A Brief About Head and Neck cancers
However, thanks to modern medicine, cancer research is a well-established and fast-progressing field, and there are many treatment options available to patients nowadays. The survival rate of head and neck cancer patients has gone up in recent years, and there is more awareness of its prevention. Knowledge of the different types of head and neck cancers, their causes and symptoms, and prevention methods are key to evading or managing it properly and effectively.
Head and neck cancer primarily affects the following parts of the upper body.
- Oral cavity: It includes the lips, the gums, the bottom of the mouth under the tongue, the roof of the mouth, the area behind the wisdom teeth, and two-thirds of the tongue.
- Pharynx: It is a tube connecting the nose to the esophagus.
- Larynx: It is situated just below the pharynx and is usually known as the voice box. It contains the vocal cords that vibrate when you talk, and the epiglottis, which is a small tissue to block food from getting into the windpipes.
- Tonsils: These are a pair of soft tissue masses located at the back of your throat
- Nasal cavity and paranasal sinuses: These are the hollow spaces in the nose and the bones of the skull around the nose, respectively.
- Salivary glands: They are the organs that are responsible for producing saliva, located under the tongue, and close to the jawbones. They are made of a few different parts, such as the parotid glands, located in front of and below the ears, sublingual gland, located below the tongue, and the submandibular gland, located below the jawbone.
What are the types of Head and Neck Cancer?
1.Throat cancer: Throat cancer is a carcinoma that affects several parts of the throat, such as the pharynx, larynx, and tonsils. It can be further classified as
- Nasopharyngeal cancer: It is a type of cancer in which the cells of the nasopharynx become cancerous.
- Oropharyngeal cancer: This type of cancer affects the area in the throat that includes the tonsils.
- Hypopharyngeal cancer: Cancerous cells form in the hypopharynx (also known as laryngopharynx) which is the lower region of the pharynx just above the windpipes.
2.Laryngeal cancer: Laryngeal cancer affects the larynx or the voice box along with the vocal cords. They are further classified into
- Glottic cancer: This cancer affects the cells of the vocal cords.
- Supraglottic cancer: It affects the upper regions of the voice box and the cells of the epiglottis
- Subglottic cancer: The lower parts of the larynx just below the vocal cords are affected
3.Lip and oral cavity cancer: It affects the squamous cells that line parts of the mouth that includes lips, mouth, gums and tongue, but it can go deeper into the inner tissues of the mouth.
4.Nasal cavity and paranasal sinus cancer: It affects the areas near the nose, such as the nasal cavity as well as the paranasal cells of the sinuses.
5.Salivary gland cancer: In salivary gland cancer, malignant cells form in the tissues of the salivary glands.
What are the early signs of Head and Neck Cancer?
In general, head and neck cancer symptoms include sore throat, pain in the mouth, lumpiness in the cheeks, trouble swallowing or chewing, changes in the voice, and more. Let us look at the symptoms of the different types of head and neck cancer in detail.
1.Nasopharyngeal cancer: The symptoms of nasopharyngeal cancer are
- Lump in the nose and/or neck
- Sore throat
- Difficulty in speaking, breathing or hearing
- Pain or ringing in the ear
2.Oropharyngeal cancer: The symptoms of oropharyngeal cancer are
- Persistent sore throat and mouth pain (common symptom)
- Lumps in the cheeks and neck
- White or red patches on the gums, tongue, inside of the mouth or tonsils
- Difficulty moving the jaws or tongue
- A change in the voice
- Weight loss
- Persistent bad breath
3.Hypopharyngeal cancer: The symptoms of hypopharyngeal cancer are
- Persistent sore throat
- Pain in the ear and neck
- Pain or difficulty swallowing
- Voice changes
4.Laryngeal cancer: The symptoms of glottic, subglottic and supraglottic cancers are
- Change in voice to a more hoarse voice
- Pain or difficulty swallowing
- Lump and swelling in the neck
- Persistent sore throat and cough
- Persistent earache
- Difficulty in breathing
5.Lip and oral cavity cancer: The symptoms of the lip and oral cavity cancer are
- Persistent soreness on the lips or in mouth
- Lump or thickening in the gums and lips
- Red or white patches on the gums, tongue, or lining of the mouth.
- Bleeding and/or numbness in the lip or mouth
- Loose gums
- Difficulty chewing or swallowing
- Swelling of jaw
- Sore throat or lumpiness in the throat.
