Table of Contents
Cancers of the Neck and Head: Causes and Treatments
Head and neck cancer is a collective term used for various cancers that can manifest in the head and neck regions (larynx, salivary glands, oral cavity, etc.), and it starts with the squamous cells. Those are flat and thin cells that line the mucosal surfaces inside the head and the neck.
Areas in Which Cancers of the Head and Neck Can Develop
Cancers in the neck and head may be categorized according to what general part or area of the head and neck they start. Below are the broad categories and the specific body parts they cover.
The salivary glands produce saliva. The salivary glands can be found under or behind your jaw, on the floor of the mouth.
The larynx is a hollow tube-like structure that acts as the passageway of air and is connected to the top of the windpipe, or the trachea, and below the pharynx. The larynx epiglottis stops food and foreign particles from entering air passages. The larynx is also responsible for producing our vocal sounds.
This area includes the horizontal part of the roof of your mouth. This can also be called the hard palate.
It also consists of:
- The front two-thirds of the tongue
- The lips
- The gum area behind the wisdom teeth
- The gum itself
- The bottom of the mouth (under the tongue)
- The cheeks’ and lips’ inside linings
Paranasal Sinuses and Nasal Cavity
Paranasal sinuses are the air-filled spaces inside the bones of the head which surround the nose. The nasal cavity is the hollow inside of the nose.
The pharynx is the throat – the hollow tube whose length starts from the mouth and nose up to the esophagus and larynx.
It is composed of three parts:
- Nasopharynx (behind the nose and is the upper part of the pharynx)
- Oropharynx (middle part and includes the back of the mouth)
- Hypopharynx (lower part of the pharynx)
The cancerous squamous cells can also be found in the upper neck’s lymph nodes, even if there are none in the other parts of the head and neck.
However, not all cancers of the other parts of the head are categorized within the head and neck cancers.
- Cancer of the brain
- Cancer of the esophagus
- Cancer of the bones and muscles of the head and neck
- Cancer of the eye
- Cancer of the thyroid glands
What Causes Head and Neck Cancer?
The chances and risk of developing head and neck cancers depend on how exposed people are to certain environmental factors or their lifestyle behavior, like the use of alcohol and tobacco.
Tobacco and alcohol use is linked to many cancers of the head and neck. It composes almost 75% of these cases — especially cancers of the larynx, oral cavity, oropharynx, and hypopharynx. However, tobacco and alcohol use are not risk factors for cancer of the salivary gland.
Other risks or possible causes of these head and neck cancers include:
The human papillomavirus or HPV is a viral infection passed through skin-to-skin contact. People infected with this virus have a high risk for some mouth and throat cancers.
It is also known as Human herpesvirus 4 and is one of the most common viruses. Infection with this virus is also a risk for cancers of the salivary glands and nasopharynx.
Exposure to Radiation
The head and neck being exposed to radiation is a factor in getting cancer of the salivary glands.
Salted and Preserved Food
Consumption of food that is preserved using salt when a person is still young is linked to an increased risk of nasopharyngeal cancer.
People who work at jobs where they are exposed to asbestos and synthetic fibers are at risk of getting cancer of the larynx. While being exposed to wood dust has a chance of getting nasopharyngeal cancer.
Workers exposed to nickel dust or formaldehyde are at risk of getting cancer of the nasal cavity and paranasal sinuses. Also, jobs in industries like logging, food, ceramic, construction, metal, and textile have increased risks of getting cancer of the larynx.
Poor Oral Health
Poor oral hygiene leads to poor oral health and is a risk for oral cavity cancers. Simultaneously, using and washing with mouthwash with high alcohol content is a possible risk for cancers of the oral cavity.
What Are the Head and Neck Cancer Symptoms?
Can cancer cause neck pain? Yes, it can, and this pain might be a symptom. Some common neck and head cancer symptoms are:
- Lumps in the neck, nose, or throat that can be accompanied by pain, soreness, or swelling that does not heal
- Difficulty in moving the jaw and even in swallowing
- Painful bumps on the head and neck
- Loose teeth
- Hoarseness or a change in voice
- Uncommon bleeding or pain in the mouth
However, these symptoms may also equate to some other illness, so it would be best to visit a doctor or a dentist to be sure.
Symptoms can also vary depending on which area of the head and neck they affect. Below are signs a person may experience for each area:
Some symptoms of cancers of the larynx patients encounter include pain in the ears and when swallowing.
Symptoms like red or white patches inside the mouth, unusual bleeding, or pain in the mouth, and even swelling of the jaw may be experienced.
