molecules or pathways involved in cancer growth. They are often used in cases where specific molecular abnormalities are present, and they can be used alongside other treatments.
  • Immunotherapy: Immunotherapy works by stimulating the body's immune system to recognize and attack cancer cells. It has shown promising results in certain types of head and neck cancers, particularly those associated with human papillomavirus (HPV).
  • Palliative Care: Palliative care focuses on providing relief from symptoms, pain, and discomfort associated with cancer, regardless of the stage of the disease. It aims to improve the patient's quality of life.

Treatment plans are usually tailored to the individual patient's needs and may involve a combination of these treatment modalities. A multidisciplinary team of specialists, including oncologists, surgeons, radiation oncologists, and supportive care providers, collaborate to create the most effective and personalized treatment approach. 

It's important for patients to discuss all available treatment options, potential side effects, and the expected outcomes with their healthcare team to make informed decisions about their care.  Early detection and prompt treatment can significantly improve the prognosis for head and neck cancer patients.