Head and Neck Cancer

Cancer is made of changed cells that grow out of control. The changed (abnormal) cells often grow to form a lump or mass called a tumor. Cancer cells can also grow into (invade) nearby areas, and they can spread to other parts of the body. This is called metastasis. 

Types of Head and Neck Cancer

Head and neck cancers encompass a variety of types that impact different areas of the head and neck region. Here are some common ones:

• Oral Cancer: Starts in the mouth or oral cavity. Watch for sores, growths, or pain in the mouth.
• Throat Cancer: Found in the throat, known as the pharynx. Symptoms include a sore throat that doesn’t go away and trouble swallowing.
• Nasopharyngeal Cancer: Occurs in the upper part of the throat behind the nose. Common signs are blocked sinuses and hearing issues.
• Salivary Gland Cancer: Begins in the salivary glands. Symptoms might include swelling near the jaw and face.
• Thyroid Cancer: Develops in the thyroid gland at the base of the neck. Look for lumps in the neck as a possible sign.
• Laryngeal Cancer: Found in the larynx, or voice box. The main sign to watch for is a change in voice, like hoarseness that doesn’t improve.

Where are head and neck cancers located?

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. But risk factors can make it more likely for a person to have cancer. Some risk factors may not be in your control. But others may be things you can change.

Understanding the risk factors for head and neck cancer is crucial for prevention and early detection.

• Tobacco Use: The most significant risk, whether it's smoking cigarettes, cigars, or using chewing tobacco.
• Alcohol Use: Heavy drinking can also increase risk, especially when combined with tobacco.
• Poor Diet: A diet low in fruits and vegetables may increase risk.
• HPV Infection: Human Papillomavirus, especially HPV16, is linked to cancers in the oral cavity and throat.
• Sun Exposure: UV light is a risk for lip and skin cancers in the head and neck area.
• Age and Genetics: Older age and certain inherited genetic conditions can increase risk.

By knowing these risk factors, you can take steps to reduce your risk and catch the disease early when it is most treatable. Talk with your healthcare provider about your risk factors for head and neck cancer and what you can do about them.

Head and neck cancer symptoms vary depending on the specific area affected, but there are common signs to watch for:

Oral Symptoms

• Growth or sore in the mouth that doesn’t heal.
• Red or white patches in the mouth.
• Loose teeth or dentures that no longer fit well.
• Bad breath that persists despite good oral hygiene.

Throat and Voice Symptoms

• Persistent sore throat that doesn’t go away.
• Feeling something is stuck in the throat.
• Difficulty swallowing or pain when swallowing.
• Changes in voice, such as hoarseness or not speaking clearly.

Nasal and Sinus Symptoms

• Lump or sore inside the nose that won’t heal.
• Chronic sinus infections or sinus issues that do not clear up.
• Frequent nosebleeds that are hard to stop.
• Blocked sinuses or nasal congestion that persists.

Neck and Facial Symptoms

• Lump in the neck which may be felt as a nodule or mass.
• Swelling of the eyes, under the chin, or around the jaw.
• Weakness or numbness in the face or neck muscles.
• Pain in the ear, face, chin, neck, upper back, jaw, or upper teeth.

General Symptoms

• Coughing up blood or experiencing significant bleeding in the mouth.
• Frequent headaches or pain around the nose, cheeks, or forehead.
• Double vision or other vision changes.
• Unexplained weight loss, which may be sudden.

Remember, many of these symptoms can be caused by issues other than cancer. It's crucial to consult with a healthcare provider for a proper diagnosis, especially if symptoms persist. Only a professional can determine whether they are signs of cancer or another condition.

Initial Examination and Tests

When you visit your doctor with concerns about possible head and neck cancer, the first step is usually a thorough physical examination. Your doctor will check for lumps or irregularities in your neck, face, and throat. You might be asked about your health history, symptoms, and any risk factors like smoking or heavy drinking.

Imaging and Biopsy

To get a closer look at the suspected areas, your doctor may order imaging tests such as:

• CT Scan: Offers detailed images of the neck's structure, helping to locate tumors.
• MRI: Provides a clear view of soft tissues, useful for assessing cancer's spread.
• Ultrasound: Sometimes used to examine the thyroid gland and lymph nodes.

If these tests suggest cancer, a biopsy is essential. During a biopsy, a small piece of tissue from the affected area is removed and examined under a microscope to check for cancer cells.

Advanced Diagnostics in Radiation Oncology

For more precise treatment planning, especially when considering radiation therapy, you may undergo additional diagnostic tests. These help radiation oncologists target cancer cells more effectively while sparing healthy tissue.

Your treatment choices depend on the type of head and neck cancer you have, test results, and the stage of the cancer. The goal of treatment may be to cure you, control cancer, or help ease problems caused by the cancer. Talk with your healthcare team about your treatment choices, the goals of treatment and what the risks and side effects may be.

Treatment Options for Head and Neck Cancer

Local Treatments

Surgery and radiation therapy are primary local treatments for head and neck cancer. Surgery involves removing the cancerous tissue, which may include parts of the mouth, throat, or even lymph nodes if the cancer has spread. Radiation therapy uses high-energy rays to target and destroy cancer cells, often used before or after surgery to improve outcomes.

