Cancer of Head and Neck

“Head and neck cancer” describes a number of different malignant tumors that develop in or around the throat, larynx, nose, sinuses, and mouth.

Most head and neck cancers are squamous cell carcinomas. They begin in flat squamous cells of the different sites.  

Carcinoma in situ. —

If a cancer is only found in the squamous layer of cells (epithelium

Invasive squamous cell carcinoma –

If the cancer has grown beyond this cell layer and moved into the deeper tissue. 

Cancer of unknown primary –

If doctors cannot identify where the cancer began. 

If a head and neck cancer starts in the salivary glands (see below), the tumor will usually be classified as an adenocarcinoma, adenoid cystic carcinoma, or mucoepidermoid carcinoma.

Types of head and neck cancer

There are 5 major types of head and neck cancer, named according to the part of the body where they originate. 

• Laryngeal and hypopharyngeal cancer. The larynx is commonly called the voice box. This tube-shaped organ in the neck is important for breathing, talking, and swallowing. It is located at the top of the windpipe, or trachea. The hypopharynx is also called the gullet. It is the lower part of the throat that surrounds the larynx. 
• Nasal cavity and paranasal sinus cancer. The nasal cavity is the space just behind the nose where air passes on its way to the throat. The paranasal sinuses are the air-filled areas that surround the nasal cavity.  
• Nasopharyngeal cancer. The nasopharynx is the air passageway at the upper part of the throat behind the nose. Oral and oropharyngeal cancer. The oral cavity includes the mouth and tongue. The oropharynx includes the middle of the throat, from the tonsils to the tip of the voice box.  
• Salivary gland cancer. The salivary gland produces saliva. Saliva is the fluid that is released into the mouth to keep it moist and that contains enzymes that begin breaking down food. 

RISK FACTORS OF HEAD AND NECK CANCERS—

 There are 2 substances that greatly increase the risk of developing a head and neck cancer:

• Tobacco- includes smoking cigarettes, cigars, or pipes; chewing tobacco; and using snuff. It is the single largest risk factor for head and neck cancer. Researchers estimate that 70% to 80% of head and neck cancers are linked to tobacco use, and the amount of tobacco use may affect the chance of recovery. Second Hand Smoking OR Passive Smoking  may increase a person’s risk of developing head and neck cancer.
• Alcohol. Frequent and heavy consumption raises the risk of developing cancer in the mouth, pharynx, larynx, and esophagus.

Using alcohol and tobacco together increases this risk even more.

• Human papillomavirus (HPV). Research shows that infection with HPV is a risk factor for head and neck cancer. Sexual activity with a person who has HPV is the most common way someone gets HPV. There are different types of HPV, called strains. 
• Epstein-Barr virus (EBV). Exposure to EBV, which is more commonly known as the virus that causes mononucleosis or “mono,” plays a role in the development of nasopharyngeal cancer.
• Gender. Men are 2 to 3 times more likely than women to develop head and neck cancer. However, the rate of head and neck cancer in women has been rising for several decades.
• Age. People over the age of 40 are at higher risk for head and neck cancer.
• Poor oral and dental hygiene. Poor care of the mouth and teeth may increase the risk of head and neck cancer.
• Environmental or occupational inhalants. Inhaling asbestos, wood dust, paint fumes, and certain chemicals may increase a person’s risk of head and neck cancer.
• Marijuana use. Research suggests that people who have used marijuana may be at higher risk for head and neck cancer.
• Poor nutrition. A diet low in vitamins A and B can raise a person’s risk of head and neck cancer.
• Gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux disease (LPRD). Reflux of stomach acid into the upper airway and throat may be associated with the development of head and neck cancer.
• Weakened immune system. A weakened immune system can raise a person’s risk of head and neck cancer.
• Exposure to radiation. Exposure to radiation is associated with salivary gland cancer.
• Previous history of head and neck cancer. People who have had 1 head and neck cancer have a higher chance of developing another head and neck cancer in the future.

PREVENTION

Although there is no proven way to completely prevent this disease, you may be able to lower your risk. 

• Stopping the use of all tobacco products is the most important thing a person can do to reduce their risk, even for people who have been smoking for many years. Other steps that can reduce the risk of head and neck cancer include:

• Avoiding alcohol
• Reducing your risk of HPV infection is also important. HPV exposure can be limited by reducing your number of sexual partners and using barrier methods of contraception during sex.
• Maintaining proper care of dentures. Poorly fitting dentures can trap tobacco and alcohol’s cancer-causing substances. People who wear dentures should have their dentures evaluated by a dentist at least every 5 years to ensure a good fit. Dentures should be removed every night and cleaned and rinsed thoroughly every day.

Head and Neck Cancer: Symptoms and Signs

Sometimes, people with head and neck cancer do not have any of the symptoms and signs described below. Or, the cause of a symptom or sign may be a medical condition that is not cancer.