Head and Neck Cancers

Head and Neck Cancers

The American Academy of Otolaryngology-Head and Neck Surgery estimates more than 55,000 Americans will develop cancer of the head and neck in 2015.

Cancers in the head and neck usually begin in the squamous cells that line moist surfaces, such as the mouth, nose and throat. They may be found in the oral cavity: lips, front of the tongue, gums, lining of the cheeks and lips, the inside of the mouth under the tongue, the hard, bony palate at the roof of the mouth, and the gum tissue behind the back teeth; pharynx, or throat: the hollow tube that starts behind the nose, passes the back of the mouth and tonsils and leads to the esophagus; larynx, or voicebox: the vocal cords and dangling epiglottis; the nasal sinuses and cavity inside the nose; or very rarely, in the salivary glands.

About 75% of head and neck cancers occur in people who use alcohol or tobacco, including smokeless tobacco, and those who use both are at even greater risk, according to the National Cancer Institute. Certain types of human papillomavirus (HPV) infection are associated with oropharyngeal cancers of the tonsils and base of the tongue. Epstein-Barr infection, radiation exposure, and work-related exposure to wood dust, nickel dust, formaldehyde, and some other industrial products have also been linked to an increased risk for head and neck cancers.

Head and Neck Cancers

Possible symptoms of head and neck cancer include a lump in the neck, a persistent sore throat or change in voice, a growth in the mouth, continually producing blood in the saliva or phlegm, difficulty swallowing, changes in the skin, numbness in the tongue, or ongoing pain in or around the ear when swallowing.

Treatment is different for each individual, but often depends on the location, stage, and type of cancer, as well as consideration of other existing medical conditions. The goal of surgery is to excise or remove the cancerous tissue at the tumor site and if possible, areas where it has spread, such as the lymph nodes. Early stage tumors, especially those found in the larynx, are sometimes treated with laser technology. In addition to the risks faced during any surgery, such as bleeding or infection, some surgeries for head and neck cancers may lead to difficulty speaking or swallowing or thyroid dysfunction, and post surgical therapy may be required to maintain communicating, chewing, or swallowing. If surgery leads to facial disfigurement, reconstructive surgery may be recommended.

Radiation therapy may be used alone or in conjunction with other treatments to destroy head and neck cancers. External-beam radiation approaches may include intensity-modulated radiation therapy (IMRT), which specifically directs beams to the tumor while sparing nearby tissues. Internal radiation therapy uses seeds or implants to direct radiation to destroy cancerous tissue. Radiation therapy of the head and neck can lead to swelling or irritation, tooth decay, dry mouth, fatigue, nausea, mouth sores, difficulty swallowing, hearing loss, changes in voice, change in taste, and loss of appetite. It, too, may lead to thyroid problems that can be treated with hormone therapy.

Chemotherapy for head and neck cancers may be given on a specific schedule orally or through the bloodstream. Side effects during treatment may include fatigue, nausea, vomiting, risk of infection, hair loss, loss of appetite, and diarrhea. Targeted therapy identifies specific genes, proteins, or tissue environments that promote cancer growth and survival, and blocks those targets to inhibit the growth and spread of cancer cells. In some head and neck cancers, epidermal growth factor receptor (EGFR) may be identified as an effective target for slowing or stopping tumor growth. Researchers are currently studying new targeted therapies and proton therapy for head and neck cancers in clinical trials.

A 2015 study in the Journal of American Medicine Otolaryngology-Head and Neck Surgery found that current smoking and heavy alcohol consumption – defined as drinking every day, drinking more than a specified amount per week, or having a history of alcohol-related illness and still drinking appeared to be risk factors for prolonged use of a feeding tube in patients with head and neck cancers undergoing radiotherapy or chemoradiotherapy. The study authors suggest nicotine may suppress appetite, and smoking and drinking may lead to poor patient motivation to resume eating habits after treatment with radiation.

Relieving symptoms and physical and emotional side effects using medication, nutritional changes, relaxation techniques, and other therapies, is known as supportive or palliative care, and may help patients at all stages of head and neck cancers. Find screening, statistics, research news, and a support community concentrated in the Southeastern United States at the Head and Neck Cancer Alliance.