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Frequently Asked Questions about Head & Neck Cancers

In 2020, 4.77% of the new cases of cancers were classified as head and neck cancers — cases involving the nasopharynx, lip & oral cavity, larynx, salivary glands, oropharynx, and hypopharynx in the Philippines. This accounts for more than 7,000 Filipinos diagnosed with this type of cancer. [1]

In all types of cancer, including head & neck types, early detection is vital for the patient’s recovery. Fighting cancer is a race against time. Hence, it is important to know the things to look out for to avoid them and minimize their effects.

Here are some of the frequently asked questions regarding head and neck cancers:

What are head and neck cancers?

Head and neck cancers[2] are cancers that usually begin in the squamous cells[3] that make up the outermost layer of the mucosal surfaces of the head and neck such as the inside of the mouth, throat, and larynx. Cancer from these areas is also referred to as squamous cell carcinomas. Head and neck cancer can also develop from salivary glands, paranasal sinuses, or muscles or nerves in the head and the neck, although these cases are much rarer.

Cancers found in other parts of the head such as the brain, eyes, thyroid gland, esophagus, and skin of the head are generally not classified as head and neck cancers.

What causes head and neck cancer? Who is at risk?

Smoking (including secondhand smoke and smokeless tobacco) and alcohol use are seen as the two primary risk factors for head and neck cancers. Most head and neck squamous cell carcinomas are caused by excessive tobacco and alcohol use, and people who use both tobacco and alcohol are more likely to develop these cancers than those who use either of the two alone.

Consequently, smokers and alcoholic individuals have the highest risk of developing this type of cancer. Long-time smokers are 5 to 25 times more prone to cancers in the larynx or pharynx, while excessive alcohol drinkers have an increased risk of getting cancer in the mouth or throat.[4]

Human papillomavirus (HPV)[5] is another risk factor for head and neck cancers. HPVs are a common virus that spreads during skin-to-skin contact with infected people. The virus is responsible for the increasing cases of cancers in the tonsils or the base of the tongue.

Prolonged sun exposure can cause not only skin cancer[6] but head and neck cancers as well, particularly in the lip and oral area[7].

Radiation exposure[2] to the head and neck is associated with salivary gland cancer.

Occupational and environmental exposure[2] are risk factors for cancer in the pharynx, paranasal sinuses, and nasal cavity. Inhaling asbestos, synthetic fibers, wood dust, paint fumes, and certain chemicals increases the risk of head and neck cancer. Hence, people who work in environments with high exposure to these substances are at greater risk of developing head and neck cancer.

Epstein-Barr virus infection[8] is another risk factor for cancer in the nasopharyngeal area and salivary glands.

What are the common symptoms of head and neck cancer?

Symptoms of head and neck cancer vary. Most of the symptoms can also be caused by other, less severe conditions. The only way to know for certain is to see a physician and conduct different tests.

Here are some of the symptoms[2] of head and neck cancer in specific areas:

  • Oral cavity – White or red patch on the gums, tongue, or lining of the mouth; a growth or swelling of the jaw; and unusual bleeding or pain in the mouth.
  • Throat (Pharynx) – Pain in the neck or sore throat that does not go away; pain when swallowing; hearing problems, and pain or ringing in the ears.
  • Voicebox – Difficulty in breathing or speaking, pain when swallowing; and ear pain.
  • Paranasal sinuses and nasal cavity – Blocked sinuses that do not clear; chronic sinus infections that cannot be treated with antibiotics; nosebleeds; headaches; pain in the upper teeth and problems with dentures; and swelling in the eyes.
  • Salivary glands – Swelling of the jaw; numbness or paralysis of the face; or pain in the face, chin, or neck that lingers.

How to detect head and neck cancer?

The following are some tests[9] that may be used to diagnose head and neck cancer:

  • Physical examination
  • Blood and urine tests
  • Endoscopy
  • Biopsy
  • X-ray
  • Barium swallow
  • Panoramic radiograph
  • CT scan/PET scan/PET-CT scan
  • Ultrasound
  • MRI

Typically, more than one of these tests is done to have a more accurate diagnosis of the patient’s condition.

Once the tests are completed, the physician will review the results with the patient. If the diagnosis is cancer, the results from the tests will help the doctor describe it.

Treatment options for head and neck cancer

As for the treatment[2] of the disease, surgery, chemotherapy, radiation therapy, targeted therapy, immunotherapy, or a combination of them are used. The patient’s treatment plan for head and neck cancer depends on various factors, including the tumor’s location, the stage of cancer, and the patient’s age, medical history, and health condition.

The treatment options must be carefully discussed by the patients and their doctors. Each type of treatment may affect the way the patient looks, breathes, talks, and eats differently. As the goal of any cancer treatment is to improve the quality of life and survivorship of the patient, the effects and side effects of the treatment options must be fully understood by the patient.

When dealing with cancer, time is of utmost importance. If you experience any symptoms of head and neck cancer or any other type of cancer, make sure to see a doctor, get treatment, and seek help from cancer support groups.

References:

  1. Philippines. The Global Cancer Observatory. https://gco.iarc.fr/today/data/factsheets/populations/608-philippines-fact-sheets.pdf

Calculation: TOTAL new cases of nasopharynx, lip & oral cavity, larynx, salivary glands, oropharynx, and hypopharynx equals 7,344, divided by the total number of new cancer cases, 153,751. 7,344/153,751 = 4.77% of new cases.

  1. Head and Neck Cancers. National Cancer Institute USA. Accessed 22 June 2021 from https://www.cancer.gov/types/head-and-neck/head-neck-fact-sheet
  2. Squamous Cell Cancer. Healthline. Accessed 22 June 2021 from https://www.healthline.com/health/squamous-cell-skin-cancer
  3. Head and Neck Cancers: What You Need to Know. MSD in the Philippines. Accessed 22, June, 2021 from https://businessmirror.com.ph/2021/04/29/head-and-neck-cancers-what-you-need-to-know/
  4. HPV and Cancer. American Society of Clinical Oncology. Accessed 22 June 2021 from https://www.cancer.net/navigating-cancer-care/prevention-and-healthy-living/hpv-and-cancer
  5. What are the Risk Factors for Skin Cancer? Centers for Disease Control and Prevention. Accessed 22 June 2021 from https://www.cdc.gov/cancer/skin/basic_info/risk_factors.htm
  6. Risk Factors for Head and Neck Cancer. Cancer Treatment Centers of America. Accessed 22 June 2021 from https://www.cancercenter.com/cancer-types/head-and-neck-cancer/risk-factors
  7. Everything You Need to Know About Epstein-Barr Virus. Healthline. Accessed 22 June 2021 from https://www.healthline.com/health/epstein-barr-virus
  8. Head and Neck Cancer: Diagnosis. American Society of Clinical Oncology. Accessed 22 June 2021 from https://www.cancer.net/cancer-types/head-and-neck-cancer/diagnosis

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