Systemic Treatments

Chemotherapy: This treatment uses drugs to kill cancer cells throughout the body and is often combined with other treatments to tackle cancer from multiple angles.

Targeted Therapy: Unlike chemotherapy, which affects all rapidly dividing cells, targeted therapy focuses on specific aspects of cancer cells that allow them to grow and divide, offering a more precise approach with potentially fewer side effects.

Innovations in Treatment

Recent advances include immunotherapy, which boosts the body's natural defenses to fight cancer. Clinical trials are also exploring new drugs and combinations, pushing forward the boundaries of what's possible in cancer care.

What are treatment side effects?

Cancer treatment such as chemotherapy and radiation can damage normal cells. This can cause side effects such as hair loss, mouth sores, or vomiting. Talk with your healthcare provider about side effects you might have and ways to manage them. There may be things you can do and medicines you can take to help prevent or control side effects.

There is no sure way to prevent head and neck cancers, but some things may help lower your risk for certain types of head and neck cancer including certain lifestyle changes, HPV prevention, and regular medical check-ups.

Prevention and Risk Management for Head and Neck Cancer

Lifestyle Changes

To potentially reduce the risk of developing head and neck cancer, consider the following lifestyle changes:

• Avoid Tobacco: Smoking and chewing tobacco are major risk factors.
• Limit Alcohol: Reducing alcohol consumption can decrease risk.
• Sun Protection: Use sunscreen and lip balm with SPF to protect against UV rays, particularly for areas like the lips.
• Healthy Diet: Eating plenty of fruits and vegetables can help lower cancer risk.

HPV Prevention

Human Papillomavirus (HPV) is linked to several types of head and neck cancers, especially in the throat. Preventative measures include:

• HPV Vaccine: Getting vaccinated before becoming sexually active.
• Safe Sex Practices: Limiting sexual partners and using condoms can reduce HPV transmission, though condoms do not offer complete protection against HPV.

Regular Medical Check-ups

Regular visits to your healthcare provider for dental and medical check-ups can help catch precancerous conditions or cancer in its early stages when it's most treatable. Discuss any unusual symptoms, like persistent sore throats or unexplained weight loss, with your doctor.

Talk with your healthcare provider about what you can do to lower your risk. Ask for resources to help. Making changes can be hard, but you don’t have to make them alone.

Emotional and Psychological Support

Receiving a diagnosis of head and neck cancer can be emotionally challenging. It's important to seek support to manage the stress and emotions that come with this illness:

• Talk with Family and Friends: Sharing your feelings can provide comfort and support.
• Professional Counseling: A therapist or counselor can help you process emotions and develop coping strategies.
• Support Groups: Connecting with others who are facing similar challenges can reduce feelings of isolation and provide practical advice.

Managing Treatment Side Effects

Treatment for head and neck cancer, like chemotherapy and radiation, can cause significant side effects, which vary from person to person. Here are some tips to manage them:

• Nutritional Support: Eating well can help maintain your strength and reduce treatment side effects. Speak with a dietician if you have trouble eating.
• Physical Activity: Light exercise, as recommended by your healthcare team, can improve mood and reduce fatigue.
• Medication Management: Your doctor can prescribe medications to alleviate specific side effects like nausea or pain.
• Rest and Sleep: Your body needs adequate rest to recover. Ensure you have a comfortable sleeping environment and schedule regular rest periods to help your body heal.

Staying Informed and Involved

Understanding your condition and treatment plan can empower you to make informed decisions about your care. Here’s how you can stay informed:

• Educational Materials: Ask your healthcare provider for resources that explain your type of cancer and treatment options.
• Treatment Plan Discussions: Regular discussions with your healthcare team can help you understand the progress of your treatment and what to expect next.

The field of head and neck cancer treatment is continuously evolving with significant advancements that enhance patient care and outcomes. Here are some key areas of innovation:

Clinical Trials

Clinical trials help to advance treatment effectiveness and increase treatment options available. Testing new drugs, procedures, and therapies that could improve survival rates and quality of life for patients. Participation in a clinical trial offers access to cutting-edge treatments that are not yet widely available.

Radiation Oncology Advances

Recent innovations in radiation oncology include techniques that focus radiation more precisely on tumors, minimizing damage to surrounding healthy tissues. This precision helps reduce side effects and improve the effectiveness of treatment.

Targeted Therapy and Immunotherapy

• Targeted Therapy: These treatments target specific genetic changes seen in some types of head and neck cancer, such as squamous cell carcinoma. By focusing on these changes, targeted therapies can block the growth and spread of cancer cells.
• Immunotherapy: This approach boosts the body’s immune system to fight cancer. New immunotherapies are being developed that show promise in treating various types of head and neck cancer, particularly those resistant to traditional treatments.

Interdisciplinary Care Approaches

The integration of multiple specialties in treatment planning and execution ensures comprehensive care. Teams often include surgeons, medical oncologists, radiation oncologists, dietitians, and rehabilitation specialists, working together to tailor treatment plans to individual patient needs.

Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:

• New symptoms or symptoms that get worse.

• Signs of an infection, such as a fever.

• Side effects of treatment that affect your daily function or don't get better with treatment.

Ask your healthcare provider what signs to watch for, and when to call. Know how to get help after office hours and on weekends and holidays.