Head & Neck Cancer
Overview
Introduction
Head and neck cancer is a group of cancers that starts in any of the following parts of the body:
Nose and sinuses
Mouth and lips
Salivary glands
The area at the back of the nose and mouth (nasopharynx)
Voice box (larynx)
Throat (pharynx)
Alcohol and tobacco (smoked and chewed) are the key etiological factors, and their use increases the risk of head and neck cancers.
etiology
Tobacco use is the biggest risk factor for head and neck cancer. An estimated 85 per cent of head and neck cancers are linked to tobacco use, and 75 per cent of head and neck cancers are associated with the combination of tobacco and alcohol use.
Other primary risk factors include:
Gender: Men are more likely to have head and neck cancers than women.
Age: Head and neck cancers are more commonly seen in people over the age of 50.
Diagnosis
There are various diagnostic procedures to detect and diagnose head and neck cancers:
a. Physical Examination: This is also a screening method for head and neck cancers. During the physical exam, the doctor looks for lumps on the neck, lips, gums, and cheeks. Insides of the mouth are checked for red or white patches, persistent bleeding, unhealed ulcers, etc. The nose, mouth, throat, and tongue are also inspected for abnormalities.
b. Endoscopy: This procedure uses a thin, lighted, flexible tube called an endoscope to examine the regions of the throat down to the oesophagus for the signs of head and neck cancers.
c. Biopsy: A biopsy involves the removal of a small amount of tissue from the suspected area, which is later examined under the microscope for cancer cells.
d. Molecular Testing of Tumour: Molecular tests are performed to identify specific genes, proteins, and other factors unique to the tumour. The results from these tests help specialists in planning targeted therapy.
Treatment
Optimal treatment for head and neck cancers depends on the location of the cancer and its stage. The treatment protocols use a multidisciplinary approach and focus on preserving the functions of nearby nerves, tissues and organs.
The main treatment options are surgery, radiation therapy, chemotherapy, targeted therapy and immunotherapy.
Early cancers (stage 1 and stage 2 cancers) are treated with a single modality treatment, either surgery or radiotherapy. Whereas, locally advanced cancers (stage 3 and stage 4 cancers) are treated with combined modality treatment, which involves either surgery and radiotherapy or chemotherapy and radiotherapy.