Head and Neck Cancers: What They Are, Causes, Symptoms, and Treatment

Head and neck cancers refer to the uncontrolled and abnormal growth of cancer cells in the head and neck area of the body. Early diagnosis and treatment of head and neck cancers are crucial. While these cancers can be treated successfully in many cases, they can also cause permanent damage in some situations. To prevent such damage, various treatment methods can be applied to eliminate the cancer cells or halt their progression.

What are Head and Neck Cancers?

The head and neck include the oral cavity, nasopharynx (upper throat), oropharynx, hypopharynx (lower throat), larynx, sinuses, certain parts of the ear, and the neck. Head and neck cancers refer to various types of cancers that occur in the head and neck region of the body. All types of cancer are caused by the uncontrolled and abnormal growth of cells in a specific part of the body. Head and neck cancers are often named according to the area of involvement.

Oral cancer includes the lips, tongue, gums, cheeks, floor of the mouth, and the palate. The term throat or neck cancer is sometimes used for cancers of the nasopharynx, larynx, and esophagus.

Head and neck cancers are categorized according to their location as follows:

Oral Cavity Cancer
Oral cavity cancer involves the lips, tongue, gums, cheeks, floor of the mouth, and the palate. Lip cancer is most commonly seen on the lower lip and is more common in men than women. Its frequency increases with age. Tongue cancer, like other cancers, occurs due to the abnormal growth of cells. Tongue cancer is easier to diagnose compared to other cancers because it is in the open oral cavity. It is closely associated with smoking. Gum cancer is related to irritants, such as poorly fitting dentures. Cancers of the floor of the mouth and the back of the jaw are particularly difficult to diagnose.

Nasopharyngeal (Upper Throat) Cancer
The nasopharynx, also known as the back of the nose, is the upper section of the throat located behind the nose. Cancer in the nasopharynx is referred to as nasopharyngeal cancer. Early detection of nasopharyngeal cancer is difficult. It may present with ear problems and nasal congestion, and sometimes the first symptom is a neck mass.

Laryngeal (Voice Box) Cancer
The larynx is the structure in the throat that separates the windpipe from the esophagus. It prevents food from accidentally entering the windpipe by opening and closing. The formation of malignant (cancerous) cells in the larynx is called laryngeal cancer. Laryngeal cancer typically occurs in the upper part of the larynx. Persistent hoarseness lasting more than three weeks should be included in the differential diagnosis.

Paranasal Sinus and Nasal Cavity Cancer
Paranasal sinuses are the cavities next to the nasal cavity. Tumors that develop in the paranasal sinuses and nasal cavity can be referred to as sinus cancer or nasal cancer, depending on their location. Malignant nasal cavity cancer is rare. These cancers have a lower risk of metastasis at the time of diagnosis.

Salivary Gland Cancer
Salivary glands are located in the head and neck area and produce saliva to aid digestion. The secretion produced by the salivary glands also contains antibodies that help prevent infections. There are many types of salivary gland cancers. However, most salivary gland tumors are benign and do not spread.

What Are the Causes of Head and Neck Cancers?

Cancers can affect individuals of all age groups. However, the formation of cancer types is more commonly seen in individuals aged 65 and above. Most cancer types are more common in men than in women. Several factors, including age, gender, and others, play a role in the development of head and neck cancers. Among these, smoking and alcohol consumption are the primary contributors. In addition to these factors, cancer rates are higher in industrialized societies. The consumption of processed foods, radiation exposure, diet, and personal care habits can also contribute to the development of some cancers.

In Turkey, cancers such as laryngeal cancer are more prevalent. The main reason for this is attributed to smoking habits among men. Factors contributing to the development of head and neck and other cancers can be related to genetic and family structures. On the other hand, hormonal factors, diet, physical factors, chemicals, viruses, bacteria, and parasites can also play a role. While genetic makeup alone may not be the sole cause of cancer, it can contribute to its development. It is known that tobacco use is one of the biggest causes of cancer worldwide. Smoking is known to contribute to various cancers, including lung, head, neck, esophageal, cervical, pancreatic, and bladder cancers.

