Though we hear more frequently about other types of cancers,
head and neck cancers are still something to be on your radar.
Cancers of the head and neck are labeled by their location and type. The most common type is
squamous cell carcinoma, says Sameep Kadakia, MD.
The squamous cells line the moist, mucosal surfaces — such as the inside of your mouth, throat, and nose — that are inside your head and neck.
“Cancers can occur in the oral cavity, including the tongue, jaw, mandible, and floor of the mouth,” Dr. Kadakia says. You can also get cancer in your tonsils, larynx, along the vocal cords, pharynx, esophagus, sinuses, nose, eyes, and even
in your brain.
About 4 percent of all cancers in the U.S. are head and neck cancers, according to the American Cancer Society. An estimated 65,000 men and women were diagnosed with this type of cancer in 2017.
Causes And Symptoms
There isn’t a single cause of head and neck cancers, but there are risk factors connected with them.
“If you look at risk factors, overwhelmingly for head and neck cancer,
smoking and alcohol use are number one and number two in terms of things that increase people’s risk of getting head and neck cancer,” Dr. Kadakia says. “There’s also a synergistic
effect of tobacco and alcohol, so number three is patients who use tobacco and alcohol together. They have a slightly higher risk than those who use just tobacco or just alcohol.”
Having
human papillomavirus (HPV) has recently been found also to be a factor in increasing your risk of getting head and neck cancers.
HPV has played a role in the recent increase in head and neck cancer. Dr. Kadakia says many more young patients are being diagnosed with oro-pharyngeal cancers, which include tonsil cancer and cancer of the back of the tongue. And, more and more often,
these cancers are linked to HPV.
The type of head or neck cancer you have will affect the type of symptoms you might have.
“Patients who have a cancer that’s beginning in their nose or their sinuses, initially they may not feel anything,” Dr. Kadakia says. “However, once the tumors become larger, they may complain of nose bleeds. They may complain
of consistent nasal congestion. They may complain of nasal drainage.”
A tumor in your mouth, however, might cause:
Difficulty swallowing
Pain while chewing
Tongue pain
Weight loss
Symptoms for some head and neck cancers can seem very similar. So, once you start having symptoms or a persistent issue that’s bothering you, it’s important to visit your doctor and work to find the root cause.
Detection And Risk Reduction
Head and neck cancers are different from more common types of cancer — like breast cancer, for example — because there isn’t a specific screening to see if you have a type of head or neck cancer. Finding cancers of the head or neck oftentimes
relies on routine physical exams and dental visits.
Once you’ve been diagnosed with a form of head or neck cancer, your prognosis will depend on the type of cancer, how aggressive it is, and how early it was found.
“When things are detected at earlier stages, typically it’s a sign that the cancer hasn’t gotten very large, maybe it hasn’t gotten very aggressive,” Dr. Kadakia says. “What that means is that we can do more for you
by being less aggressive.”
You can make lifestyle changes to help reduce your risk of getting head or neck cancers.
“One way to reduce the risk of head and neck cancer is
smoking cessation and limiting alcohol intake,” Dr. Kadakia says. “As far as smoking goes, we know nowadays that smoking is related to many, many adverse things in the human body. Aside
from that, we always recommend alcohol consumption in moderation.”
Examples of head and neck cancer include: tongue cancer, jaw cancer, cancer of the voice box, cancer of the sinuses. Really any part of the head and neck can be a potential site for a cancer.
Cause is not necessarily the best word to use for really any kind of cancer. We typically like to characterize them by risk factors. The reason is that if someone does action A, it does not always lead to cancer. If someone does not do action A it does not mean they will not get cancer. But typically for head and neck cancers the major risk factors that we discuss are tobacco, alcohol and the synergetic effect of tobacco and alcohol. Whether it be chewing tobacco, smoking, chronic alcoholism. One of the things we always recommend to our patients is to stop doing these things. We know nowadays that smoking and tobacco usage is a very, very large risk factor for not just head and neck cancer but lung cancer as well. The same has been shown for alcohol as well. Nowadays also, we've also found with certain cancers of the head and neck, the human papilloma virus as well can be a risk factor.
Anytime that you begin developing a symptom or some kind of finding that wasn't quite there before, I always tell people to have a very low threshold to go see your physician. Depending on the part of your head or neck that's involved by the cancer, the symptoms could be entirely different. For many people they may develop some lumps and bumps in the neck, enlarged lymph nodes for example. For some people they may develop sores on the tongue if maybe they have an early tongue cancer, or a sore inside the mouth that just quite won't go away. For some folks that have voice box cancers, they may notice that swallowing is a little bit different. Their voice is hoarse and it's more than just a common cold.
As with any cancer, if the cancers are caught at earlier stages and we can intervene quicker, then patients will do better in the survival and the outcomes will be much greater. Typically like any other cancer, I think the earlier you recognize, the earlier you move forward with treatment, patients will do better. Now, as far as prognosis goes, my personal philosophy is not to give hard numbers for prognosis. The reason is, I think again there are lots of studies out there, there are lots of graphs and charts and statistics you can read, but for an individual patient, you are one. You are not 600 people you are not 1,000 people. The reason I mention that is because whenever you look at these studies with different curves that say so and so cancer has a X % chance of survival, to a single patient that doesn't mean anything.
Well they're finding that the HPV virus is being linked to certain cancer. In the head and neck the one subside that it is strongly linked to is what we call the oral pharynx. The back of your tongue, the tonsils, and again the exact reason, they don't know. But what's being found, and again similar to why women get pap smears to screen for cervical cancer is that the HPV virus can cause certain changes in that particular area which can lead to cancers. The good news is though that if a cancer in the back of the mouth is associated with HPV, typically the prognosis is more favorable than someone who has a HPV negative cancer.
The best way to screen for head and neck cancer is to have regular visits with your primary care doctor and your dentist. The reason I say these two is because dentists are often times the first line professionals that will find different growths and different abnormalities in a persons mouth. Being that the mouth is one of the most common locations of head and neck cancer, dentists are fantastic people because they will find them and at the end of the day a lot of the guidelines say that we should be seeing dentists for routine screenings and cleanings at least once or twice a year.
Again, seeing your primary care doctor is of upmost importance because they will be checking your general health, and if anything is abnormal they're the ones that can then say okay, maybe you need to have this test or maybe you need to see this person. Typically as a cancer surgeon a patient isn't' coming to me regularly until they either have a diagnosis or until they have a finding that's concerning enough that it needs to be intervened on.
A significant amount of it is up to chance just because it's very hard to predict who will get a second cancer, if they will get a second cancer. Like the initial question that we discussed, it's all about modifying the risk factors. If you have a cancer, then again it's always prudent to stop smoking, to stop alcohol use, those kinds of things. Again, those risk factors that predispose you to maybe having the first cancer are also the same risk factors that could predispose you to having a second cancer.
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