Head And Neck Cancer

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Head And Neck Cancer

Head And Neck Cancer

Keep your Head and Neck healthy; they perform a number of important tasks. They help us in movement, to chew, swallow, speak, express with our face and with the movement of our eyes.

Head and Neck Cancer, is a major public health problem in India. Of all the cancers, 30% are Head and Neck cancer in India. The problem of managing this cancer is different in India than in other countries because people are not serious about follow up after the treatment. So detecting it at an early stage, and treating should be given an utmost priority.

Areas in Which Head and Neck Cancer Starts

This cancer usually starts in the cells that moist the mucosal surfaces inside the head and neck, like inside the mouth, nose and throat. These cells are also known as SQUAMOUS CELL CARCINOMAS of the HEAD and NECK. They can even begin in the salivary gland.

The areas of Head and Neck cancer are:

1)Oral Cavity: Includes lips, the front tongue, gums, lining inside the cheeks and lips, Under the mouth, top of the mouth, a small       area behind the wisdom teeth.

    2)Pharynx: The area is behind the nose to the oesophagus—the upper, middle parts of the pharynx, the tongue and tonsils.

    3)Larynx: It is the voice box, just below the pharynx in the neck. 

    4)Paranasal Sinuses and Nasal  Cavity: This is the hollow spaces in the bones of the head surrounding the nose.

    5) Salivary Glands: The floor of the mouth and close to the jawbone that produces saliva.

Causes of Head and Neck Cancer

  1. Alcohol, tobacco—smoking, chewing, snuff are the significant reasons for head and neck cancer.
  2. HPV– human papillomavirus type 16-this involves the tonsils or the base of the tongue.
  3. Paan especially people from Southeast Asia who eat paan—betel quid, have a risk of oral cancer, can get oral cavity cancer.
  4. Consumption of preserved or salted foods during childhood is another cause, prone to nasopharyngeal cancer.

Oral health: Unhygienic way and not taking care of the mouth. Use of mouth wash which has a high content of alcohol, can get cancer of the oral cavity.

 Exposure at the workplace: Exposure to wood or nickel dust, asbestos, synthetic fibres. People working at construction sites, industries—metal, textile, ceramic and food, have a risk of paranasal and nasal cavity cancer.

Radiation Exposure: When given is a risk to salivary glands.

Symptoms of head and Neck Cancers:

  1. lump or a sore throat, change in the voice, difficulty in swallowing.
  2. white or red patch on the gums, tongue, lining of the mouth; swelling of the jaw, bleeding mouth.
  3. trouble in hearing, breathing, speaking, swallowing—frequent headaches and ringing in the ears.
  4. sinuses; bleeding of the nose, trouble in the eyes, pain in the upper teeth.
  5. swelling under the chin or jawbone, pain in the face, chin or neck.

DIAGNOSES:

Medical history, physical examination and a few tests are conducted based on the symptoms. If diagnosed as cancer, a few more tests are done to know the stage. If it has spread to the other parts of the body. The doctor can ask for an x-ray and laboratory tests.

Treatment for Head and Neck Cancer:

The treatment depends on the location of the tumour, age of the patient, stage and general health. The doctor discusses and changes the medicine according to the patient’s looks, eating habits, the way he speaks or breathes.

The treatment includes SURGERY, RADIATION THERAPY, CHEMOTHERAPY, TARGETED THERAPY or a combination of treatments.

Head and Neck Cancer is more common in men than in women. It is more common among people above 50 years.

Risks and Side Effects After Treatment:

 After surgery, the patient’s facial expression changes because of the swelling in the neck region and the face. After surgery in the neck- neck and throat can become numb so, the shoulder and neck can become weak.

On account of Radiation, redness, irritation, dry mouth, sores in the mouth, taste changes and difficulty in swallowing. Changes in the texture of the skin, stiffness in the jaw and patient may not be in a position to open the mouth as wide as he used to before treatment. 

If the patient reports to the doctor about the side effects being faced after treatment, the doctor can help to deal with it.

FOLLOW-UP CARE: This is necessary to check that cancer has not come back or new cancer has not started. The doctor can perform a physical exam, blood tests, x-rays, CT, PET and MRI scans. With radiation, the doctor also checks the thyroid and the functioning of the pituitary gland. The patient should have also stopped smoking completely; otherwise, the cancer can come back.  

FREQUENTLY ASKED QUESTIONS:

1.Where do Head and Neck cancers generally occur?

Head and Neck Cancers generally occur in the nose, sinuses, mouth, throat, voice box, salivary glands, in the lymph nodes of the neck and also in the thyroid gland. Sometimes it can also spread into the lungs. They can be cancerous or non-cancerous, on a doctor can diagnose that.

2. Can they be treated? Why is it difficult to treat?

Head and neck cancer is difficult to treat and challenging because the tumour grows near the brain, spine, close to the vital nerves and near major blood vessels. A team of multidisciplinary specialists closely monitor and take a decision and treat the patient.

3. Who all can get Head and Neck Cancer?

  • It is a rare cancer and anyone can get it.
  • It can also be inherited, one cannot say it has occurred by chance.
  • Working environment and lifestyle is another factor.

4. How important is a follow up after treatment of Head and Neck Cancer?

  • A minimum of years of follow up is important after treatment.
  • For patients whose condition was severe, it can extend.
  • In the first two years, once in two months meeting the doctor is a must and then once in three to six months, according to the doctor.
  • Even the follow up by the multidisciplinary team of doctors should be done.

AWARENESS OF HEAD and NECK CANCER:

This cancer is the 8th most common cancer in the world.  Many hospitals do provide information regarding this cancer. These days cancer knowledge is higher in educated people, so mostly rural public should be more highlighted with head, and neck cancer as chewing of tobacco is common among them. More awareness must be brought about the Head and Neck Cancer.