6.Nasal cavity and paranasal sinus cancer: Symptoms of cancer in the nasal and sinus cavities are
- Blocked sinuses or sinus pressure
- Runny nose
- Persistent lump in the nose or on the roof of the mouth
- Numbness in the face
- Swelling in the eyes
- Double vision or eyes pointing in different directions
- Pain in the upper teeth
7.Salivary gland cancer: Signs and symptoms of salivary gland cancer are
- Lump near the ear, lips, cheek, jaw, or inside the mouth
- Fluid discharge from the ear
- Difficulty in swallowing or opening the mouth
- Numbness in the face
- Persistent pain in the face
What are the Causes of Head and Neck Cancer?
Risk Factors involved in Head and Neck Cancer
- Nasopharyngeal cancer: Some of the risk factors associated with nasopharyngeal carcinoma include alcohol consumption, eating excessively salty foods, from Chinese or South African ancestry, exposure to wood dust, exposure to the Epstein-Barr virus (EBV) and having a family history of nasopharyngeal cancer.
- Oropharyngeal cancer: The causes of oropharyngeal cancer are found to be excessive smoking of cigarettes, excessive alcohol consumption, exposure to human papillomavirus (HPV), and family history.
- Hypopharyngeal cancer: People who consume excessive alcohol, chew tobacco, smoke cigarettes, are not getting enough nutrients, and/or have Plummer-Vinson Syndrome are at a much higher risk of getting hypopharyngeal cancer.
- Laryngeal cancer: People who smoke tobacco, cigarettes or drink alcohol excessively are at risk of getting laryngeal cancer.
- Lip and oral cavity cancer: Men are at a higher risk of getting lip and oral cavity cancer than women. Moreover, those who use tobacco and alcohol excessively, and those who are exposed to excessive sunlight are also at a much higher risk.
- Nasal cavity and paranasal sinus cancer: It has been found that people who are more exposed to various types of dust in the workplace, such as sawdust, wood dust, leather dust, flour and nickel and chromium dust are more prone to getting nasal cavity and paranasal sinus cancers. Exposure to various chemicals such as radium, which is a radioactive element, and mustard gas, a poison used in chemical weapons, are also found to lead to these cancers.
- Salivary gland cancer: Exposure to various types of radiation, such as the ones used in radiation therapy and other toxic chemicals are possible risk factors associated with salivary gland cancer. Older adults are also at a higher risk.
How to prevent Head and Neck Cancer
For those who are exposed to risk factors by way of occupational hazards, awareness is the key. Be aware of all the early signs and symptoms of the head and neck cancers and conduct physical examinations regularly. Check the inner portions of the mouth, tongue, gums, ears, nasal cavity, sinus and throat for any lumps or discolorations. If you notice any lumps or soreness or pain in any of the above areas, especially if you have a family history with the head and neck cancers, go to the doctor or a specialist immediately. The earlier the cancer is detected, the easier it is to treat it, the more effective the treatment and higher the chances of recovery it would be.
Diagnosis of Head and Neck Cancer
- Physical examination: A physical exam of the relevant body part such as the lips, throat, nasal cavity, inside of the mouth, etc. can be done to check for any lumps, discolorations, or abnormal appearance.
- Biopsy: A procedure in which a group of cells or tissues are removed from the body part that is suspected of being cancerous to check and examine under the microscope by a pathologist.
- Laryngoscopy: In this procedure, the doctor checks the larynx or voice box with a probe called the laryngoscope. It can also be used to extract cells from the vocal cords for analysis. This technique is primarily used in the diagnosis of laryngeal cancer and oropharyngeal cancer.
- Nasoscopy: In this procedure, the doctor checks the inside of the nose for abnormalities or lumps that may be cancerous using a probe called the nasoscope. It can also be used to extract cells from the nose.
- Upper endoscopy: Endoscopy is typically used to examine the stomach, but in this case, the probe, which is called an endoscope, is inserted into the nose or mouth and used to examine the nose, throat, and esophagus and in some cases the duodenum. It is used to detect nasopharyngeal cancer, laryngeal cancer, oropharyngeal cancer, and salivary gland cancer.
- Bronchoscopy: It probes the trachea and the bigger airways of the lung for anomalies using a bronchoscope (a thin, lighted tube) by inserting it through the nose or mouth into the lungs.
- Magnetic resonance imaging (MRI) scan: It uses an electromagnet, radio waves, and computational techniques to image the body internally and is a highly useful method in detecting cancer. This method is used in diagnosing almost all the different types of head and neck cancers.
- CT scan (or CAT scan): Computerised tomography, computed tomography, or computerized axial tomography is used in creating a detailed image of the body’s internal organs by using x-rays. It is used prominently in head and neck cancer diagnosis in almost all its various subtypes.
