Head & neck cancer
Head & neck cancers – What are they, how do they start, any symptoms to identify them, and how are they treated?
Head and neck cancers usually begin in the squamous cells that line the mucosal surfaces of the head and neck. These cancers can also begin in the salivary glands, sinuses or muscles or nerves in the head and neck.
Head and neck cancers form in the oral cavity, throat (pharynx), voice box (larynx), paranasal sinuses and nasal cavity, paranasal sinuses and nasal cavity and salivary glands.1
Symptoms
Common symptoms are:
- Pain
- Swelling
- Hoarse voice
- Sore throat that doesn’t get better
- Coughing all the time
- Difficulties swallowing
- Bad breath
- Mouth sores
- Swelling or change in colour of the mouth
- Unexplained weight loss
Risk factors
Head and neck cancers are common in people above the age of 40 and men are three times more likely susceptible to it than women.
- Alcohol consumption
- Tobacco consumption
- Weakened immune system
- Poor oral hygiene including gum disease
- Obesity
- Smoking
- Excessive sun exposure
- Radiation therapy
- Inherited condition of Fanconi anaemia or Li-Fraumeni syndrome2
Diagnosis
The symptoms mentioned above may be indicative of head and neck cancers but a proper diagnosis relies on the following methods.
Nasendoscopy – Nasendoscope or flexible laryngoscopy, which is a thin flexible tube with a light and camera on the end is used to examine the throat and the nose, under local anaesthesia.
Micro laryngoscopy – A laryngoscope, which is a tube with a light and camera at the end is used to check your voice box and throat and a biopsy is taken. This is performed under anesthesia.
Biopsy – Tissue samples or cells are removed from the affected area and examined under a microscope for cancer cells.
X-rays – Tumors or damage to the bones can be checked by X-rays.
CT Scan – A computerised tomography, popularly known as CT scan, uses x-ray beams to create cross-section images of the inside of your body.
MRI – A Magnetic Resonance Imaging (MRI) scan uses powerful magnet and radio waves to create detailed criss-cross section images of the inside of your body.
PET-CT Scan – A positron emission tomography (PET) scan combined with a CT scan helps identify the location of abnormalities. PET-CT Scan is used to usually evaluate the spread of laryngeal, pharyngeal or oral cancers.
Ultrasound – Ultrasound can be used to look at the salivary glands, thyroid and lymph glands in the neck.
Treatment options
Treatment options depend on the stage and location of your cancer. However, since these treatments can affect your teeth, mouth and gums, it is important to see a dentist for oral care, consult a dietician for your diet and nutrition as you may lose weight, have an exercise regimen to build strength and if you are a smoker, quit smoking so that you can respond better to treatment.
The following are the treatment options for head and neck cancer:
Surgery – Surgery is the choice of treatment when the cancerous tissues have to be removed while preserving the functions of the head and the neck.
Radiation therapy – Radiation therapy is used when a controlled dose of radiation is required to kill or damage cancer cells.
Chemotherapy – Specific drugs are used to kill cancer cells or slow down their growth. The drugs are usually injected.
Targeted therapy – Targeted therapy as the name suggests uses drugs that affect specific features of cancer cells to stop their growth.
Immunotherapy – Immunotherapy treatment uses the body’s own immune system to fight cancer. Major breakthroughs in the treatment of head and neck cancer have been achieved with this approach.
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