HEAD AND NECK CANCERS

Cancer is a primary health problem in India, with occurrence of approximately 1 million cases each year. Over 200,000 cases of head and neck cancer (HNC) occur each year in India.

Head and neck (H&N) cancers are group of cancers that start in the tissues and organs of the head and neck. They begin in squamous cells (which compose most of the skin's upper layers (the epidermis)) that line moist surfaces inside the head and neck (for example, the mouth, nose, and throat). Head and neck cancers can also originate in the salivary glands. However, salivary gland cancers are relatively rare. Salivary glands have different types of cells that can become cancerous, so there are many different types of salivary gland cancers.

Head and neck cancers are classified into different types, based on the area from which they begin. Following are the locations in the head and neck from which the cancer originates.

• Oral cavity : Includes lips, front two third of the tongue, the gums, lining inside the cheeks and lips, bottom of the mouth under the tongue, bony top of the mouth, area of gum behind the wisdom tooth.
• Pharynx (Throat): It is a hollow tube that starts behind the nose and leads to esophagus. It has three parts: Nasopharynx, Oropharynx, and Hypopharynx.
• Larynx (Voice box) : It is a hollow tube that starts behind the nose and leads to esophagus. It has three parts: Nasopharynx, Oropharynx, and Hypopharynx.
• Paranasal sinuses and nasal cavity : It is a hollow tube that starts behind the nose and leads to esophagus. It has three parts: Nasopharynx, Oropharynx, and Hypopharynx.
• Salivary glands : It is a hollow tube that starts behind the nose and leads to esophagus. It has three parts: Nasopharynx, Oropharynx, and Hypopharynx.

SYMPTOMS OF HEAD AND NECK CANCER

The ears, nose and throat are the common areas affected by head and neck cancers. Symptoms depend on where the cancer develops and how it spreads.
Oral cavity:

• One can observe formation of white or red colored patch on the gums, the tongue, or the lining of the mouth.
• Swelling of the jaw and unusual bleeding or pain in the mouth.

Pharynx:Cancer cells form in the tissues of the larynx causing laryngeal cancer. Symptoms of laryngeal cancer include:

• You may face trouble in breathing or speaking and hearing.
• Also suffer pain when swallowing, pain in the neck or the throat that does not go away.
• Frequent headaches or ringing in the ears or trouble hearing.

Larynx:

• A sore throat or a cough that does not go away.
• Trouble or pain when swallowing.
• Ear pain.
• A lump in the neck or throat.
• A change or hoarseness in the voice.

Paranasal sinuses and nasal cavity:

• Blocked sinuses, chronic sinus infections that do not respond to treatment with antibiotics.
• Bleeding through the nose, frequent headaches, swelling or problems with the eyes.
• Pain in the upper teeth or problems with dentures.

Salivary glands:

• One can sign swelling under the chin or around the jawbone.
• Numbness or paralysis of the muscles in the face.
• Pain in the face, the chin, or the neck.

Other symptoms:Unexplained weight loss, frequent coughing, change in voice or hoarseness, double vision, blood in the saliva or phlegm, which is mucus discharged into the mouth from respiratory passages and loosening of teeth.

RISK FACTORS FOR HEAD AND NECK CANCER

• Tobacco Use
• Alcohol Use
• Prolonged sun exposure
• Human papillomavirus (HPV) infection
• Epstein-Barr virus (EBV) infection
• Poor oral and dental hygiene
• Gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux disease (LPRD)
• Marijuana use
• Environmental or occupational inhalants
• Weakened immune system
• Gender : Men are 2 to 3 times more prone to develop H&N cancer

Diagnosis

To diagnose the reason of the signs or symptoms of a problem in the head and neck area, your doctor assesses the medical history, performs a physical examination, and orders other diagnostic tests. The exams and tests may vary depending on the symptoms of the patient.

Microscopic examination of the tissue sample is always necessary to confirm a diagnosis of cancer. Your doctor considers below factors when choosing a diagnostic test:

• The type of cancer suspected
• Your signs and symptoms
• Your age and medical condition
• The results of earlier medical tests

Doctor may order lab tests, scans, or other tests or procedures. Below are the general tests helpful for the diagnosis of any type of cancer.

Lab Tests: Levels of certain substances in the body can be a sign of a cancer. Hence, your doctor may ask for blood, urine or other fluid tests. But, the doctor may ask for further tests such as:

1. Imaging Procedures: Imaging procedures help in creating images of areas inside the body. This helps the doctor in the visualization of the tumor. Imaging can be done using CT scan, nuclear scan, ultrasound, MRI, PET scan and X-rays.
2. Biopsy: In many cases, the doctor may advise a biopsy test for diagnosing cancer. A biopsy is a procedure in which a sample of tissue is removed and sent for pathological examination. Biopsy can be done using a simple needle, endoscope or a surgery.
3. Staging: If the person is diagnosed with cancer, the doctor will want to learn the stage of disease. Staging is performed to find out whether the cancer has spread and, if so, to which parts of the body. Staging may include an examination under anesthesia (in an operating room), x-rays and other imaging procedures and laboratory tests. Knowing the stage of the disease helps the doctor to plan the treatment.

TREATMENT OPTIONS

The treatment plan depends upon location of the tumor, stage of the cancer and the person's age and general health condition.

Options used for the treatment of H&N cancer are:

• Surgery
• Radiation
• Chemotherapy
• Targeted therapies
• Combination treatments.

Why BSR Hospital?

BSR ENT hospital is one of the renowned ENT Specialist Hospitals in Hyderabad and Secunderabad and well-known for its team of expert and experienced surgeons with a proven track record of successful surgeries. The experienced and highly qualified doctors at BSR are skilled to provide the best treatment with high success rate, since 40 years.

The latest technologies and the equipment further support the vision of BSR to provide the best in class treatment facilities to patients. Our in-house Clinical and Biochemical Laboratory/Radiology help in quick diagnosis and treatment making it convenient for our patients. We at BSR believe in patient-centric treatment and ensure that every patient receives cost effective treatment with the finest quality.