CANCER OF THE HEAD
AND NECK
Definition of head and neck cancer:
Cancer that arises in the head or neck region (in the
nasal cavity, sinuses, lips, mouth, salivary glands,
throat, or larynx [voice box]).
Most head and neck cancers begin in the cells that
line the mucosal surfaces in the head and neck area,
e.g., mouth, nose, and throat. Mucosal surfaces are moist
tissues lining hollow organs and cavities of the body
open to the environment. Normal mucosal cells look like
scales (squamous) under the microscope, so head and neck
cancers are often referred to as squamous cell carcinomas.
Some head and neck cancers begin in other types of cells.
For example, cancers that begin in glandular cells are
called adenocarcinomas.
Cancers of the head and neck are further identified
by the area in which they begin:
- Oral cavity. The oral cavity includes
the lips, the front two-thirds of the tongue, the gingiva
(gums), the buccal mucosa (lining inside the cheeks
and lips), the floor (bottom) of the mouth under the
tongue, the hard palate (bony top of the mouth), and
the small area behind the wisdom teeth.
- Salivary
glands. The salivary glands produce saliva,
the fluid that keeps mucosal surfaces in the mouth
and throat moist. There are many salivary glands; the
major ones are in the floor of the mouth, and near
the jawbone.
- Paranasal
sinuses and nasal cavity. The paranasal
sinuses are small hollow spaces in the bones of the
head surrounding the nose. The nasal cavity is the
hollow space inside the nose.
- Pharynx. The
pharynx is a hollow tube about 5 inches long that starts
behind the nose and leads to the esophagus (the tube
that goes to the stomach) and the trachea (the tube
that goes to the lungs). The pharynx has three parts:
Nasopharynx. The nasopharynx, the upper part of the
pharynx, is behind the nose.
Oropharynx. The oropharynx is the middle part of
the pharynx. The oropharynx includes the soft palate
(the back of the mouth), the base of the tongue,
and the tonsils.
Hypopharynx. The hypopharynx
is the lower part of the pharynx.
- Larynx. The larynx, also called
the voicebox, is a short passageway formed by cartilage
just below the pharynx in the neck. The larynx contains
the vocal cords. It also has a small piece of tissue,
called the epiglottis, which moves to cover the larynx
to prevent food from entering the air passages.
- Lymph nodes
in the upper part of the neck. Sometimes, squamous cancer cells are found
in the lymph nodes of the upper neck when there is
no evidence of cancer in other parts of the head and
neck. When this happens, the cancer is called metastatic
squamous neck cancer with unknown (occult) primary.
Cancers of the brain, eye, and thyroid as well as those
of the scalp, skin, muscles, and bones of the head and
neck are not usually grouped with cancers of the head
and neck.
Head and neck cancers account for approximately 3 to
5 percent of all cancers in the United States. These
cancers are more common in men and in people over age
50. It is estimated that about 39,000 men and women in
this country will develop head and neck cancer in 2005.
Tobacco (including smokeless tobacco, sometimes called
“chewing tobacco” or “snuff”) and alcohol use are the
most important risk factors for head and neck cancers,
particularly those of the oral cavity, oropharynx, hypopharynx,
and larynx. Eighty-five percent of head and neck cancers
are linked to tobacco use. People who use both tobacco
and alcohol are at greater risk for developing these
cancers than people who use either tobacco or alcohol
alone.
Other risk factors for cancers of the head and neck
include the following:
- Oral
cavity. Sun exposure (lip);
possibly human papillomavirus (HPV) infection.
- Salivary
glands. Radiation to the head and neck. This exposure
can come from diagnostic x-rays or from radiation therapy
for noncancerous conditions or cancer.
- Paranasal
sinuses and nasal cavity.
Certain industrial exposures, such as wood or nickel
dust inhalation. Tobacco and alcohol use may play less
of a role in this type of cancer.
- Nasopharynx.
Asian, particularly Chinese, ancestry; Epstein-Barr
virus infection; occupational exposure to wood dust;
and consumption of certain preservatives or salted
foods.
- Oropharynx. Poor oral hygiene;
HPV infection and the use of mouthwash that has a high
alcohol content are possible, but not proven, risk
factors.
- Hypopharynx. Plummer-Vinson (also
called Paterson-Kelly) syndrome, a rare disorder that
results from iron and other nutritional deficiencies.
This syndrome is characterized by severe anemia and
leads to difficulty swallowing due to webs of tissue
that grow across the upper part of the esophagus.
- Larynx. Exposure to airborne particles
of asbestos, especially in the workplace.
Immigrants from Southeast Asia who use paan (betel quid)
in the mouth should be aware that this habit has been
strongly associated with an increased risk for oral cancer.
Also, consumption of mate, a tea-like beverage habitually
consumed by South Americans, has been associated with
an increased risk of cancers of the mouth, throat, esophagus,
and larynx.
People who are at risk for head and neck cancers should
talk with their doctor about ways they can reduce their
risk. They should also discuss how often to have checkups.
Symptoms of several head and neck cancer sites include
a lump or sore that does not heal, a sore throat that
does not go away, difficulty swallowing, and a change
or hoarseness in the voice. Other symptoms may include
the following:
- Oral cavity. A white or red patch
on the gums, tongue, or lining of the mouth; a swelling
of the jaw that causes dentures to fit poorly or become
uncomfortable; and unusual bleeding or pain in the
mouth.
- Nasal cavity
and sinuses. Sinuses
that are blocked and do not clear, chronic sinus infections
that do not respond to treatment with antibiotics,
bleeding through the nose, frequent headaches, swelling
or other trouble with the eyes, pain in the upper teeth,
or problems with dentures.
- Salivary
glands. Swelling under
the chin or around the jawbone; numbness or paralysis
of the muscles in the face; or pain that does not go
away in the face, chin, or neck. Oropharynx and hypopharynx.
Ear pain.
- Nasopharynx. Trouble breathing
or speaking, frequent headaches, pain or ringing in
the ears, or trouble hearing.
- Larynx. Pain when swallowing, or
ear pain.
- Metastatic
squamous neck cancer.
Pain in the neck or throat that does not go away.
These symptoms may be caused by cancer or by other,
less serious conditions. It is important to check with
a doctor or dentist about any of these symptoms.
To learn more about Cancers of the
head and neck please visit the NCI website: click here
(Source: NCI)
RESOURCES
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public and health professionals. To get to the ACS
unterine cancer information pages please
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is the world's largest organization representing specialists
who treat the ear, nose, throat, and related structures
of the head and neck. To visit their website please
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