What is Head And Neck Cancer
“Head and neck cancer” is the term used to describe a number of different malignant tumors that develop in or around the throat, larynx, nose, sinuses, and mouth.
Most head and neck cancers are squamous cell carcinomas. This type of cancer begins in the flat squamous cells that make up the thin layer of tissue on the surface of the structures in the head and neck. Directly beneath this lining, which is called the epithelium, some areas of the head and neck have a layer of moist tissue, called the mucosa. If cancer is only found in the squamous layer of cells, it is called carcinoma in situ. If cancer has grown beyond this cell layer and moved into the deeper tissue, then it is called invasive squamous cell carcinoma. If doctors cannot identify where cancer began, it is called a cancer of unknown primary.
Types of head and neck cancer
There are types of head and neck cancer, each named according to the part of the body where they develop.
1. Oropharyngeal Cancer
A disease in which cancerous cells are found in the tissues of the oropharynx – the middle part of the throat (also called the pharynx) . This includes the soft palate/back of the mouth, the base of the tongue and the tonsils. The pharynx is a hollow tube about 5 inches long that starts behind the nose (nasopharynx) and goes down to the neck (hypopharynx) to become part of the esophagus, the tube that goes to the stomach. Air and food pass through the pharynx on the way to the windpipe (trachea) or the esophagus.
2. Hypopharyngeal Cancer
A disease in which cancerous cells are found in the tissues of the hypopharynx—the bottom part of the throat, also called the pharynx. The pharynx is a hollow tube about 5 inches long that starts behind the nose (nasopharynx) and goes down to the neck (hypopharynx) to become part of the esophagus, the tube that goes to the stomach. Air and food pass through the pharynx on the way to the windpipe (trachea) or the esophagus. Cancer of the hypopharynx most commonly starts in the cells that line the hypopharynx.
3. Laryngeal Cancer
A disease in which cancerous cells are found in the tissues of the larynx (voice box). The larynx (voice box) is located just below the pharynx (throat) in the neck. The larynx contains the vocal cords, which vibrate and make sounds when air is directed against them. The sound echoes through the pharynx, mouth and nose to make a person’s voice.
4. Lip and Oral Cavity Cancer
A disease in which cancerous cells are found in the tissues of the lip or mouth. The oral cavity includes the front two-thirds of the tongue, the upper and lower gums, the lining of the inside of the cheeks and lips, the floor of the mouth under the tongue, the bony top of the mouth (hard palate), and the small area behind the wisdom teeth.
5. Nasopharyngeal Cancer
A disease in which cancerous cells are found in the tissues of the nasopharynx – the upper part of the throat (also called the pharynx) located behind the nose. The holes in the nose through which people breathe lead into the nasopharynx. Two openings on the side of the nasopharynx lead into the ear. The nasopharynx sits above the soft palate.
6. Soft Tissue Sarcoma
A disease in which cancerous cells are found in the soft tissue of part of the body. The soft tissues of the body include the muscles, connective tissues (tendons), vessels that carry blood or lymph, joints, and fat.
7. Salivary Gland Cancer
A disease in which cancerous cells are found in the tissues of the salivary glands. The salivary glands make saliva, the fluid that is released into the mouth to keep it moist and to help dissolve food. Major clusters of salivary glands are found below the tongue, on the sides of the face just in front of the ears, and under the jawbone. Smaller clusters of salivary glands are found in other parts of the upper digestive tract. The smaller glands are called the minor salivary glands.
8. Thyroid Cancer
A disease in which cancerous cells are found in the tissues of the thyroid gland. The thyroid gland is at the base of the throat and has two lobes, one each on the right and left side. The thyroid gland produces hormones that help the body function normally. There are four main types of cancer of the thyroid, based on how the cancer cells look under a microscope: papillary, follicular, medullary, and anaplastic.
9. Paranasal Sinus and Nasal Cavity Cancer
A disease in which cancerous cells are found in the tissues of the paranasal sinuses or nasal cavity. Paranasal sinuses are small, hollow spaces around the nose. The sinuses are lined with cells that make mucus, which keeps the nose from drying out; the sinuses also are a space through which the voice can resonate to make sounds when a person talks or sings. There are several paranasal sinuses, including the frontal sinuses (forehead), the maxillary sinuses in the upper part of either side of the upper jawbone (cheeks), the ethmoid sinuses (between nose and eyes), and the sphenoid sinus behind the ethmoid sinus in the center of the skull. The nasal cavity is the passageway just behind the nose through which air passes on the way to the throat during breathing.
10. Squamous Cell Neck Cancer
A disease in which cancerous cells are found in the squamous cells – thin, flat cells found in tissue that forms the surface of the skin, the lining of body organs and the passages of the respiratory and digestive tracts. Cancer can begin in the squamous cells and spread from its original site to the lymph nodes in the neck or around the collarbone. Lymph nodes are small bean-shaped structures that are found throughout the body. They produce and store infection-fighting cells. When the lymph nodes in the neck are found to contain squamous cell cancer, a doctor will try to find out where the cancer started (the primary tumor). If the doctor cannot find a primary tumor, the cancer is called a metastatic cancer with unseen (occult) primary.
Symptoms and Signs
People with head and neck cancer often experience the following symptoms or signs.
- Swelling or a sore that does not heal; this is the most common symptom
- Red or white patch in the mouth
- Lump, bump, or mass in the head or neck area, with or without pain
- Persistent sore throat
- Foul mouth odor not explained by hygiene
- Hoarseness or change in voice
- Nasal obstruction or persistent nasal congestion
- Frequent nose bleeds and/or unusual nasal discharge
- Difficulty breathing
- Double vision
- Numbness or weakness of a body part in the head and neck region
- Pain or difficulty chewing, swallowing, or moving the jaw or tongue
- Jaw pain
- Blood in the saliva or phlegm, which is mucus discharged into the mouth from respiratory passages
- Loosening of teeth
- Dentures that no longer fit
- Unexplained weight loss
- Ear pain or infection
During surgery, the goal is to remove the cancerous tumor and some surrounding healthy tissue during an operation. Types of surgery for head and neck cancer include Laser technology, Excision, Lymph node dissection or neck dissection, Reconstructive (plastic) surgery
Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A radiation therapy regimen, or schedule, usually consists of a specific number of treatments given over a set period of time. Radiation therapy may be used in different ways to treat head and neck cancers, including to help cure the disease or lessen the symptoms of cancer and its treatment. It can be used on its own or in combination or in sequence with other treatments, such as surgery or chemotherapy.
Therapies using medication
Treatments using medication are used to destroy cancer cells. Medication may be given through the bloodstream to reach cancer cells throughout the body. When a drug is given this way, it is called systemic therapy. Medication may also be given locally, which is when the medication is applied directly to the cancer or kept in a single part of the body.
The types of medications used for head and neck cancer include:
- Targeted therapy