What Are the Symptoms of Head and Neck Cancers?

Head and neck cancers can present with certain symptoms, or they may show no symptoms at all. Generally, some important symptoms can be listed as follows:

• Swelling in the head and neck region
• Swelling around the eyes
• Numbness or tingling in the mouth
• Hoarseness
• Difficulty swallowing
• Coughing
• Difficulty breathing
• Difficulty swallowing
• Lesions in the mouth, tongue, and lips
• Ear pain, ringing, or hearing loss

How is Head and Neck Cancer Diagnosed?

Early diagnosis of head and neck cancers is of great importance. Nearly three-quarters of all head and neck cancers can be detected during an examination. Your doctor may perform certain tests to make a diagnosis. These tests may include a physical examination of the mouth, nose, throat, and tongue. Another diagnostic method that may be needed is an endoscopy. Your doctor may require an endoscopy to examine the larynx, throat, and nasal cavity. Blood and urine samples may be requested for laboratory analysis. Imaging methods such as X-ray, MRI (Magnetic Resonance Imaging), and CT (Computed Tomography) scans can also be used. Additionally, a biopsy sample may be taken for examination by a pathologist. The biopsy sample can be taken in the operating room, in a clinic, or via needle biopsy with local anesthesia for salivary gland lesions. In certain cases, a biopsy sample may be taken under general anesthesia during surgery. A biopsy is the most reliable method for making a definitive diagnosis of the type of cancer.

How is Head and Neck Cancer Treated?

The treatment of head and neck cancers varies depending on the individual and the type of cancer. The goal of cancer treatment is to ensure recovery and restore lost functional abilities. Surgery, chemotherapy, and radiotherapy are used in the treatment of head and neck cancers. In some cases, multiple treatment methods can be combined. For example, complementary radiotherapy may be applied after surgery. While these methods aim to ensure recovery, sometimes the goal is to prevent distant spread and extend life expectancy. Head and neck cancers are treated with care provided by a combination of many different health disciplines. The personalized treatment plan is determined based on the tumor's histological structure, size, location, and the patient's condition. Age, gender, and overall health also affect the selection of the treatment method.

What Methods Are Used in the Treatment of Head and Neck Cancers?

In head and neck cancers, the treatment method is determined based on the extent of the cancer cell spread. In personalized treatment plans, only one of the methods—surgery, chemotherapy, or radiotherapy—may be used. In some cases, combined treatment methods, such as dual or triple therapies, may be applied.

Surgical Treatment
Surgical treatment is a method used to remove the cancerous tissue or organ from the body. It can be effective when cancer has not spread. Even if cancer cells have spread, surgery can be used alongside other treatment methods. Surgical treatment is a commonly used method.

Chemotherapy
Chemotherapy refers to the chemicals used to destroy cancer cells. It has a systemic effect on the body compared to other treatment methods. Chemotherapy may be used in cases where cancer cells have spread.

Radiotherapy
Radiotherapy, or radiation therapy, can be used alone or as part of a combined treatment. Radiation is generated using special devices to try to eliminate cancer cells. In the treatment of head and neck cancers, radiotherapy is used to treat the cancer, prevent or delay its spread, and reduce pain.

The first step in the treatment of head and neck cancer is determining the stage of the cancer. Tumors are staged histologically under four categories. In stages 1 and 2, cancer cells are small, and recovery is possible through surgical treatment. Chemotherapy or radiotherapy may also be used additionally to prevent remaining spread. In stages 3 and 4, tumor cells may have spread to surrounding tissues and lymph nodes. Stages 3 and 4 represent advanced spread. Typically, treatment involves surgery and radiotherapy, or combined treatment with chemotherapy to treat the cancer.

When head and neck cancers are diagnosed and treated early, it is possible to prevent them or reduce symptoms. If you experience common symptoms of head and neck cancers, such as hoarseness, coughing, and difficulty swallowing, you should consult with a healthcare provider and ask any questions you may have.