Numbness of muscles in the face, continuous pain in the chin, neck, and face, and swelling around the jawbone or under the chin are common symptoms.
Symptoms like continuous pain in the throat and neck, difficulty in speaking or breathing, frequent pain or ringing in the ears, headaches, or even difficulty in hearing may be experienced.
Paranasal Sinuses and Nasal Cavity
Denture problems, pain in upper teeth, trouble and swelling of eyes, chronic sinus infections, bleeding through the nose, and blocked sinuses are all possible symptoms.
How to Avoid Getting Head and Neck Cancer
A way to reduce the chances and risks of getting any head and neck cancer is to reduce tobacco and alcohol use and intake. People who are already at risk should talk and discuss with a doctor about ways to lessen chances and how often they have to come for checkups.
Clinical trials are still ongoing to determine certain medications’ efficiency in preventing head and neck cancers for people at high risk. For more information about these clinical trials, you can access the U.S. National Library of Medicine website. Clinical trial details can also be viewed and accessed through the National Cancer Institute (NCI) lists of trials. This list includes all NCI-supported clinical trials which are happening in Canada and the United States.
Another way to avoid and lessen the risks of getting head and neck cancer is avoiding oral HPV infection. Avoiding this may reduce the chances of any HPV-related cancers of the head and neck. Although there are existing HPV vaccines, it has not been tested if these vaccines can prevent HPV infection of the oral cavity. Also, no measure is 100% approved yet for the prevention of oropharynx cancer.
How Are Head and Neck Cancer Diagnosed?
Doctors try to find the cause or causes of any symptom of a health problem. If you are experiencing unusual changes or any of the signs mentioned above, it is best to talk to a doctor immediately. They will ask questions such as how long and often you experience the symptoms, your medical history, your current health condition, and perform and run some examinations and tests to give you a proper diagnosis.
The following are some of the tests that are done by doctors. These are to diagnose cancers of the head and neck appropriately:
- Physical examinations
- Blood and urine tests
- CT scan
After all the necessary tests, the doctors will discuss the results with you or with a trusted family member.
After a person is diagnosed with cancer, their doctor will explain their illness’s extent.
The extent is often described through the stages. The stages of cancers determine whether the disease has spread to other parts of the body and if any additional damage has occurred.
What Are the Stages of Head and Neck Cancer?
The stages of head and neck cancer are represented by Roman numerals and start from zero up to four. They describe and state the sizes of a neck tumor or head tumor and whether it has spread or not. Below are the primary stages:
This stage is also called carcinoma in situ (CIS), which refers to abnormal cells found in the place or area where they are formed – the cells have the possibility to be cancer and the ability to spread. This is the start of the scale.
This stage represents the very early stage of cancer. The spread of cancer has not reached any lymph nodes, and the tumor is still small, with a size of 2 cm at most.
At this stage, the head and neck tumor has grown and is already larger than two centimeters and at most four centimeters. But, fortunately, cancer has still not gotten into the lymph nodes.
The size of cancer at this stage is more than four centimeters.
This stage may also indicate that it has reached a lymph node on the same side of the neck and the lymph node’s size is smaller than three centimeters.
This stage is the most advanced and means that the tumor has spread to parts of the body that are very distant from the original place, to nearby tissue or other parts of the head and neck, or other lymph nodes. This is also the last stage.
What Are the Available Head and Neck Cancer Treatments?
Treatment plans vary depending on the tumor’s specific location, the stage of cancer, and the patient’s overall health and age. The treatment choice that a patient wants to undergo is carefully discussed with their doctor since it could change the way they eat, talk, look, and even breathe.
Treatment plans may include:
It is often one of the first options for cancer in the neck and head. Surgery can be done to remove head and neck tumors in a minimally invasive approach. It may be applied with a combination of other treatments such as chemotherapy and radiation therapy.
A patient can undergo several types of surgery, like Transoral Laser Microsurgery and Transoral Robotic Surgery.
Transoral Laser Microsurgery uses lasers to remove the neck’s tumor, specifically the larynx or oropharynx, through the patient’s mouth. This approach does not need external incisions, and this would avoid affecting swallowing and speech abilities.
Transoral Robotic Surgery is a minimally invasive surgery and is used to remove cancer in the oropharynx. This approach also does not use external incisions because it uses 3D imaging and tiny robotic surgical tools and instruments.
Chemotherapy can be used alone or with a combination of other treatments. It is usually a reserved treatment for cancer patients whose cancer has metastasized to any part of the body. This treatment uses drugs to battle cancer. These drugs can be given as pills or injections, as long as they go into the blood and reach all parts of the body. This type of treatment usually lasts for months and is given in rounds. Chemotherapy as a patient’s treatment plan usually comes with radiation.
