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Head & Neck Cancer

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Overview

Head & neck cancer is marked by beginning of cancer in the flat squamous cells lining the surface of the structures in the head and neck. In this type of cancer, a wide array of malignant tumors develops in or around the mouth, throat, nose, larynx, and sinuses [1] . Head and neck cancer accounts for 4% of all the cancers around the world. This type of cancer is more likely to occur in men than in women. Head & neck cancers are the sixth most common cancer occurring worldwide. It accounts for 30-40% of all cancers in India. According to the Globocan 2018 report, 197,649 new cases and 117,728 deaths were reported in India

Types of head & neck cancer

Oral & oropharyngeal cancer

Cancer of the oral cavity and cancer of the oropharynx are 2 of the most common types of cancer that develop in the head and neck cancer. More than 90% of oral and oropharyngeal cancers are squamous cell carcinoma. This means that they begin in the flat, squamous cells found in the lining of the mouth and throat.

Laryngeal and hypopharyngeal cancer

About 95% of all cancers of the larynx and hypopharynx are categorized as squamous cell carcinomas. This means they began in the flat, squamous cells that form the linings of these organs.

Nasal cavity and paranasal sinus cancer

The nasal cavity and paranasal sinuses are lined by a layer of mucus-producing tissue that contains: Squamous epithelial cells, Minor salivary gland cells, Nerve cells, Infection-fighting cells called lymphocytes, and blood vessel cells. Abnormal activity of these cells lead to nasal cavity paranasal sinus cancers.

Nasopharyngeal cancer

Also called Nasopharyngeal carcinoma or NPC include:

  • Angiofibromas and hemangiomas that involve the vascular, or blood-carrying, system.
  • Tumors that develop in the lining of the nasopharynx, including the minor salivary glands.

Salivary gland cancer

Both benign and cancerous tumors can begin in any of the major or minor salivary glands. Most of the tumors (80%) that develop in the parotid gland, and about half of the tumors in the submandibular gland, are benign. Sublingual gland tumors are frequently cancerous. Most cancerous tumors of this type begin in the parotid gland or in the submandibular glands.

Causes

Infection with human papillomavirus (HPV), especially HPV type 16, is a risk factor for some types of head and neck cancers, particularly oropharyngeal cancers that involve the tonsils or the base of the tongue. People who use both tobacco and alcohol are at greater risk of developing these cancers than people who use either tobacco or alcohol alone.

Risk Factors

The risk factors associated with head and neck cancer are

Alcohol

Consumption of excessive alcohol increases the risk of cancer in the regions of mouth, esophagus, pharynx, and larynx.

Tobacco

This is the largest risk factor for developing head and neck cancer. 85% of head and neck cancers are associated with tobacco use.

Human papillomavirus

Head and neck cancer risks develop when a person is infected with Human papillomavirus.

Sun/ Radiation exposure

Exposure to sun is associated with skin cancer of the head and neck.

Epstein-Barr virus

This virus is responsible for developing nasopharyngeal cancer.

Signs & symptoms

Inflammation/swelling is the most common symptom

Red/white patches in the mouth

Lump or bump in the area of head or neck region

Frequent nasal bleeding or nasal discharge

Difficulty in breathing

Nasal congestion/ obstruction

Difficulty in chewing, swallowing, or movement of tongue

Pain in jaws and loosening of teeth

Diagnosis

Endoscopy

The examination has different names depending on the area of the body that is examined, such as laryngoscopy to view the larynx, pharyngoscopy to view the pharynx, or nasopharyngoscopy to view the nasopharynx. When all these procedures are combined, they are referred to as a panendoscopy.

Biopsy

A small part of the tumour be excised to see whether the person has HPV. Presence of HPV can be a factor in determining the selection of treatments.

Panoramic radiograph

Radiograph, A panoramic radiograph is a rotating, or panoramic, x-ray of the upper and lower jawbones to detect cancer or evaluate the teeth before radiation therapy or chemotherapy. This is often called a Panorex.

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References