- Positron emission tomography (PET) scan: It uses a small quantity of radioactive glucose which is injected into the body. The cancerous cells can be detected using the PET scanner, which rotates the body and images the parts where glucose is present since malignant cells show brighter on the image due to its higher absorption of energy. The method is used in detecting nasopharyngeal cancer, laryngeal cancer, hypopharyngeal cancer, and lip and oral cavity cancer.
- PET-CT scan: The images obtained from the CT scan and the PET scan can be combined to get a more detailed picture of the area in question to make a more accurate diagnosis and prescribe the best treatment. This is used in the diagnosis of laryngeal cancer.
- Ultrasound: This is also another imaging technique that works by radiating ultrasonic waves (sound waves) onto the tissues, which then bounce back to produce an image called the sonogram. The sonogram can be printed out and studied to make a diagnosis. It is mostly used to diagnose nasopharyngeal cancer.
- X-ray: It is the most common radiative method of examining the body for ailments or anomalies, which uses x-ray radiation for imaging. It is used in the diagnosis of nasopharyngeal and paranasal and sinus cavity cancers.
- Bone scan: A small amount of radioactive element is injected into the bloodstream, which latches on to cancerous cells in the bone. It can be used to check if cancer has progressed into the bones. It is used to diagnose hypopharyngeal cancer and lip and oral cavity cancer.
- Barium swallow: The patient drinks a liquid containing barium, which gets coated on the insides of the esophagus and the stomach. This is then studied using an x-ray image of the suspected area. It is used to diagnose laryngeal cancer and lip and oral cavity cancer.
- Human papillomavirus (HPV) test: It tests for the HPV DNA markers and antibodies in the blood and is used in the diagnosis of oropharyngeal cancer.
- Epstein-Barr virus (EBV) scan: It tests for the EBV DNA markers and antibodies in the blood and is used in the diagnosis of nasopharyngeal cancer.
Treatment for various Stages of Head and Neck Cancer
- Surgery: The tissues that contain the tumor are removed surgically along with some of the healthy surrounding tissues to stop the growth of the tumor any further. Surgery may not be enough to remove the tumor completely, in which case it is followed by radiation therapy and chemotherapy.
- Radiation therapy: This is a technique in which X-rays or other high energy electromagnetic radiations are irradiated on to the affected area to destroy the tumor. In some cases, radiosensitizers, which are drugs that can make cancerous cells more sensitive to radiation, are also used to make the killing of tumors more effective.
- Chemotherapy: This method uses powerful drugs to destroy and inhibit the growth of cancer cells by keeping them from dividing further. These drugs may be injected into the bloodstream through a vein or muscle, which can then go to the cancerous part to destroy those cells. This is called systemic chemotherapy. Alternatively, the drugs may be administered directly on to the affected area, and this process is called regional chemotherapy. The extent of the side effects depend on the dosage used as well as on the individual.
- Immunotherapy: This is a relatively new treatment method in which the patient’s own immune system is used and boosted to fight against cancer. Proteins produced by the human body (which can also be synthesized in the laboratory) that act as inhibitors to cancerous growths are used to direct and activate the body’s natural defense mechanisms against cancer.
stages of head and neck cancer
- Stage 0: At this stage, abnormal cells are found in the lining of the nasopharynx, larynx, hypopharynx, salivary ducts, lips, and oral cavity or that of the mucous membranes depending on the specific type of cancer. Stage 0 is also called carcinoma in situ. The treatment is usually surgery to remove the tumorous cells. Possible side effects of surgery may include permanent change of voice, difficulty chewing or swallowing, difficulty breathing, and disfigurement of the part that has been removed. The 5 year relative survival rate is 92% in such cases.
- Stage 1: Cancer gets progressed into the primary organ such as the nasopharynx, the larynx, the hypopharynx, the lip, nasal cavity, sinus, or the salivary gland and is generally larger than 2 cm. For stage 1 tumors, surgery is followed by radiation therapy. Possible side effects of radiation therapy may include loss of appetite, speech impairment, hypothyroidism, fatigue, nausea, and sore mouth or throat. The 5-year survival rate is between 77 and 99.9 percent.
- Stage 2: The tumor is between 2 and 4 cm large and progress further in this stage, into one or more lymph nodes near the primary organ such as the throat, epiglottis, neck, vocal cords, tongue, soft tissues around the salivary glands, jawbones, skull or the roof of the mouth on the same side as the primary tumor. To deal with stage 2 head and neck cancers, first, the patient must undergo surgery, followed by radiation therapy, and, in some cases, chemotherapy is also needed. Possible side effects of chemotherapy include nausea, vomiting, diarrhea, and infection. The survival rate is around 65 percent in such cases.
