Head and Neck Cancer: The Basics
Head and neck cancer is caused by cells growing out of control. As the number of cells grow, they form into a tumor. There are many different areas that make up the head and neck, and cancers are grouped by the area in which they occur. Cancers in one area are treated similarly:
- Oral cavity: Includes the lips, front part of the tongue, roof and floor of the mouth, parts of the gum line, and the inside lining of the cheeks.
- Nasopharynx: The areas of pharynx (throat) behind the nose and the lining of the nose.
- The sinuses: Hollow spaces in the bones of the head) and the nasal cavity (open space inside the nose).
- Salivary glands: Found in the bottom of the mouth and produce saliva.
- Oropharynx: area of the pharynx (throat) behind the mouth, the soft part of the roof of the mouth, tonsils, and the base of the tongue.
- Hypopharynx: The area of the pharynx (throat) below the oropharynx down to the esophagus (tube that food goes down).
- Larynx: The voice box and the epiglottis, which are in front of the hypopharynx.
- Parts of the ear including the external auditory canal, middle and inner ear.
Head and neck cancer that has spread from one part of the head and neck to any other part of the body is called metastatic cancer.
Head and neck cancers are often caused by tobacco and alcohol use. This includes both smoke and smokeless types of tobacco. Other risk factors include:
- Infection with certain strains of the Human Papilloma Virus (HPV). Head and neck cancers caused by HPV is becoming more common, particularly among oropharyngeal cancers.
- Diet high in salt-cured foods.
- Chronic sun exposure to the lip.
- Exposure to substances including asbestos, second hand smoke, radiation and wood dust.
- Inactive infection with the Epstein Barr virus.
- Poor oral health.
There are currently no specific screening tests recommended for early detection of head and neck cancers.Your dentist should examine your oral cavity and tongue during a routine dental exam.
Signs and Symptoms
Signs and symptoms of head and neck cancer depend on where the tumor is located. Symptoms can include:
- Weight loss from having trouble swallowing food
- A new lump or sore that doesn’t go away
- Sore throat
- Change in voice
Diagnosis of Head and Neck Cancer
If your healthcare provider suspects head and neck cancer, they will order tests to examine the inside and the outside of your head and neck. Tests may include:
- Endoscopy uses an endoscope, which is a thin tube with a camera on it. It is inserted into the nose or down the throat to look at and biopsy any suspicious areas.
- CT scan ("Cat Scan", a 3-D x-ray).
- PET scan.
Staging for Head and Neck Cancer
To guide treatment, head and neck cancer is "staged." This stage is based on:
- Size and location of the tumor.
- Whether cancer cells are in the lymph nodes.
- Whether cancer cells are in other areas of the body.
Stages range from stage I (smallest, most confined tumors) to stage IV (tumors that have spread to other areas of the body, also called metastatic cancer). The stage and type of cancer will guide your treatment plan.
Head and neck cancers are treated in a variety of ways depending on where the tumor is, the stage of the tumor, and how healthy the patient is. In general, the following treatments may be used:
- Surgery with the goal of removing the entire tumor and some surrounding healthy tissue. You may need reconstructive surgery to maintain function and appearance.Radiation uses high-energy x-rays to destroy cancer cells. It can be used before or after surgery and/or chemotherapy.
- Chemotherapy is the use of medication to kill cancer cells. It may be given with radiation to help the radiation work better, which is called radiosensitization.
- Targeted and Immunotherapies (another type of medication) can be used in squamous cell head and neck cancers.
This article is a basic guide to head and neck cancer. You can learn more about your type of cancer and treatment by using the links below.