Head & Neck Cancer

What is Head & Neck Cancer?

Head & neck cancer damages the head & neck tissues. This cancer can be primary or secondary. Primary head & neck cancer (HNC) starts from the head region or the neck region. Secondary cancer starts from other tissues or organs and reaches the neck or head area. Secondary cancer can start from the sinuses, muscles, nerves, or salivary glands. They are commonly found in the head or neck lining. These linings are also known as squamous cells. Cancer of the squamous cells is often associated with a smoking history or exposure to papillomavirus.

Almost 58% of the global HNC cases are found in Asia, and in particular, India. Almost 30% of all cancer malignancies in India are head & neck related. Among them, 60-80% of cases are advanced, compared to only 40% in developed nations.

With a collective clinical experience of 30+ years, the oncology department of Medica excels in globally recognized cancer treatment facilities. We have a multidisciplinary approach to treating cancer. Our oncosurgeons and oncologists work worders with our latest technologies in cancer treatment. The oncology department is supported by teams of high-quality reconstructive surgeons. Together, Medica delivers an extensive and world-class treatment for all patients, adults as well as children.

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    Types

    There are several types of head & neck cancer. These are:

    Oral cavity cancer: It affects the lips, front section of our tongue, inner cheeks, and gums. It also includes the hard palate or bony part of the upper mouth. Primary causes are excessive smoking or tobacco chewing.

    Pharyngeal Cancer: Our pharynx is a 4-5 inches long hollow tube. It starts from behind our nose to our esophagus. It is essentially cancer of the throat. It occurs in areas like the base of our tongue, tonsil region, or back of our mouth.

    Laryngeal Cancer: This cancer affects the larynx, which is located beneath the pharynx. The larynx comprises our vocal cord which produces our voice. This cancer often results in voice changes in the person.

    Nasopharyngeal Cancer: This cancer is present inside the nasopharynx tissues. It is found in our throat’s upper region, behind our nose.

    Cancer of the Salivary Gland: It affects our salivary glands. Our salivary gland produces saliva. This saliva is important for dissolving food. The glands are also present in our digestive tract. All these areas are affected by cancer.

    Squamous Cell Cancer: It affects the neck region. Squamous cells are flat and thin cells. These are present on the skin’s surface, the lining of organs as well as the respiratory tract. It spreads from the original location towards lymph nodes. They affect our neck & collar bones.

    Soft Tissue Cancer: The soft parts around the head & neck are affected by the cancerous cells. These include connective tissues, muscles, and vessels carrying blood, fat, and lymph

    Symptoms

    The symptoms of head & neck cancer vary based on the affected organ and disease stage. A few common symptoms are:

    Oral Cavity: Red and white patches can be found on the tongue, gums, and the mouth’s inner lining. Other signs are unusual bleed and pain in the gum area.

    Throat: Symptoms include throat and neck pain, difficulty swallowing, and longer healing time. Other signs can be ears ringing and difficulty hearing.

    Voice box: Speaking becomes difficult. You may also feel significant ear pain.

    Nasal Cavity and Paranasal sinuses: Symptoms include blocked sinuses and chronic infection of the sinuses. The infection is non-responsive to antibiotics. Other signs include frequent headaches and nose bleeds.

    Salivary Gland: Swelling around the jawbone or beneath the chin.

    Causes

    The exact causes behind the development of these cancers are still unknown. Excessive alcohol and tobacco use is a major reason. This is confirmed by researchers. Cancer primarily affects our oral cavity, larynx, and pharynx regions. Head & neck cancer can also be due to human papillomavirus.

    Risk Factors

    Several factors increase the risk of head & neck cancer. These are:

    Pan chewing: Regular chewing of pan or betel nut causes oral cancer.

    Consuming salty or preserved food: Consuming variously salted or preserved food causes nasopharyngeal cancer

    Lack of oral health: Unethically dental and oral hygiene can cause oral cancer.

    Occupational exposure: People working in areas with high wood dust have a high risk of larynx cancer.

    Radiation exposure: Excessive exposure to radiation in the head or neck can cause cancer of the salivary glands.

    Epstein Barr Disease: Person exposed to viruses like Epstein Barr have a high risk of salivary gland and nasopharyngeal cancer.

    Family history: A person with a family history of HNC has a higher risk of developing cancer.

    Stages

    There are five different stages of head & neck cancer. These are:

    Stage 0: It is also called carcinoma in situ. This means the person has aberrant cells within the area. These cells can become cancerous in the future. It is the beginning stage.

    Stage I: This means cancerous cells have developed in the area. The tumor at this stage is very small. The diameter is less than two millimeters. The cancer is yet to reach the lymph nodes.

    Stage II: The tumor is growing in this stage. The diameter is still less than four centimeters. The tumor is yet to reach any lymphatic nodes.

    Stage III: The tumors are now bigger with a diameter above four centimeters. They have reached the lymph nodes. The tumor is yet to reach the opposite lymph nodes.

    Stage IV: It is the most prolific and advanced stage. The tumor size can vary. The tumor expands to several locations such as:

    • Other neck and head locations or neighboring tissues
    • Larger lymph nodes. The diameter of these lymph nodes is above three centimeters. The tumor can affect any lymph node across any side of the neck & head.

    Initial diagnosis of HNC is often at the advanced stages. This is due to the late onset of symptoms. Stage IV cancer can also be recurrent. This means cancer has returned after treatment. It can be a regional recurrence meaning cancer returns to its original location. It can be regional relapse means in the lymph node area. It can also be a distant recurrence meaning a different location.

    Diagnosis

    Early diagnosis of head & neck cancer can result in a positive outcome. The diagnosis process involves the physician ordering several diagnostic tests. It also includes physical examinations. The diagnosis can include:

    Physical Examination: The physician checks the overall health of your nasal and oral cavity. The physician will look for lumps within the neck, gums, and lips.

    Diagnostic tests: Diagnostic tests are recommended for confirming neck & head cancer. These tests are:

    • Blood test
    • Endoscopy for nasal cavity, throat, and voice box evaluation
    • Urine test
    • Neck and head x-ray
    • MRI
    • CT- scans
    • Biopsy
    • HPV Test
    • Pee Test

    Treatment

    Treatment for head & neck cancer depends on several situations:

    • Cancer location
    • Cancer stage
    • Age, overall patient health

    Head & neck cancer treatment involves the following:

    Radiation: High-energy radiation beams are used for killing cancer cells. However, the procedure is risky as it can damage surrounding tissues

    Surgery: The surgeon removes the cancer cells in this procedure. The cancerous cells might reach the nearby lymph nodes. In this case, the surgeon also removes these lymph nodes.

    Chemotherapy: Here drugs are used for killing the tumor cells. They do so by interfering with the growth & division of the cancer cells. The surgeon administers the drugs in various cycles. It is often a long-term treatment procedure.

    Target therapy: In this therapy, the genes, proteins, or vital processes associated with the cancer cells are targeted. Specific drugs are used for this therapy.

    Immunotherapy: This therapy involves boosting the immune system. This helps in fighting cancer.

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