Head and Neck Cancer

Following are the different types of head and neck cancers:

• Oral cancer
  It is the cancer that originates from the gums, tongue, lips, lining of the lips and cheeks, the bottom and top of the mouth, or behind the wisdom teeth.
• Oropharyngeal cancer
  It is the cancer of the oropharynx, the middle part of the throat. The most common type of oropharyngeal cancer is tonsil cancer.
• Hypopharyngeal cancer
  It is the cancer of the hypopharynx, bottom part of the throat.
• Laryngeal cancer
  Laryngeal cancer is the cancer of the larynx or the voice box. Larynx contains the vocal cords.
• Nasopharyngeal cancer
  It refers to the cancer of nasopharynx ( upper part of the throat).
• Salivary gland cancer
  It refers to the malignant tumour of the salivary glands, that release saliva.
• Cancer of the nasal cavity and paranasal sinuses
  This cancer forms in the hollow spaces in the bones around the nose or inside the hollow area of the nose.

Sometimes, head and neck cancers involve the lymph nodes in the upper part of the neck. Eye, brain, thyroid, and esophageal cancers aren’t considered as head and neck cancers, despite their locations. Their treatment is also different from that given for head and neck cancers.

Males are upto three times more likely to get diagnosed with head and neck cancers than females. Age has a role to play as well. Most patients who get diagnosed are above the age of 50 years. The presence of certain risk factors increase your susceptibility to developing head and neck cancers. These include alcohol and tobacco use and Human Papillomavirus infection.

Head and neck cancers are not diagnosed easily. This is because the symptoms are not that prominent and they commonly mimic less serious conditions like a sore throat or a cold. The most common symptom of head and neck cancer is a sore throat that doesn’t seem to get better with treatment.

Following are some common symptoms of head and neck cancers:

• Frequent headaches
• A persistent sore throat
• Pain while chewing or swallowing
• Hoarseness or voice changes
• Facial pain or numbness
• Pain in the upper teeth
• Trouble speaking or breathing
• Neck pain that doesn’t go away
• A lump in the mouth, throat, or neck
• Persistent infections or earaches
• Bloody saliva, nosebleeds, or phlegm
• Frequent sinus infections that don’t respond to antibiotics
• A non-healing tongue or mouth sore
• A red or white patch on your tongue, gums, or inside of the mouth
• Swelling in the neck, jaw, or the side of the face

If you notice any of these symptoms, you must talk to a healthcare provider immediately. Even though these may be symptoms of something less serious, you still need a thorough examination to be sure.

Head and neck cancers are more common in men above the age of 50 years. Apart from age and sex, other common risk factors for these cancers are excessive consumption of alcohol, tobacco, and HPV infections. Depending on the type of cancer, the risk factors for head and neck cancers may vary.

• Using tobacco
  The commonest cause of head and neck cancers is tobacco use. About 70-80% of these cancers are associated with tobacco use. Tobacco includes cigars, cigarettes, pipes, or chewing snuff, tobacco, or dip. The risk is also increased by exposure to secondhand smoke.
• Excessive consumption of alcohol
  Excessive alcohol consumption may enhance your risk.
• Human papillomavirus (HPV) infection
  The head and neck cancers linked with Human Papillomavirus infection are increasing, especially among younger adults. Around 75% of oropharyngeal carcinomas are linked with HPV infection.
• Epstein-Barr virus (EBV) infection
  Ebstein Barr virus is generally linked with other infections, but it is also associated with cancer risk. EBV infection can result in nasopharyngeal carcinoma.
• Being immunocompromised
  If someone is immunocompromised, it is harder for them to fight against cancer. Recent major surgeries and HIV infection both are linked with cancer resulting from a weakened immune system.
• Occupational exposure
  Your job may expose you to agents associated with head and neck cancers such as pesticides, asbestos, paint fumes, and wood dust.
• Radiation exposure
  Exposure to radiation as a part of the treatment for benign or malignant tumours has been associated with salivary gland cancers. However, the risk is quite low.
• Diet
  Consuming a salt rich food can increase your susceptibility to developing nasopharyngeal carcinoma.
• Genetics
  Your cancer risk may be increased due to your genes.
• Poor dental hygiene
  Not taking proper care of your oral health can increase your risk of developing oral cancer, apart from developing periodontal disease.

The key to a successful cancer treatment is early detection. Most head and neck cancers are easily detected by examination. Apart from performing a complete physical examination, the healthcare provider will order certain investigations to establish the diagnosis of head and neck cancer.

