What is Head and Neck Cancer?
The term head and neck cancer encompasses a variety of malignant tumors affecting the nose, sinuses, mouth, throat, neck, thyroid and skin. Each head and neck cancer is unique and requires individualized treatment. In the U.S., these account for about 4 percent of all new cancer diagnoses. Generally, men are more than twice as likely to be affected. Also, these cancers are more frequently found in people over the age of 50.
Several risk factors have been strongly linked to head and neck cancers. They include:
- Alcohol and tobacco: People who smoke cigarettes, use smokeless tobacco (chewing tobacco or “snuff”), or are chronically exposed to secondhand smoke are at the highest risk. People who use both alcohol and tobacco are at greater risk than those who use either alone.
- Human papillomavirus (HPV): HPV is a sexually transmitted viral infection that can infect the back of the throat (oropharynx), tonsils, anus and genitals. More than 70 percent of oropharyngeal cancer cases in the U.S. are linked to HPV infections.
- Occupational factors: Exposure to certain chemicals such as wood dust, asbestos, nickel or formaldehyde have been linked to head and neck cancers.
- Betel quid: Chewing the seed of the fruit of the areca palm has been strongly linked to cheek (buccal) cancer.
- Ancestry: There is an increased risk of developing cancer in the back of the nose (nasopharyngeal) for people of Southeast Asian ancestry.
- Radiation: History of radiation exposure to the head and neck increases risk, particularly for thyroid cancer.
Affected Body Parts
This cancer can affect many areas of the head and neck and may sometimes spread to multiple sites. These areas include:
- Mouth (oral cavity): Tumors may appear as ulcers or sores on the tongue, gums, palate or lips.
- Throat (pharynx): Tumors may involve any of the three sections of the throat, including the nasopharynx, oropharynx (tonsils and back of tongue) and hypopharynx.
- Voice box (larynx): This includes the vocal cords and surrounding structures.
- Nasal cavity and sinuses: Tumors can afflict the inside of the nose or the air-filled spaces inside the skull. Advanced tumors may also involve the eyes or brain.
- Salivary glands: Tumors can affect the major saliva glands of the cheeks and under the jaw or any of the hundreds of tiny glands lining the mouth and throat.
- Thyroid: Cancers of the thyroid are relatively common. Individuals with a family history or history of radiation are at higher risk.
- Skin: Various types of cancers can affect the skin of the scalp, face, ears and neck.
- Lymph Nodes: Tumors here are typically the result of cancer spreading from another location. There are more than 100 lymph nodes throughout the face and neck.
Symptoms of head and neck cancer include:
- Ulcer or sore in the mouth, throat or skin that lasts several weeks or months
- Loose teeth or ill-fitting dentures
- Bleeding from the mouth, nose or spots on the skin
- Difficulty or painful swallowing
- Voice changes
- Neck mass or swelling
- Difficulty breathing
- Facial paralysis or numbness
- One-sided ear pain that does not go away
- Unexplained weight loss
Many of these cancers will be detected by a head and neck surgeon during a comprehensive exam or with the help of a small camera in the clinic. Others, however, may need specialized tests and procedures for diagnosis. A biopsy of the cancer is required to confirm the correct diagnosis. Sometimes biopsies can be done in the clinic, but an additional procedure may be required. Your team may also order additional tests (including imaging and blood work) to complete a comprehensive cancer workup.
Our priority in treating your cancer is to achieve the best possible outcome while also helping you maintain the best quality of life possible. Your cancer care team will design a customized treatment plan for your specific cancer type and treatment goals.
Our team approach pulls together the expertise and special training of head and neck surgeons, medical oncologists, radiation oncologists, plastic surgeons, dental oncologists, speech and language pathologists, physical therapists and others. They will work to not only remove your cancer, but also maintain or restore your appearance, facial structure and functions such as speech, eating, and hearing.
Treatment often starts with surgery. Whenever possible, our four fellowship-trained head and neck cancer surgeons use the latest minimally invasive technologies, including trans-oral robotic surgery, laser-assisted surgery, endoscopic surgery and sentinel lymph node biopsy. When tumors are more advanced, we offer specialized reconstruction in partnership with our head and neck plastic and reconstructive surgeons to rebuild what has been destroyed by the cancer. Some patients will need surgery combined with radiation and/or anti-cancer medications to fully treat their cancer.
Radiation is used to target cancers that are difficult to reach. This treatment may be combined with surgery to ensure destruction of tumor cells. Our radiation oncologists use advanced technologies, including intensity-modulated radiation therapy (IMRT) and proton therapy, to precisely target tumors within the small spaces of the head and neck. This protects healthy tissue from the effects of radiation, allowing you to recover faster. Orlando Health Cancer Institute is the only proton center in Central Florida offering this advanced treatment.
Our medical oncologists use the latest evidence to select the best medications to treat your specific type of head and neck cancer. Orlando Health offers many locations throughout the Orlando region where you can receive infusions closer to home.
- Chemotherapy: These medications destroy cancer cells by stopping them from growing and dividing.
- Immunotherapy: This boosts your immune system and prompts it to attack cancer cells.
- Targeted therapy: These treatments target specific genetic changes (mutations) in cancer cells to slow their growth.
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