Radiation therapy can be intensity-modulated radiation therapy or proton beam therapy. In this kind of treatment, radiation is delivered, in high doses, to the tumor cells in the neck and head with the use of technology to lessen possible damage to other healthy organs and tissues. The radiation can be focused directly on the tumor to reduce possible common side effects of this treatment.
Intensity-modulated radiation therapy (IMRT) is a combination of an advanced computer program and a collimator device. These equipment are used to shape the radiation beams into desired sizes or to the area’s dimensions to be treated.
On the other hand, Proton therapy is a form of radiation that uses proton beams in place of photon beams. Proton beams do not penetrate past the tumor and, therefore, this radiation reduces possible damage to normal tissues and its side effects. Currently, this treatment is used by people whose cancer came back after their previous treatment.
Targeted therapy uses drugs that are developed to block the growth and further spreading of cancer. It does so by attacking proteins and impeding the cancer cells from dividing or, sometimes, just killing them directly.
There are also approved drugs for head and neck cancers. Some of these drugs include:
- Trexall (Methotrexate Sodium)
- And others
Are There Required Treatments for Specific Head and Neck Cancers?
Treatments may also be identified depending on what type or kind of head and neck cancer a patient has. Below are specific types of head and neck cancers and what treatment plans are recommended or required for them:
Oral Cavity and Lip Cancer
For this type of cancer, two types of standard treatment are used: surgery and radiation therapy. These therapy types may cause side effects on the patient and require them to attend follow-up checkups with the doctor.
Three types of treatment are used for this type of cancer: surgery, radiation therapy, and chemotherapy. Like other treatments, it would cause side effects, and follow-ups with the doctor might be needed.
Salivary Gland Cancer
Like for hypopharyngeal cancer, surgery, chemotherapy, and radiation therapy might be used for this type of cancer. Although, there is still another treatment being tested: the radiosensitizers. These would also cause side effects and would require follow-ups with the doctor.
Treatments for patients with oropharyngeal cancer, which are HPV-positive, may be different from those with HPV-negative oropharyngeal cancers. This is because recent research shows that less intense treatment would be enough for patients with oropharyngeal cancer that are HPV-positive since they have a better prognosis. Clinical trials are still ongoing and testing this information.
In summary, the most common and used treatments are chemotherapy, surgery, and radiation therapy. It is best to note that all these treatment plans would cause the patient to experience side effects that might last for a short while, like a few weeks. But it can also sometimes be in longer periods.
What Are the Effects of These Treatments?
The treatments for head and neck cancers may create side effects for the patient. For patients who underwent surgery, they might have trouble talking and even chewing and swallowing. Swelling may also be experienced for some time, for a few weeks or longer time. After surgery of the larynx or any part of the neck, the throat and the neck might feel numb.
People who received radiation therapy may or may not experience nausea. They can also have trouble swallowing, a change of taste, sore throat, redness and irritation in the mouth, dryness of the mouth, difficulty opening the mouth wide, swelling of skin under the chin, stiffness in the jaw, and dry skin.
Patient Care and Support
The during and aftermaths of treatment may be a handful, and patients might need some support and care. Also, treatments are done to control the disease, with the goal of patients going back to their normal lives. Rehabilitation and other forms of supports may be recommended.
The kind of rehabilitation a patient needs depends on what treatment they underwent and what cancer they had. Rehabilitations may include speech therapy, dietary counseling, and physical therapy. There are times that a patient would need plastic surgery to build their bones and tissues again, especially for people who had oral cavity cancer. If a surgery like this is impossible due to the possible damage it may inflict on the remaining tissues, getting a prosthesis is an alternative.
Are Follow-Ups Necessary?
Follow-up checkups are essential to ensure that the cancer is completely gone and has not come back. These are called recurrent cancers. Recurrent cancer may develop at the same original area, in another part of the body, or a lymph node. The doctor may require some examinations and tests to monitor the person’s condition, like blood tests, physical examinations, and MRI scans.
How to Prevent Head and Neck Cancer From Appearing a Second Time
The chances of developing new cancer for people who have had head and neck cancers are high, mainly if they use tobacco and drink alcohol. Doctors encourage previous head and neck cancer patients to quit such habits, especially tobacco use, to lower the risks of developing new cancer.
Going for follow-up check ups would be a good idea to monitor your health and be sure that there is no developing cancer again in the head and neck areas or even in the other parts of the body.
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