- Stage 3: More lymph nodes are affected including the ones on the opposite side of the primary organs and cancer has spread to more organs such as the bottom skull, neck, nearby muscles, larynx, the roof of the mouth, parts of the tongue, tissues under the skin, nearby jawbones, ear canal, and the trachea, depending on the primary type of head and neck cancer. The tumor is generally larger than 4 cm. The prescribed treatment is usually a combination of surgery, radiation, and chemotherapy. The survival rate of Stage 3 treatment is around 25 percent.
- Stage 4: The tumor has now spread further into the body affecting organs that are far from the primary organ. The 5 year Relative survival rate may be around 52 percent. Stage 4 cancer can be further classified into stage 4A, stage 4B, and stage 4C. They are explained below.
- Stage 4A: The tumor has spread into the brain, cranial nerves, salivary glands, thyroid cartilage, tissue beyond the larynx, jawbones, skin outside areas of the neck, lower jawbone, skin, and sinus. A combination of surgery, radiation therapy, and chemotherapy are given as treatment.
- Stage 4B: The tumor has spread into distant lymph nodes in the lungs, collarbones, armpit, groin, spine, the carotid artery, jawbones, cheek tissues, facial nerves, eye sockets, ear canal and parts of the skull. Here too, surgery followed by radiation therapy and chemotherapy are administered.
- Stage 4C: At this stage, cancer has spread far beyond the primary organs into the lungs, liver, or bones. A complete cure is not possible, but chemotherapy may be given to slow down the progression of the tumor.
Besides the head and neck cancer treatment methods discussed above, the patient can achieve full recovery only if treatment is followed by a series of lifestyle changes. This can include changing and improving your diet, getting rid of unhealthy habits like drinking or smoking, introducing exercise and activity into their daily routine, counseling and being part of support groups. This kind of holistic treatment is often called integrative treatment, and it is vital for the head and neck cancer treatment for the recovery process to be effective. Integrative treatment is also necessary for the patients to recuperate from the trauma that the body and mind had undergone.
Life in remission
The stage in which all the primary signs and symptoms of cancer—in this case, head and neck cancer—have disappeared, post treatment is called remission. Scans will show no trace of any tumors or cancerous cells. Despite this, it is imperative for survivors to undergo regular check-ups and physical exams, even after the treatment is completed.
The chances of cancer returning (called recurrence) are high, and the risk always remains. These scans and check-ups may be required for years following remission, depending on the gravity of each individual’s condition as well as the doctor’s prescription. It is also important to ensure a healthy and cancer proof lifestyle during remission by avoiding habits and lifestyle choices that increase the risk of getting head and neck cancers at all costs.
Another aspect of life in remission is the patient’s mental health. Battling cancer is a rather traumatic and life-altering experience, and so it ends up taking a heavy toll on the patient’s mind along with the body. The stress and anxiety and mental torment one goes through during the disease may remain long after the body has healed and entered remission. This is why emotional support and care is necessary for those who are in remission.
How can ZenOnco.io help?
- Nourish yourself: The key to prevent and fight the growth of cancer in your body is to nourish it with nutritious foods that can fight them off and inhibit their growth. Be sure to have a balanced diet and take supplements whenever necessary.
- Stay fit yourself: Being fit is another key factor in fighting off cancer. A healthy lifestyle includes not only a good diet but also exercise and physical activity. Being active is also vital to have a fast and easy recovery, and to live a longer and healthier life.
- Keep calm: Fear and worry have never cured any disease, and so we need to stay calm in the phase of cancer. Know that when cancer is detected early and treated with the right treatment, cancer is very much manageable. By keeping yourself fit and healthy, recovery also becomes less of a hassle. In any case, know that cancer research, diagnosis, and treatment methods are progressing every day, and the chances of survival are much higher with each passing year. There is hope.
- Cancer-proof your home: Prevention is better than cure, and so be sure to keep your family and your home away from cancer by adopting healthy lifestyle choices as early as possible. Make efforts to quit on bad habits like smoking and drinking alcohol which are major risk factors associated with head and neck cancers. Stop using products and food items that contain harmful chemicals and known carcinogens. Read and do more research into the various ingredients and chemicals that go into the foods and products we use every day.
- Get community support: In difficult times, finding a community that you can relate to and that understands you is vital to get you through the drawn-out process of head and neck cancer treatment and recovery. The relief and support they provide are invaluable. ZenOnco.io puts head and neck cancer patients in touch with these communities so that they can share and learn about each other’s experiences and offer support.
Visit ZenOnco.io and get connected to our support community and learn more about our wellness programs. Let us help you win over this battle against cancer.