The cancer of the head and neck is the fifth most common cancer form. It occurs in areas that include the pharynx, larynx, nasal cavity, thyroid, and salivary glands.
Head and neck cancer are tumors that occur in the head and neck region. Such cancers are said to occur in areas that include the oral cavity, pharynx, larynx, nasal cavity, paranasal sinuses, thyroid, and salivary glands. The cancer of the head and neck is the fifth most common cancer in the world. it is particularly prevalent in regions where there is high tobacco and alcohol consumption.
In India, the cancers of the mouth and tongue are more common than other head & neck cancers. Moreover, it has been observed that males are affected more than females with the cancers of head and neck. According to the International Journal of Head and Neck Surgery, overall 57.5% of global head and neck cancers occur in Asia especially in India, in both males and females. Over 2 lakh cases of head and neck cancers occur each in India. Further, head and neck cancers in India account for 30% of all cancers in males. In women, they constitute 11-16% of all sites of cancers.
Tobacco (smoked and smokeless) is the most important known risk factor for the development of head and neck cancer. There is some evidence for a genetic predisposition to the carcinogenic effects of tobacco. In addition, tobacco and alcohol consumption appear to have a synergistic effect. Human papillomavirus (HPV) infection has been established as another causative agent for head and neck cancer. Head and neck cancers arising due to HPV generally occur in the oropharynx (tonsils and base of tongue). Some other causes head and neck cancer include exposure to radiations, chewing of betel nut, deficiency of certain vitamins, periodontal (gum) disease, and occupational exposures.
Some of the symptoms of head and neck cancer include:
- Mouth sores or bleeding in the mouth
- A sore throat
- Trouble swallowing
- A hoarse voice
- A long-lasting cough or coughing up blood
- A lump in the neck
- Ear pain, hearing loss, or ringing in the ears
Following are some ways through which the risk factors of head & neck cancers can be reduced:
- Quitting smoking and ceasing the use of other tobacco products
- Decreasing consumption of alcohol
- Stopping the use marijuana
- Regularly using sunscreen including a lip balm which contains sufficient SPF
- Having multiple sexual partners increases the risk of HPV infections. Thus, one can reduce this risk by limiting the number of sexual partners.
To diagnose the cause of the symptoms, a doctor conducts a physical examination and other tests. During physical examination, the doctor uses a small mirror and/or lights to inspect the oral and nasal cavities, neck, throat, and tongue. The doctor may also check the patient for any lumps on the neck, lips, gums, and cheeks. Other tests to detect head & neck cancer include endoscopy, X-rays, CT scan, MRI, PET scan and lab tests like examination samples of blood, urine or other body substances.
The treatment for head & cancer depends upon the location of the tumor, the stage of cancer and the patient’s overall health. The treatment options usually involve one or more of the following:
Surgery – To remove the cancer, the doctor might conduct surgery. It might also involve removing some of the healthy tissues around the cancer affected area. If it is suspected that the cancer has spread, then the doctor might also remove the lymph nodes in the neck.
Chemotherapy – Chemotherapy is the term used to describe a group of medicines that are prescribed to kill cancer cells throughout the body. The treatment method usually has certain side effects like loss of appetite, loss of hair, sores in the mouth, tiredness etc. It is recommended that the patient consults the doctor about the side effects and the ways to cope up with them.
Radiation therapy – Radiotherapy involves using high energy rays to kill cancer cells. Radiation might be external or internal.
After the treatment, the patients might experience problems in chewing, eating, or talking. If this happens, then rehabilitation or “rehab” is recommended wherein the doctors, nurses, and other health professionals would work together with the patient to help him chew, eat, and talk normally. After treatment, your doctor will check you every so often to see if the cancer comes back. Follow-up tests can include exams, blood tests, and imaging tests. Regular post surveillance has become an essential part of the care of patients after they are treated of head and neck cancer. Patients should be counseled so as to look for any possible signs of tumor recurrence. Post follow up also includes screening for treatment-related complications (eg, hypothyroidism) and counseling for quitting smoking.
This article has been written by Dr. J.B. Sharma, Senior Consultant, Medical Oncology, Delhi based Action Cancer Hospital
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