Head & Neck Cancers

  • Overview

  • Symptoms

  • Diagnosis

  • Treatment

Overview

Squamous cell carcinomas originate in the inner lining of parts of the head and neck. Invasive squamous cell carcinoma spreads into the deeper tissues. Tumours found in glandular cells, like the salivary glands are called adenocarcinomas.

Head and neck cancers can include oral cancer, cancer of the larynx (voice box), throat cancer, and tumours arising in the vicinity of the nose, throat, mouth and upper part of the oesophagus. Cancers of the head and neck do not include cancer of the skin on these regions.

Early Symptoms

  • A lump in the neck or a persistent sore throat
  • A sore in the mouth or a red/white patch in the mouth that doesn’t heal
  • Nasal congestion, nosebleeds or chronic sinus infections
  • Hoarseness
  • Blood in sputum
  • Persistent neck, throat or ear pain
  • Difficulty in chewing, swallowing or moving the tongue
  • Numbness in certain areas
  • Loosening of teeth or dentures, which no longer fit
  • Discolouration of a mole

Diagnosis

  • Medical History
  • Physical Examination
  • Endoscopy
  • Imaging Tests
  • Biopsy

After the diagnosis, the oncologist will determine the stage of the tumour using some of the above techniques and the Tumour, Node, Metastasis (TNM) staging system.

Treatment

Surgery: Surgery is the first treatment for most head and neck cancers; advanced techniques allow surgeons to extract many tumours without causing damage to sensory structures. Now it is possible to remove lymph nodes while sparing nerves vital for shoulder function. Surgery to remove tumours at the base of the skull was nearly impossible till recently. Reconstruction of bones, etc. can now be possible immediately after surgery.

Minimally Invasive Procedures: Image-guided procedures are often used to remove tumours near sensitive areas. Endoscopic laser surgery can extract tumours from the larynx, pharynx and thyroid while preserving nerves involved in speech. Tumours of the tongue or tonsils can be removed with robotics arms placed in the mouth.

Radiation Therapy: Radiation therapy may be used after surgery, often with chemotherapy in curative treatment plans. Different types of radiation therapy can be particularly useful for patients not eligible for surgery or with significant side effects post surgery.

 

Chemotherapy: Chemotherapy is increasingly used, along side radiation therapy, to kill tumours difficult to reach surgically. Chemotherapy has been seen to enhance the efficacy of radiation and patient outcomes. If the cancer is incurable, chemotherapy serves to increase survival and decrease symptoms.