Head and Neck
What is head and neck cancer?
It is the group of cancers that arise in squamous cells of the head and neck mucosa. They include:
- Oral cancer
- Paranasal sinuses
- Salivary glands
- Throat and lymph nodes of the neck
Cancer types
- Oral cancer: Presence of cancerous cells that develop in any part of the mouth, for example, lips, gums, tongue, internal lining of the cheeks, palate, base of the mouth (underneath the tongue).
- Cancer of the paranasal sinuses and the nasal cavity: A disease in which cancerous cells form in the tissues of the paranasal sinuses and the nasal cavity.
- Cancer of the salivary glands: It is an uncommon disease in which cancerous cells form in salivary gland tissues.
- Throat cancer: It is the formation of cancerous cells in the pharynx or the larynx due to the genetic mutation of the cells in those areas.
Cancer symptoms usually vary across individuals and not everyone exhibits prior symptomatology.
Alarm signals include:
- Lump in the neck
- Painful lesion or wound in the mouth or the throat which does not heal.
- Soreness of the throat which does not go away
- Difficulty swallowing
How is diagnosis made?
It begins with a suspicion that can be verified by means of the following:
- Physical examination: The medical team examines the head and the neck, palpating to determine the presence of any abnormality. This exam includes the cervical lymph nodes. In order to detect cancer of the mouth, larynx or pharynx, the physician uses mirrors to check the throat, the base of the tongue and part of the larynx.
- Biopsy: Removal of cells or tissues to be analyzed by the pathologist under the microscope in order to detect any cell mutations.
- Imaging studies: The physician can ask for imaging studies in order to look for tumors. These may include computerized tomography (CT scan), magnetic resonance (MRI) and positron emission tomography (PET).
There are different ways to treat cancer depending on the type and whether it has spread. Treatment includes:
- Surgery
Some form of surgery is used in the majority of patients with head and neck cancer as part of the treatment. The type of surgical procedure will depend on the intention to treat and the clinical and/or pathological stage of the disease. It is also important to mention that a combination of different surgical procedures can be used.
- Immunotherapy
Immunotherapy is the use of drugs to stimulate the patient’s immune system so that it can recognize and destroy cancer cells more effectively. This therapy can be used to treat some types of head and neck cancer.
- Chemotherapy
The aim is to shrink or eliminate the tumor using drugs administered as tablets or by the intravenous route. Chemotherapy treatment is indicated in some cases, depending on the stage of the disease or the patient’s clinical condition.
- Radiotherapy
Radiotherapy uses high-energy beams (or particles) that destroy or reduce cancer cells. It can be used in several situations, such as:
After surgery to lower the probability of the cancer reappearing in the same site or in adjacent lymph nodes.
After surgery in the case of a tumor lesion or if cancer was found in many lymph nodes, or if cancer is present in certain surgical margins, such as skin or muscle margins.
If cancer has spread to other parts of the body, such as the bones or the brain.
- Hormone therapy
This type of therapy is indicated mostly in tumors with positive hormone (estrogen and progestogen) receptors. However, there are some cases in which their use is recommended considering the risk-benefit balance.