Overview
Head and neck cancer actually includes many different malignancies. The way a particular head and neck cancer behaves depends on the site in which it arises (the primary site). For example, cancers that begin on the vocal cords behave very differently than do those that arise in the back of tongue, just an inch or less from the vocal cords. The most common type of cancer in the head and neck is squamous cell carcinoma, which arises in the cells that line the inside of the nose, mouth and throat. Other less common types of head and neck cancers include salivary gland tumors, lymphomas and sarcomas.
Cancers spread in three main ways. The first is direct extension from the primary site to adjacent areas. The second is spread through the lymphatic channels to lymph nodes. The third is spread through the blood vessels to distant sites in the body. In head and neck cancer, a spread to the lymph nodes in the neck is relatively common.
Head and neck cancer is the term given to a variety of malignant tumors that develop in the :
- Oral cavity (mouth);
- Pharynx (throat);
- Paranasal sinuses (small hollow spaces around the nose lined with cells that secrete mucus);
- Nasal cavity (airway just behind the nose);
- Larynx ("Adam's apple" or voice box); and
- Salivary glands (parotid, submanidular, sublingual glands that secrete saliva).
Signs And Symptoms
Cancers of the head and neck are some of the few cancers for which a particular cause can often be identified. When examined, patients who report the symptoms described below commonly admit to being smokers and/or frequent consumers of substantial quantities of alcohol.In fact, some doctors candidly admit that it is quite rare to see patients with head and neck cancer who do not smoke or drink excessively.
The common symptoms of cancer of the head and neck include :
- Persistent pain in the throat;
- Pain or difficulty with swallowing;
- Persistent hoarseness or a change in voice;
- Pain in the ear; and
- Bleeding in the mouth or throat.
What Kinds Of Cancers Are Considered Cancers Of The Head And Neck?
Most head and neck cancers begin in the cells that line the mucosal surfaces in the head and neck area, e.g., mouth, nose, and throat. Mucosal surfaces are moist tissues lining hollow organs and cavities of the body open to the environment. Normal mucosal cells look like scales (squamous) under the microscope, so head and neck cancers are often referred to as squamous cell carcinomas. Some head and neck cancers begin in other types of cells. For example, cancers that begin in glandular cells are called adenocarcinomas.
Cancers of the head and neck are further identified by the area in which they begin:
- Oral cavity. The oral cavity includes the lips, the front two-thirds of the tongue, the gingiva (gums), the buccal mucosa (lining inside the cheeks and lips), the floor (bottom) of the mouth under the tongue, the hard palate (bony top of the mouth), and the small area behind the wisdom teeth.
- Salivary glands. The salivary glands produce saliva, the fluid that keeps mucosal surfaces in the mouth and throat moist. There are many salivary glands; the major ones are in the floor of the mouth, and near the jawbone.
- Paranasal sinuses and nasal cavity. The paranasal sinuses are small hollow spaces in the bones of the head surrounding the nose. The nasal cavity is the hollow space inside the nose.
- Pharynx. The pharynx is a hollow tube about 5 inches long that starts behind the nose and leads to the esophagus (the tube that goes to the stomach) and the trachea (the tube that goes to the lungs).
The pharynx has three parts:
- Nasopharynx. The nasopharynx, the upper part of the pharynx, is behind the nose.
- Oropharynx. The oropharynx is the middle part of the pharynx. The oropharynx includes the soft palate (the back of the mouth), the base of the tongue, and the tonsils.
- Hypopharynx. The hypopharynx is the lower part of the pharynx.
- Larynx. The larynx, also called the voicebox, is a short passageway formed by cartilage just below the pharynx in the neck. The larynx contains the vocal cords. It also has a small piece of tissue, called the epiglottis, which moves to cover the larynx to prevent food from entering the air passages.
- Lymph nodes in the upper part of the neck. Sometimes, squamous cancer cells are found in the lymph nodes of the upper neck when there is no evidence of cancer in other parts of the head and neck. When this happens, the cancer is called metastatic squamous neck cancer with unknown (occult) primary.
How Are Head And Neck Cancers Treated ?
· Surgery , The surgeon may remove the cancer and some of the healthy tissue around it. Lymph nodes in the neck may also be removed (lymph node dissection), if the doctor suspects that the cancer has spread. Surgery may be followed by radiation treatment.
· Radiation therapy, also called radiotherapy. This treatment involves the use of high-energy x-rays to kill cancer cells. Radiation may come from a machine outside the body (external radiation therapy). It can also come from radioactive materials placed directly into or near the area where the cancer cells are found (internal radiation therapy or radiation implant).
· Chemotherapy, also called anticancer drugs. This treatment is used to kill cancer cells throughout the body. The side effects of chemotherapy depend on the drugs that are given. In general, anticancer drugs affect rapidly growing cells, including blood cells that fight infection, cells that line the mouth and the digestive tract, and cells in hair follicles.
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