These tests and examinations might include:

• Physical examination
  Your doctor checks your nasal cavity, oral cavity, throat, neck, and tongue for any sign of abnormalities.
• An endoscopy
  During this procedure, a narrow, lighted tube known as an endoscope is used. It allows the healthcare provider to visualise the throat, nasal cavity, larynx, and other areas where symptoms are present. Depending on the body area involved, endoscopy is named differently. For example, nasal endoscopy is the name given to the endoscopy of the nose. Laryngoscopy is the endoscopy of the larynx.
• Imaging tests
  X-rays, MRIs, CT scans, and PET scans of the head and neck region produce pictures of areas inside the head and neck. Your doctor will decide the tests which will be more useful for establishing a diagnosis of your condition.
• Laboratory tests
  Your doctor may obtain a blood sample and use it for testing. For example, they may test for viruses like EBV or HPV. They may even run molecular tests to check for proteins commonly found in certain head and neck cancers. The information derived from these tests may help guide the treatment plan.
• Biopsy
  A tissue of the suspected area is obtained and sent for pathological examination. The tissue is examined under the microscope for the presence of cancer cells. Some common biopsy methods employed for the diagnosis of head and neck cancers include core needle biopsy and needle aspiration.

The staging of cancers helps doctors determine how advanced the cancer is and this information helps guide the treatment plan. For the staging of head and neck cancers, the TNM (tumour, node, metastasis) system is used.

Factors like the size and location of the tumour, its extent of spread to the surrounding lymph nodes and distant organs are considered for staging. Based on this information, a number ranging from I to IV is assigned to each cancer. Higher the number, the more advanced the disease is. Depending on the location and stage of the cancer, the staging is different. The treatment plan is guided by the stage of the cancer, its location, and age and overall health of the patient.

After establishing the diagnosis, appropriate treatment for Head & Neck Cancer is selected for specific cancer based on its site, stage, and type. Other factors like comorbid conditions, social and economic factors, and patients' personal preferences are also considered. If you are looking for the best Head & Neck treatment Hospital in Indore, your search is over. Our treatment plan includes a combination of treatment modalities— surgery, radiation therapy, chemotherapy, and targeted therapy.

Surgical resection and radiation therapy are the mainstays of treatment for most head and neck cancers and remain the standard of care in most cases. If the tumour is small, primary, and there is no regional metastasis, wide surgical excision or curative radiation therapy is used. For more extensive tumours or tumours with regional metastasis, complete surgical excision combined with pre-or post- operative radiation therapy is used.

The main treatment modalities used for head and neck cancers are surgery, chemotherapy, and radiation therapy. Your doctor may also recommend novel treatment options such as immunotherapy and targeted therapy.

• Surgery
  The tumour along with a margin of the surrounding healthy tissue is removed. Apart from that, the lymph nodes in the neck are also removed if the surgeon suspects that those might have been involved by the cancer.
• Radiation therapy
  The commonest type of radiation for such cancers employs a machine that directs high-energy X-rays towards the cancerous cells. Radiation may be delivered as a standalone treatment or in combination with other treatments such as chemotherapy or surgery. The symptoms may also be relieved by radiation therapy.
• Chemotherapy
  A single drug or a combination of multiple drugs is used to damage or kill the malignant cells. Chemotherapy is more commonly preferred for advanced head and neck cancers.
• Targeted therapy
  Specific types or forms of cancers are targeted by these drugs. Targeted therapy is also commonly used in combination with other treatment modalities to treat head and neck cancers.
• Immunotherapy
  These drugs stimulate the immune system to identify and kill the malignant cells more efficiently.

Apart from the above mentioned treatment options, your doctor may suggest palliative care. Such treatment is delivered by a team of palliative care professionals including doctors, social workers, nurses, and others who are experts at helping people deal with terminal chronic illnesses. Palliative care helps enhance the quality of life for the patient, no matter the stage of the cancer.

Following are some steps you can take to prevent head and neck cancers:

• Quit tobacco
  If you want to decrease your susceptibility towards developing head and neck cancers, quit using tobacco in all forms including cigars, cigarettes, dip, snuff, and chewing tobacco.
• Reduce your drinking
  Cutting on your alcohol consumption can decrease your susceptibility towards developing such cancers.
• Get the HPV vaccine
  HPV vaccine protects you against several strains of the Human Papillomavirus, including those that lead to oropharyngeal carcinoma. It prevents HPV most effectively if you take it before getting sexually active. It may still be beneficial to take it upto the age of 45. You must ask your doctor if you are the right candidate for taking this vaccine.

If you already had the cancer, cutting down on alcohol and quitting smoking can decrease your risk of facing relapse. Visiting a doctor at the first sign of symptoms may also prevent the progression of the cancer.

Prognosis

Head and neck cancers are curable if diagnosed early. If diagnosed late at a time when the disease has reached an advanced stage, the outcome is generally poor. The stage of cancer when it is diagnosed is a critical factor in the prognosis of head and neck cancers. The average 5-year survival following diagnosis in the developed world is 42–64%.

Early-stage head and neck cancers are usually treatable with surgery and radiation therapy. If you are experiencing any symptoms of head and neck cancer, you must visit a healthcare provider and seek immediate medical care and treatment. Early diagnosis and treatment are the best ways to deal with the cancer to ensure optimum outcome.