Head and Neck Cancers

Head and neck cancer is the uncontrolled and abnormal growth of cancer cells in the head and the neck.

Finding and treating these cancers early matters. They can be treated, and in some cases they also leave permanent damage. Treatment aims to stop that damage.

The head and neck region covers the mouth, the nasopharynx at the top of the throat, the oropharynx, the hypopharynx at the bottom of the throat, the larynx, the sinuses, parts of the ear and the neck. Head and neck cancers are named after the area they involve.

The types

Cancer of the mouth. It covers the lip, the tongue, the gums, the cheeks, the floor of the mouth and the palate. Lip cancer appears most often on the lower lip and is commoner in men than in women. It becomes commoner with age. Tongue cancer forms, like other cancers, when cells multiply abnormally. Because the tongue lies open in the mouth, it is easier to diagnose than other cancers.

Cancer of the nasopharynx. The nasopharynx is the part behind and above the nose and the throat. Cancer there is hard to find early. It shows itself with ear problems and a blocked nose. Sometimes the first sign is a lump in the neck.

Cancer of the larynx. The larynx sits in the throat, after the pharynx, and separates the windpipe from the gullet. It opens and closes, which stops food passing into the windpipe by mistake. Cancer of the larynx usually forms in its upper part. Hoarseness lasting more than three weeks must be examined.

Cancer of the sinuses and the nasal cavity. The paranasal sinuses lie beside the nasal cavity. A tumour there is called sinus cancer or nasal cancer, depending on where it forms. Malignant cancer of the nasal cavity is rare. These cancers carry a lower risk of having spread at the time of diagnosis.

Cancer of the salivary glands. The salivary glands lie in the head and neck and produce the saliva that helps digestion. Their secretion also carries antibodies that prevent infection. There are many types of salivary gland cancer, though most salivary gland tumours are benign and do not spread.

Who gets them

Cancer affects every age group, and it is commoner over the age of 65. Most cancers are commoner in men than in women.

Age, sex and many other factors play a part. Smoking and alcohol come first. Cancer is also commoner in industrialised societies. Processed food and exposure to radiation contribute.

Turkey has a high rate of head and neck cancers such as cancer of the larynx. The main reason is smoking among men.

The other causes are genetics and family history, hormonal factors, diet, physical factors, chemicals, viruses, bacteria and parasites. Genetics alone does not cause cancer.

The warning signs

• Swelling in the head or the neck
• Swelling around the eye
• Numbness or tingling in the mouth
• Hoarseness
• Difficulty swallowing
• Cough
• Difficulty breathing
• Sores in the mouth, on the tongue or on the lip
• Ear pain, ringing in the ear, or reduced hearing

Diagnosis

Finding head and neck cancer early is very important. Almost three quarters of all head and neck cancers can be detected during an examination.

Your doctor performs tests to reach the diagnosis. These start with a physical examination of the mouth, the nose, the throat and the tongue. Endoscopy may follow, so that the doctor can examine the larynx, the throat and the nasal cavity.

Treatment

Treatment differs from person to person and by the type of cancer. The aim is to cure the disease and to restore the functions that have been lost.

The method is decided by how far the cancer cells have spread. A treatment plan made for the individual patient can use surgery, chemotherapy or radiotherapy alone, and in some conditions a combination.

Surgery removes the cancerous tissue or organ. It is effective when the cancer has not spread. Even when it has spread, surgery is used together with the other treatments. Surgery is used very often.

Chemotherapy is the name for the chemicals used to destroy cancer cells. Unlike the other methods it acts on the whole body. It is used when the cancer cells have spread.

Radiotherapy is used alone or in combination. Radiation produced by special machines destroys the cancer cells. In head and neck cancer it aims to treat the cancer, to stop or delay its spread, and to reduce pain.

Staging

The first step in treatment is to establish the stage of the cancer. Tumours are staged under four headings.

In stages 1 and 2 the cancer cells are small, and surgery cures the disease at these stages. Chemotherapy or radiotherapy can be added to prevent any remaining spread.

In stages 3 and 4 the tumour cells may have spread to the tissue around them and to the lymph nodes. Stages 3 and 4 are treated with a combination, which aims to treat the cancer.