Head and Neck Cancer

Head and neck cancer is a cancer that starts in the lip, oral cavity (mouth), nasal cavity (inside the nose), paranasal sinuses, pharynx and larynx.

Signs & Symptoms:

• Swelling or sore that does not heal
• 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 odor 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 jaws 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

Risk Factors:

• Tobacco use
• Frequent and heavy consumption of alcohol
• Prolonged sun exposure
• Human papillomavirus (HPV)
• Epstein-Barr virus (EBV)
• Gender
• Age
• Race
• Poor oral/dental hygiene
• Environmental/occupational inhalants
• Poor nutrition
• Gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux disease (LPRD).                      
• Viral infection
• Epstein-Barr virus
• Human papillomavirus
• Human immunodeficiency virus
• Herpes simplex virus
• Betel nut chewing

Common Types:

• Mouth cancer
• Laryngeal and Hypopharyngeal Cancer
• Nasal Cavity and Paranasal Sinus Cancer
• Oral and Oropharyngeal Cancer
• Salivary Gland Cancer

Diagnosis:

• Physical examination/blood and urine tests
• Endoscopy
• Biopsy
• Molecular testing of the tumor
• X-ray/barium swallow
• Panorex
• Ultrasound
• Computed tomography (CT or CAT) scan
• Magnetic resonance imaging (MRI)
• Bone scan
• Positron emission tomography (PET) scan

Stages:

• Stage 0
  A stage 0 head and neck cancer tumor means the cancer is only growing in the part of the head and neck where it started. No cancer cells are present in deeper layers of tissue, nearby structures, lymph nodes, or distant sites
• Stage 1
  A stage I head and neck cancer tumor means the primary tumor is 2 cm across or smaller, and no cancer cells are present in nearby structures, lymph nodes, or distant sites
• Stage 2
  A stage II head and neck tumor measures 2–4 cm across, and no cancer cells are present in nearby structures, lymph nodes, or distant sites
• Stage 3
  A stage III head and neck tumor means one of the following:
  • The head and neck tumor is larger than 4 cm across, and no cancer cells are present in nearby structures, lymph nodes, or distant sites
  • The head and neck tumor is any size but has not grown into nearby structures or distant sites. However, cancer cells are present in one lymph node, which is located on the same side of the head or neck as the primary tumor and is smaller than 3 cm across
• Stage 4
  One of the following applies:
  • The head and neck cancer tumor is any size and is growing into nearby structures
  • The tumor has invaded deeper areas and/or tissues. It may or may not have spread to lymph nodes and has not spread to distant sites.
  • The tumor is any size and may or may not have grown into other structures. It has spread to one or more lymph nodes larger than 6 cm across, but has not spread to distant sites.
  • The head and neck cancer tumor is any size and may or may not have spread to lymph nodes. Cancer cells have spread to distant sites.

Prevention:

• Avoid alcohol consumption
• Avoid smoking
• Avoid tobacco chewing
• Maintain good dental hygiene
• Ensure that there is no chronic irritation because of any tooth or dentures

Management:

• Surgery
• Laser technology
• Excision
• Lymph node dissection
• Reconstructive (plastic) surgery
• Radiation Therapy
• Chemotherapy
• Targeted therapy