Head and neck cancer

 

 

Head and neck cancer is a disease involving abnormal cell growth of the tissues of the head and neck that may also have the potential to invade or spread to other parts of the body. Cancer of head and neck generally begin in the cells called squamous cells which are present in the lining of the moist mucosal surfaces in the head and neck (e.g., inside of nose, throat, and mouth).

 

 

The exact cause of head and neck cancer is unknown. Common factors are:

1. Heredity: Strong family history of cancer increases the risk

2. Alcohol and tobacco: Chewing or smoking tobacco and drinking alcohol are the most important risk factors causing head and neck cancer, especially of the mouth, throat, and the voice box (larynx).

3. Human papillomavirus (HPV): HPV-16 is a virus, said to be a risk factor for some types of head and neck cancer, especially the mouth and throat cancer.

4. Paan (betel): People in habit of keeping betel leaf or betel nuts in their mouth are at increased risk of developing oral cancers.

5. Mate: Mate is tea like beverage commonly consumed by South Americans. It can increase the risk of mouth, food pipe, larynx, and throat cancer.

6. Occupational exposure: People having jobs in departments like construction, metal, textile, ceramic, (wood) logging, and food industries may be at an increased risk of larynx cancer. Industrial exposure to wood dust or nickel dust or formaldehyde is a risk factor for cancer of the sinuses around the nose and nasal cavity.

7. Radiation exposure: Radiation to the head and neck, (for treatment of some other cancer) can be a risk factor for salivary gland cancer.

8. Epstein-Barr virus (EBV) infection: Infection with the EBV is a risk factor for nose and throat cancer and salivary gland cancer.

 

 

Early symptoms include:

1. Lump in the neck: Cancer of head and neck causes enlargement of lymph nodes in the neck before spreading to other parts. Lump in the neck can be the first sign of cancer affecting the mouth, larynx, and throat.

2. Change in the voice: Cancer of larynx can cause change of voice

3. Growth in the mouth: Cancer of mouth and tongue can cause a painless swelling that does not recede.

4. Difficulty in swallowing: Throat cancer can cause difficulty in swallowing solid foods and sometimes liquids too.

5. Persistent pain in the ear: Persistent pain in or around the ear while swallowing can be a sign of infection or tumor growth in the throat.

 

 

1. Blood test: Blood tests are done to check for any viral infections like HPV and EBV.

2. Imaging test: MRI (magnetic resonance imaging), x-ray, CT scans, and PET (positron emission tomography) scans are done to determine the spread and stage of disease.

3. Biopsy: It is the only way of confirming the diagnosis. Fine-needle aspiration cytology (FNAC) is done to investigate any growth in head and neck. Sometimes endoscopy has to be done to reach lesions that are far away for biopsy.

 

 

Cancers in early stages are treated either by surgery or by radiotherapy. Advanced tumors generally need both surgery and chemoradiotherapy. Treatment options for head and neck cancer are:

1. Medications: Chemotherapy uses cancer cell killing drugs that are given by oral or intravenous route to the patient.

2. Surgery: It may be needed to remove certain cancers.

3. Radiation therapy: This is done to destroy the cancer cells using high-energy x-rays in the area that is treated.

4. Targeted therapy: This has more specific action on the cancer cells. They do minimal harm to other body cells. It is done using drugs that block the growth and spread of cancer. They prevent cancer cells from dividing and destroy them directly.