Head and neck cancer is a condition that begins with nose, throat, sinuses or mouth. It occurs in the cells that line the surfaces of these body parts. There are different types of head and neck cancer, each having different symptoms.
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Signs and Symptoms of Head and Neck Cancer
1. Head and neck cancer is a group of cancers that starts in the mouth, nose, throat, larynx, sinuses,
or salivary glands. Symptoms for head and neck cancer may include a lump or sore that does not heal, a
sore throat that does not go away, trouble swallowing, or a change in the voice. There may also be
unusual bleeding, facial swelling, or trouble breathing.
About 75% of head and neck cancer is caused by the use of alcohol or tobacco. Other risk factors
include betel quid, certain types of human papillomavirus, radiation exposure, certain workplace
exposures, and Epstein-Barr virus. Head and neck cancers are most commonly of the squamous cell
carcinoma type. The diagnosis is confirmed by tissue biopsy. The degree of spread may be determined
by medical imaging and blood tests.
2. The ears, nose and throat are the most common areas affected by head and neck cancers. Symptoms of
this cancer may depend on where the cancer develops and how it spreads.
For example, tumors in the larynx or pharynx may be discovered as a lump in the throat. Cancer in the
mouth may cause sores in the mouth or swelling of the jaw.
In addition to physical signs of head and neck cancer, these diseases often cause symptoms that are similar
to less serious conditions, like the common cold. Changes in voice, headaches, sore throat or a cough may
be symptoms of throat cancer. Pain or ringing in the ears may also accompany certain head and neck
cancers.
Some common head and neck cancer symptoms include:
A lump in the nose, neck or throat, with or without pain
A persistent sore throat
Trouble swallowing (dysphagia)
Unexplained weight loss
Frequent coughing
Change in voice or hoarseness
Ear pain or trouble hearing
Headaches
A red or white patch in the mouth
Bad breath that's unexplained by hygiene
Nasal obstruction or persistent congestion
Frequent nose bleeds or unusual discharge
Trouble breathing
3. Alcohol and tobacco
Around 75% of cases are caused by alcohol and tobacco use.
Tobacco smoke is one of the main risk factors for head and neck cancer and one of the most carcinogenic
compounds in tobacco smoke is acrylonitrile. (See Tobacco smoking). Acrylonitrile appears to indirectly cause
DNA damage by increasing oxidative stress, leading to increased levels of 8-oxo-'-deoxyguanosine (8-oxo-dG)
and formamidopyrimidine in DNA (see image). Both 8-oxo-dG and formamidopyrimidine are mutagenic.DNA
glycosylaseNEIL prevents mutagenesis by 8-oxo-dG5 and removes formamidopyrimidines from DNA.
Diet
Excessive consumption of eggs, processed meats, and red meat were associated with increased rates of
cancer of the head and neck in one study, while consumption of raw and cooked vegetables seemed to be
protective.
Vitamin E was not found to prevent the development of leukoplakia, the white plaques that are the precursor
for carcinomas of the mucosal surfaces, in adult smokers. Another study examined a combination of Vitamin
E and beta carotene in smokers with early-stage cancer of the oropharynx, and found a worse prognosis in
the vitamin users.
Epstein–Barr virus
Epstein–Barr virus (EBV) infection is associated with nasopharyngeal cancer. Nasopharyngeal cancer occurs
endemically in some countries of the Mediterranean and Asia, where EBV antibody titers can be measured to
screen high-risk populations. Nasopharyngeal cancer has also been associated with consumption of salted
fish, which may contain high levels of nitrites.
4. A person usually presents to the physician complaining of one or more of the above symptoms. The person
will typically undergo a needle biopsy of this lesion, and a histopathologic information is available, a
multidisciplinary discussion of the optimal treatment strategy will be undertaken between the radiation
oncologist, surgical oncologist, and medical oncologist.[medical citation needed]
Histopathology
Throat cancers are classified according to their histology or cell structure, and are commonly referred to by
their location in the oral cavity and neck. This is because where the cancer appears in the throat affects the
prognosis - some throat cancers are more aggressive than others depending upon their location. The stage
at which the cancer is diagnosed is also a critical factor in the prognosis of throat cancer. Treatment
guidelines recommend routine testing for the presence of HPV for all oropharyngeal squamous cell
carcinoma tumours.
Squamous-cell carcinoma
Squamous-cell carcinoma is a cancer of the squamous cell – a kind of epithelial cell found in both
the skin and mucous membranes. It accounts for over 90% of all head and neck cancers, including more
than 90% of throat cancer. Squamous cell carcinoma is most likely to appear in males over 40 years of age
with a history of heavy alcohol use coupled with smoking.
The tumor marker Cyfra 21-1 may be useful in diagnosing squamous cell carcinoma of the head/neck
(SCCHN).
Adenocarcinoma
Adenocarcinoma is a cancer of epithelial tissue that has glandular characteristics. Several head and neck
cancers are adenocarcinomas (either of intestinal or non-intestinal cell-type)
5. Radiation therapy. Radiation therapy is the most common form of treatment. There are different forms of
radiation therapy, including 3D conformal radiation therapy, intensity-modulated radiation therapy, particle
beam therapy and brachytherapy, which are commonly used in the treatments of cancers of the head and neck.
Surgery. Surgery as a treatment is frequently used in most types of head and neck cancer. Usually the goal is to
remove the cancerous cells entirely. This can be particularly tricky if the cancer is near the larynx and can result
in the person being unable to speak. Surgery is also commonly used to resect (remove) some or all of the cervical
lymph nodes to prevent further spread of the disease.
Chemotherapy. Chemotherapy in throat cancer is not generally used to cure the cancer as such. Instead, it is
used to provide an inhospitable environment for metastases so that they will not establish in other parts of the
body. Typical chemotherapy agents are a combination of paclitaxel and carboplatin. Cetuximab is also used in
the treatment of throat cancer.
Photodynamic therapy Photodynamic therapy may have promise in treating mucosal dysplasia and small
head and neck tumors. Amphinex is giving good results in early clinical trials for treatment of advanced head
and neck cancer.
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