Head and Neck Cancer

Head and Neck Cancer is a term used to describe a number of different malignant tumours that develop in or around the throat, larynx, nose, sinuses, and mouth.

Most Head and Neck Cancers are Squamous Cell Carcinomas. This type of cancer begins in the flat, squamous cells that make up the thin layer of tissue on the surface of the structures in the head and neck. Directly beneath this lining, which is called the epithelium, some areas of the head and neck have a layer of moist tissue, called the mucosa. If a cancer is limited to the squamous layer of cells, it is called Carcinoma in Situ. If the cancer has grown beyond this cell layer and moved into the deeper tissue, then it is called Invasive Squamous Cell Carcinoma.

If a Head and Neck Cancer starts in the salivary glands, the tumour will usually be classified as an adenocarcinoma, adenoid cystic carcinoma, or mucoepidermoid carcinoma.

Types of Head and Neck Cancer

There are many types of Head and Neck Cancers. Your doctor can tell you more about the type you have. Here are some of the most common types and how to say them:

  • Oral Cavity Cancer: starts in the mouth.
  • Oropharyngeal Cancer: starts in back of the mouth or the throat.
  • Nasal Cavity Cancer: 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: starts in the openings around or near the nose called sinuses.
  • Nasopharyngeal Cancer: starts in the upper part of the throat behind the nose.
  • Laryngeal Cancer: starts in the voice box.
  • Hypopharyngeal Cancer: starts in the lower part of the throat beside and behind the voice box.

The most common type of cancer in the head and neck area is called Carcinoma. These cancers start in the cells that line all parts of the nose, mouth, and throat.

Risk Factors

  • Gender
  • Age
  • Race
  • Prolonged sun exposure
  • Epstein-Barr virus (EBV) infection
  • Poor oral and dental hygiene
  • Environmental or occupational inhalants
  • Drugs, tobacco and alcohol consumption
  • Poor vitamin nutrition
  • Weakened immune system

Signs and Symptoms

  • Swelling or sore that does not heal (the most common symptom)
  • Red or white patch in the mouth
  • Lump, bump, or mass in the head or neck area, with or without pain
  • Persistent sore throat
  • Foul mouth odour not explained by hygiene
  • Hoarseness or change in voice
  • Nasal obstruction or persistent nasal congestion
  • Frequent nose bleeds and/or unusual nasal discharge
  • Difficulty breathing
  • Double vision
  • Numbness or weakness of a body part in the head and neck region
  • Pain or difficulty chewing, swallowing, or moving the jaw or tongue
  • Ear and/or jaw pain
  • Blood in the saliva or phlegm, which is mucus discharged in mouth from respiratory passages
  • Loosening of teeth
  • Dentures that no longer fit
  • Unexplained weight loss
  • Fatigue

Prognosis

The 5-year relative survival rates for Oral Cavity and Pharynx (throat) Cancers are basically 83% for cancer that has not spread, 62% for cancer that has spread to nearby lymph nodes and 38% for cancer that has spread to distant parts of the body.

In the case of the Nasal Cavity Cancer and Paranasal Sinus Cancer we find that 5-year survival rates are very similar in early stages (I and III), being around 60%. In more advanced stages (III and IV) this rate will be variable between 50% and 35% respectively.

In Larynx Cancer, in a general overview, in stage I the 5-years survival rate is around 90% and in stage II goes down to 70%. In stage III, about 60% people will survive meanwhile in stage IV this probability is very much lower being around 25%.

Head and Neck Cancer Diagnosis

PLEASE NOTE: EARLY DIAGNOSIS IN CANCER IS VERY IMPORTANT BECASUSE CANCER THAT’S DIAGNOSED AT AN EARLY STAGE, BEFORE IT’S HAD THE CHANCE TO GET TOO BIG OR SPREAD IS MORE LIKELY TO BE TREATED SUCCESSFULLY. IF THE CANCER HAS SPREAD, TREATMENT BECOMES MORE DIFFICULT, AND GENERALLY A PERSON’S CHANCES OF SURVIVING ARE MUCH LOWER.

State of the Art

Over the past, different methods have been developed in order to diagnose the presence of tumours in the head and the neck. Some of the most usual procedures employed with this purpose comprise physical examinations, endoscopies, biopsies and imaging techniques such as X-rays, CT Scans, MRI or PET Scan. However, these procedures are inherently limited because of several reasons: first of all, they can exert stress on the patient, secondly some of them can be harmful (i.e. X-rays or endoscopies) and damage some tissues during the examination and finally these procedures add significant costs over the course of treatment.