What are cancers of the head and neck?
Head and neck cancers affect roughly 12,000 people in the UK each year. The diseases are more common in men, and most people are diagnosed when they are around 60 years old. Head and neck cancers include cancer types developing in the mouth, throat, neck, sinuses, salivary glands and ears. The term does not include cancer of the eyes, skin, or brain. Common symptoms of head and neck cancers can be for instance a lump on the side of the neck, hoarseness, difficulty in swallowing along with ear pain, or an ulcer in the mouth that does not heal.
What are the symptoms of head and neck cancers?
Early signs of head and neck cancers can be vague, influenza-like symptoms. An influenza infection caused by a virus will usually go away on its own after a couple of weeks, but this does not happen in the case of head and neck cancers. If the symptoms last longer than three weeks, you should contact your GP.
A sore and movable lump on the side of the neck might be a swollen lymph node, which is seen during ordinary infections. If the lump isn’t sore or movable and if it grows quickly, it might be a sign of head and neck cancers.
Pain or discomfort in one side of the throat when you swallow can be a sign of throat cancer. Frequently, there is ear pain as well.
Inflammation of the mucosa with ulcers that don’t heal can be a sign of cancer. The first sign is often small red or white patches in the mouth or on the lips. The patches turn into small, painful ulcers, which can be precancerous lesions. If you have painful oral ulcers that won’t heal, you should see your doctor.
Cancer of the salivary glands is rather uncommon. Signs of salivary gland cancer can be a painful lump under the chin or around the jawbone or paralysis of the face.
Paranasal sinuses and nasal cavity
Blocked sinuses or a stuffy nose lasting for more than a couple of weeks or bloody snot can be signs of nasal cavity and paranasal sinus cancer.
If you experience any of the symptoms listed above for more than three weeks, you should contact your GP.
What are the causes of head and neck cancers?
The causes of head and neck cancers are not known in detail yet, but both genetic and environmental factors come into play. There is an association between factors such as smoking, snuff, alcohol and the development of head and neck cancers. When done separately, smoking and drinking alcohol is harmful, but the combination of smoking and alcohol increases the risk of developing head and neck cancers significantly. Snuff may also lead to mouth or lip cancer.
Virus infections with HPV virus or Epstein-Barr virus increase the risk of tonsil and nasal/throat cancer, respectively. In addition, long-term inflammation in the head and neck region might increase the risk of developing cancers in this region.
Dust from the woodworking industry, inhalation of fumes from wood glue and poor ventilation increase the risk of nasal cancer.
How are head and neck cancers diagnosed?
The diagnosis is established by a doctor who is specialised in diseases related to the head and neck region. The doctor will examine the neck, throat, mouth, lips, nose and ears for wounds and/or lumps. Malignant tumours are often attached to underlying structures and they grow quickly but are not sore to touch. The nose, mouth, throat and neck can be examined with an endoscope. An endoscopy is an examination where an endoscope is passed through the nasal cavity or the mouth. If the doctor finds a lump, he or she might also perform a biopsy.
Lumps on the neck can be examined through fine-needle aspiration, where a fine needle is used to make a biopsy of the lump. The biopsy is then analysed in a laboratory.
MR and/or PET/CT scanning can be used to visualise any potential malignant tumours in the head and neck region. The scans can also be used to see how the cancer metabolizes, and whether it has spread, or metastasized, to other parts of the body.
How are head and neck cancers treated?
Head and neck cancers are frequently treated with radiation therapy and surgery. Many cancer types also require additional chemotherapy. The treatment depends on cancer type, size, involved structures and whether it has spread. In addition, the patient’s age, medical history and general condition will be considered.
Tumours in the tongue, tonsils and throat are often treated with radiation and subsequently with chemotherapy. Cancers which affect the ability to chew, swallow, eat or speak often require surgery followed by radiation and chemotherapy.
Radiation may entail side-effects like nausea, reduced nutritional state, inflammation of the oral mucosa, reduced saliva production and dry mouth, changes in sense of smell and taste as well as difficulty in eating due to pain and difficulty in swallowing. Most of these side-effects can be prevented and treated with medication and dietary advice.