Head and neck cancers are those that grow in and around the throat, larynx, nose, sinuses and mouth. The majority of these cancers are squamous cell carcinomas that form in the cells lining the mucosal surfaces of the head and neck. They often spread to the lymph nodes, but are highly curable if discovered early.
Head and neck cancers are classified according to the area in the body where they form. They include:
- Larynx. Also known as the voice box, this is a tube-shaped organ in the neck containing the vocal cords. It helps us speak, swallow, and breathe.
- Oral cavity. This includes the lips, tongue, gums, and mouth.
- Salivary glands. These glands produce saliva to keep food moist and help break it down.
- Pharynx. This hollow tube begins behind the nose and leads to the esophagus and trachea.
- Nasal cavity. These are the hollow spaces in the bones around the nose, where air passes on the way to the throat.
Other cancers can form in this part of the body (brain tumors, esophageal cancer, thyroid cancer, etc.) but these behave very differently and are not classified as heck and neck cancers.
Causes of Head & Neck Cancer
The biggest risk factors for head and neck cancers are tobacco (both cigarettes and chewing tobacco) and alcohol, especially when used together. 85 percent of head and neck cancers are linked to tobacco. Other risk factors include exposure to industrial toxins (e.g., wood dust, paint fumes), dietary factors, human papillomavirus, Epstein-Barr virus, gastroesophageal reflux disease (GERD), asbestos exposure and radiation.
Certain ethnic groups (particularly Chinese) are more vulnerable, as are those from Southeast Asia who chew betel nut, and South Americans who drink mate, a beverage similar to tea.
Symptoms of Head & Neck Cancer
Symptoms of head and neck cancers are similar to those associated with other conditions and may seem harmless at first. Common signs include a lump or sore that doesn’t heal, persistent sore throat, difficulty swallowing and hoarseness.
Other symptoms you may experience: bleeding from the mouth, swelling of the jaw, frequent congestion, sinus infections that don’t respond to treatment, headaches, earaches, facial numbness or paralysis, enlarged lymph nodes and an unexplained loss of weight.
Treatment for Head & Neck Cancer
Treatment depends upon several factors. The size and location of the tumor, its stage, and your age and health must all be taken into consideration. Our team at Midwest Ear, Nose & Throat Specialists will make a decision based on these unique factors. Options might include surgery, radiation therapy, chemotherapy, targeted therapy or a combination of the above.
Head & Neck Masses
A number of masses may develop in your head or neck; these masses may also be called growths, tumors, lumps or bumps. While some head and neck masses are cancerous, many are not. It is important to see a physician if any abnormal bump or lump persists for more than two weeks. If a cancer is present, early detection provides the highest chance of successful treatment.
There are numerous causes of head and neck masses:
Enlargement of lymph nodes
This is the most common cause of new neck masses. Lymph nodes, which are part of the immune system, can enlarge when the body rallies to fight an infection. When the infection recedes, lymph swelling subsides as well.
Benign masses do not spread to surrounding tissue and are not cancerous. Nevertheless, benign masses can be serious if they impact nerves or exert pressure in the head and neck, and are often removed surgically. These include cysts, thyroid masses, vascular masses, salivary gland masses and others.
When head and neck masses are malignant they can spread to surrounding tissue or to other parts of the body. In the head and neck, tumors may be either primary or secondary.
Primary tumors originate in the head or neck itself, including the thyroid, throat, larynx, salivary gland, brain or other locations. Primary tumors of the head and neck typically spread to the lymph nodes in the neck.
About 90 percent of head and neck cancers are caused by tobacco and alcohol use. People who have been exposed to radiation, either during medical treatments as children (common in decades past) or from nuclear radiation sources, are at considerable risk for thyroid cancer and should be screened yearly.
Secondary cancers are tumors that have spread from primary tumors in other parts of the body to the head or neck. Most often, secondary tumors of the neck originate in the lung, breast, kidney or from skin cancers (squamous cell carcinoma or melanoma).
Symptoms of Head & Neck Masses
You should see your physician if you experience any of the following symptoms:
- Lump in the neck persisting for more than two weeks, especially if it is not associated with a cold, flu or other infection.
- Change in your voice including hoarseness that persists more than two weeks.
- Growth in the mouth.
- Swollen tongue.
- Blood in the saliva or phlegm.
- Swallowing problems.
- Persistent ear pain or ear pain while swallowing – may be a symptom of infection or a growth in the throat.
- Unexplained weight loss.
Treatment for Head & Neck Masses
A simple examination of some masses may allow a physician to determine their cause based on location, size and consistency. In other cases, additional tests may be required. These tests include:
- MRI: Magnetic Resonance Imaging can clearly show tumors near bones, smaller tumors and brainstem masses. It uses a magnetic field rather than x-ray radiation.
- CT Scan: Computed Tomography combines a sophisticated x-ray with computer technology. It is less accurate than an MRI but can help locate tumors or determine their types, detect swelling or bleeding and evaluate the effects of treatments. Injections of an iodine dye contrast material may be used to enhance the visibility of abnormal tissue during CT scans.
- PET (Positron Emission Tomography) and SPECT (Single Photon Emission Tomography): are useful after diagnosis to help determine the grade of a tumor or to distinguish between cancerous and dead scar tissue. They involve injections with a radioactive tracer.
- Biopsy: A sample of tissue is taken and examined under a microscope to determine if it is malignant.
Treatments are determined by the cause of the mass. Benign neck cysts and masses are usually removed by surgical excision. Head and neck cancers may be treated by some combination of radiation therapy, chemotherapy and surgery, depending on their nature.