What causes head and neck cancers?

Smoking and drinking basically causes cellular changes in the mouth, throat and nose, and that's what causes many cancers. A lot of times, classically, patients will present with a sore, a non-healing ulcer on the tongue, or non-healing ulcer on the floor of the mouth or cheek. Sometimes they’ll present with a firm, fixed lymph node to the jaw and upper neck, and then we'll see a mass in the tonsil. So for people who smoke and drink, there are actual progressive, gradual and chronic cellular changes, and that's how cancer happens.

Then there are the cancers associated with the human papillomavirus (HPV). These patients are otherwise risk-averse, or don't have a heavy smoking and drinking history, but have been exposed to the cancerous types of HPV. The cancerous types are actually the same ones that cause cervical cancer in women. Kids are now getting the HPV vaccine that protects against all of those strains. The vaccine protects young girls from developing cervical cancer, and it protects young girls and boys from developing head and neck HPV-associated cancer.

Typically HPV can be associated with head and neck cancer, and all the sites of the upper aerodigestive tract. So it can occur from the lips to the throat, but usually there's a higher incidence with the tonsils, and then the lingual tonsils, or base of the tongue.

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