Head and neck cancers are a group of tumors that originate above the collar bone. Symptoms depend on the location of the mass. The cancer can originate from the cells lining the mouth, voice box (larynx), throat (pharynx), salivary glands, nasal cavity and paranasal sinuses.
According to epidemiological data head and neck cancers constitute for 12% of all malignancies in the world.
The History of head and neck cancers like all other types of cancer developed and underwent many changes at the turn of the century.
Hippocrates was the first person who used the word “cancer” and probably he was the first who divided the tumors into benign and malignant. Over the next centuries, medical science did not develop because of religious concerns about autopsy and surgical procedures.
The 17th century is a period in which there were a lot of new information about how to treat cancers such as oral cancer. Cancer of the tongue was removed by cauterization, which in the 18th century was replaced by the use of surgical instruments. In the same age glossectomy has been accepted as the treatment of choice performed in the treatment of cancer.
The 19th century brought a major breakthrough in the treatment of surgical, diagnostic, anesthetic techniques and understanding of the pathological mechanisms.
Histological evaluation of tumors has become mandatory and standard practice in the assessment of cancer.
Laryngectomy and neck lymph nodes removal has become commonplace.
Describing ways to treat cancer, radiotherapy cannot be ignored – there are several new techniques.
Chemotherapy and the introduction of many new drugs have changed the outlook for patients suffering from cancer.
Recently there are expectations about the targeted therapy, especially epidermal growth factor receptor (EGFR) group.
A 24 year old lady with a two year complaint of nasal blockage. Present were bilateral cervical lymph nodes. Initially treated with antibiotics with no sustained relief.
Subsequent CT scan of the Head and Neck and Nasal fibroscopy by Ear, Nose and Throat specialist showed the presence of a nasopharyngeal mass.
Biopsy of the mass confirmed Nasopharyngeal Mass during the histological exam. She was staged at III after CT review.
Consequently, she has had six cycles of chemotherapy which was given concurrently with radiation.
She is currently on 3-month follow up with oncologist and ENT.
Other Symptoms can include:
- An asymptomatic neck mass
- Unexplained bleeding in/from the mouth
- Red or white patches in the mouth
- Swelling of the jaw
- Difficulty opening the mouth
- Ear pain
- Pain when swallowing
- Difficulty breathing and/or speaking
- Frequent headaches
- Chronic sinus infections
- Teeth pain, sore gums, loose teeth
- Unexplained nose bleeds
- Facial numbness or paralysis
- Hearing loss
- Weight loss.
Any head and neck symptom such as a sore throat, hoarseness, ear pain lasting more than a week should prompt a visit to the hospital for further evaluation.
Routine physical examination including thorough oral examination is the best way to detect cancers early before they become symptomatic. And in any suspected case, further tests might be done to help pin down a diagnosis and further classify the tumor.
If these tests are suspicious of cancer, definitive diagnosis requires a biopsy which is the removal of tissue in order to examine it for cancer cells
There are four stages of head and neck cancer Stages 1-4 with Stage 4 most advanced and in general, the prognosis is favorable if the diagnosis is made early and treatment is timely and appropriate.
The main treatment for Head and Neck cancer are usually Surgery and Radiation.
Risk factors reduction; is critical, and all patients should stop tobacco use and limit alcohol consumption.
Current vaccination against HPV could lower the incidence of these cancers.
The most important strategy for reducing the incidence of head and neck cancer is diligent routine examination of the mouth.
Lakeshore Cancer Center.
Overview of Head and Neck Tumors by Bradley A. Schiff, MD, Montefiore Medical Center, The University Hospital of Albert Einstein College of Medicine. Bradley A. Schiff