Head and Neck Cancer Health Article

Definition

The term head and neck cancers refers to a group of cancers found in the head and neck region. This includes tumors found in:

• The oral cavity (mouth). The lips, the tongue, the teeth, the gums, the lining inside the lips and cheeks, the floor of the mouth (under the tongue), the roof of the mouth and the small area behind the wisdom teeth are all included in the oral cavity.
• The oropharynx (which includes the back one-third of the tongue, the back of the throat and the tonsils).
• Nasopharynx (which includes the area behind the nose).
• Hypopharynx (lower part of the throat).
• The larynx (voice box, located in front of the neck, in the region of the Adam's apple). In the larynx, the cancer can occur in any of the three regions: the glottis (where the vocal cords are); the supraglottis (the area above the glottis), and the subglottis (the area that connects the glottis to the windpipe).

The most frequently occurring cancers of the head and neck area are oral cancers and laryngeal cancers. Almost half of all the head and neck cancers occur in the oral cavity, and a third of the cancers are found in the larynx. By definition, the term "head and neck cancers" usually excludes tumors that occur in the brain.

Description

Head and neck cancers involve the respiratory tract and the digestive tract; and they interfere with the functions of eating and breathing. Laryngeal cancers affect speech. Loss of any of these functions is significant. Hence, early detection and appropriate treatment of head and neck cancers is of utmost importance.

Roughly 10% of all cancers are related to the head and the neck. It is estimated that more than 55,000 Americans will develop cancer of the head and neck in 1998, and nearly 13,000 will die from the disease. The American Cancer Society estimates that in 1998, approximately, 11,100 new cases of laryngeal cancer alone will be diagnosed and 4,300 people will die of this disease. Oral cancer is the sixth most common cancer in the United States. Approximately 40,000 new cases are diagnosed each year and it causes at least 8,000 deaths. Among the major cancers, the survival rate for head and neck cancers is one of the poorest. Less than 50% of the patients survive five years or more after initial diagnosis. This is because the early signs of head and neck cancers are frequently ignored. Hence, when it is first diagnosed, it is often in an advanced stage and not very amenable to treatment.

The risk for both oral cancer and laryngeal cancer seems to increase with age. Most of the cases occur in individuals over 40 years of age, the average age at diagnosis being 60. While oral cancer strikes men twice as often as it does women, laryngeal cancer is four times more common in men than in women. Both diseases are more common in black Americans than among whites.

Causes and symptoms

Although the exact cause for these cancers is unknown, tobacco is regarded as the single greatest risk factor: 75–80% of the oral and laryngeal cancer cases occur among smokers. Heavy alcohol use has also been included as a risk factor. A combination of tobacco and alcohol use increases the risk for oral cancer by 6–15 times more than for users of either substance alone. In rare cases, irritation to the lining of the mouth, due to jagged teeth or ill-fitting dentures, has been known to cause oral cancer. Exposure to asbestos appears to increase the risk of developing laryngeal cancer.

In the case of lip cancer, just like skin cancer, exposure to sun over a prolonged period has been shown to increase the risk. In the Southeast Asian countries (India and Sri Lanka), chewing of betel nut has been associated with cancer of the lining of the cheek. An increased incidence of nasal cavity cancer has been observed among furniture workers, probably due to the inhalation of wood dust. A virus (Epstein-Barr) has been shown to cause nasopharyngeal cancer.

Head and neck cancers are one of the easiest to detect. The early signs can be both seen and felt. The signs and symptoms depend on the location of the cancer:

• Mouth and oral cavity: a sore that does not heal within two weeks, unusual bleeding from the teeth or gums, a white or red patch in the mouth, a lump or thickening in the mouth, throat, or tongue.
• Larynx: persistent hoarseness or sore throat, difficulty breathing, or pain.
• Hypopharynx and oropharynx: difficulty in swallowing or chewing food, ear pain.
• Nose, sinuses, and nasopharyngeal cavity: pain, bloody discharges from the nose, blocked nose, and frequent sinus infections that do not respond to standard antibiotics.

When detected early and treated appropriately, head and neck cancers have an excellent chance of being cured completely.