Head and Neck Cancer

Head and neck cancer is a broad term that refers to a group of malignant tumors that develop in the tissues and organs of the head and neck region. These cancers most commonly arise from the mucosal lining of areas such as the oral cavity (mouth, tongue, gums, lips), nasal cavity, sinuses, pharynx (oropharynx, nasopharynx, hypopharynx), salivary gland and larynx (voice box). About 90–95% of these cancers are squamous cell carcinomas, originating from the flat squamous cells lining these mucosal surfaces.

Characteristics of head and neck cancer include:

• Common symptoms: Persistent ulcers or sores in the mouth or throat that do not heal, changes in the voice (hoarseness), difficulty swallowing (dysphagia), white or red patches in the mouth, neck lumps, unexplained bleeding, facial numbness or pain, and persistent earache. Symptoms vary by tumor location.
  
  
• Risk factors: Tobacco use (smoking and smokeless forms) and alcohol consumption are the most significant causes, responsible for over 75% of cases. Infection with human papillomavirus (HPV), especially in oropharyngeal cancers, Epstein–Barr virus (EBV), betel nut chewing, poor nutrition, radiation exposure, and occupational hazards also contribute.
  
  
• Epidemiology: Head and neck cancer commonly occurs in adults aged 55–65 years and is more prevalent in men. Globally, it ranks among the top ten most common cancers with hundreds of thousands of new cases annually.
  
  
• Pathology: Squamous cell carcinoma is the most common. Other forms including salivary gland tumors, thyroid cancers, and skin cancers in the head and neck area also occur.
  
  
• Behavior: These cancers tend to invade locally and can spread to lymph nodes in the neck and distant organs through lymphatic and hematogenous routes. Early detection improves prognosis, but many cases are diagnosed at advanced stages.
  
  
• Diagnosis and treatment: Confirmed by tissue biopsy and imaging studies. Treatment includes surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy, often guided by a multidisciplinary team approach.

ead and neck cancer refers to malignant tumors occurring in areas of the head and neck excluding the brain and eyes. 

The main types of head and neck cancer include:

• Oral cavity cancer : Cancer originating in the oral cavity such as the lips, tongue, buccal mucosa, hard palate, floor of mouth, retromolar trigone, gums, alveolar ridge, and inside cheeks.
  
  
• Pharyngeal cancer: Cancer of the pharynx, further divided by location into:
  - Nasopharyngeal cancer (upper throat behind the nose)
  - Oropharyngeal cancer (middle part of the throat, including tonsils and base of tongue)
  - Hypopharyngeal cancer (lower part of the throat near the voice box)
  
  
• Laryngeal cancer (Voice box cancer): Classified by site into supraglottic (above vocal cords), glottic (vocal cords), and subglottic (below vocal cords) cancers.
  
  
• Salivary gland cancer: Occurs in major salivary glands such as the parotid, submandibular, and sublingual glands.
  
  
• Nasal cavity and paranasal sinus cancer: Involves the nose and associated sinus passages.
  
  
• Thyroid cancer: Though sometimes considered separately, it is included in the broad category of head and neck cancers.

Most head and neck cancers (over 90%) are squamous cell carcinomas, arising from the mucosal lining of these regions.

These types differ in location, symptoms, clinical behavior, and treatment approach.

Head and neck cancer symptoms vary depending on the tumor location but commonly include:

•   A lump or swelling in the neck, jaw, or mouth 
•   Mouth sores or ulcers that do not heal
•   White or red patches in the mouth or throat (leukoplakia or erythroplakia)
•   Pain or weakness in the face
•   Difficulty swallowing or chewing
•   Persistent sore throat or hoarseness lasting more than 3 weeks
•   Ear pain or ringing in the ears (especially with throat cancers)
•   Speech problems or changes in voice
•   Difficulty breathing or nasal congestion
•   Unexplained weight loss
•   Loose teeth or dentures that no longer fit well
•   Frequent nosebleeds or chronic sinus infections

More specific symptoms depend on the cancer site:

•   Oral cancer: mouth ulcers, numb lips/tongue, white/red patches
•   Throat (pharyngeal) cancer: sore throat, lump in the neck, ear pain, difficulty swallowing
•   Laryngeal cancer: hoarseness, earache, breathing difficulties
•   Nasal or sinus cancer: nasal blockage, nosebleeds, facial pain
•   Salivary gland cancer: swelling near jaw or ear, facial numbness or drooping

Head and neck cancer develops when cells in the tissues of the head or neck undergo genetic changes (mutations) that lead to uncontrolled growth, forming a tumor. The exact cause is often complex and may depend on the specific site of origin (mouth, throat, sinuses, etc.). Generally, cancer occurs when environmental exposures, lifestyle choices, infections, or inherited tendencies cause such cellular changes.

The main risk factors that significantly increase the likelihood of developing head and neck cancer include:

• Tobacco Use: Smoking cigarettes, cigars, pipes, or using smokeless tobacco (chewing tobacco, snuff, betel quid) is the leading risk factor. Over 70% of head and neck cancers are linked to tobacco use.
  
  
• Alcohol Consumption: Heavy and frequent drinking raises the risk, especially when combined with tobacco use. The combined risk is synergistic, not merely additive.
  
  
• Human Papillomavirus (HPV) Infection: Certain types of HPV, especially HPV-16, are associated with oropharyngeal cancers (tonsils, base of tongue).
  
  
• Epstein-Barr Virus (EBV) Infection: Associated with an increased risk for nasopharyngeal cancer and some salivary gland cancers.
  
  
• Occupational Exposures: Long-term contact with wood dust, asbestos, certain chemicals, and industrial substances (e.g., formaldehyde, nickel) can elevate risk, particularly for cancers of the nasal cavity and sinuses.
  
  
• Sun Exposure: Prolonged exposure to ultraviolet (UV) rays from sunlight or tanning beds increases the risk of cancers of the lips and facial skin.
  
  
• Poor Oral Health: Inadequate dental hygiene, gum disease, or missing teeth can increase the risk, mainly for oral cancers.
  
  
• Diet and Nutrition: Diets low in fruits and vegetables may be linked to higher risk.
  
  
• Radiation Exposure: Previous radiation therapy to the head or neck for non-cancerous conditions can increase the future risk

While not all cases are preventable, many risk factors for head and neck cancer can be reduced through certain lifestyle changes and medical precautions. 

Here are key prevention strategies:

• Avoid Tobacco Use
  Do not smoke or use smokeless tobacco (chewing tobacco, snuff, betel quid). Quitting tobacco greatly reduces your risk over time.

• Limit Alcohol Consumption
  If you drink, do so in moderation. Reducing both alcohol and tobacco use has a significant protective effect.

• Get Vaccinated Against HPV
  The HPV vaccine helps prevent oral and oropharyngeal cancers caused by HPV infection. Recommended for adolescents and young adults (typically before age 26).

• Protect Against UV Radiation
  Use sunscreen and lip balm with SPF when outdoors. Avoid excessive sun exposure, especially to the face and lips.

• Practice Good Oral Hygiene
  Brush and floss regularly.

• Visit a dentist regularly to check for any abnormal lesions in the mouth.

• Reduce Occupational Exposure
  Use protective equipment and follow safety regulations if working with chemicals (e.g., wood dust, asbestos, formaldehyde).

• Regular Health Check-Ups
  Early detection of precancerous conditions or early-stage disease improves outcomes. If you have symptoms (e.g., hoarseness, sores that don't heal), seek medical attention promptly.