Head and Neck

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What is Head & Neck Cancer?

Head & neck cancer is a group of cancers that are detected in the areas such as mouth, nose, throat, larynx, sinuses, and salivary glands. Cancers of the brain and eyes are usually not classified under this type of cancer.

Causes & Risk Factors​

Risk factors for head & neck cancers include:

  • Smoking
  • Alcohol or tobacco use
  • Radiation exposure
  • Poor oral health
  • Human Papillomavirus (HPV) infection
  • Family history of nasopharyngeal cancer (NPC)

Symptoms​

Generally, individuals with cancer in the head and neck may see signs such as a lump or sore throat that does not go away, difficulty swallowing, or hoarseness in voice. Other symptoms depend on the location of the cancer – symptoms that affect the specific parts of the head and neck can include:

AreaSymptoms
Ears
  • Ear pain
  • Hearing loss
  • Tinnitus
Mouth
  • Tumour/growth
  • Ulcer or ulcers that do not go away
  • Change in voice
  • Impaired tongue mobility
  • Teeth pain
  • Sore gums
  • Loose teeth
  • Difficulty opening the mouth
  • Swelling in jaw
Neck
  • Neck lump(s)
Nose
  • Blocked nose
  • Reduced sense of smell
  • Nasal discharge
  • Nasal blockage
  • Unexplained nosebleeds
  • Chronic sinus infections
Skin
  • An ulcer that does not heal
  • New mole(s)
  • New skin nodule(s)
Throat
  • Persistent sore throat
  • Hoarseness
  • Pain when swallowing
Others
  • Frequent headaches
  • Facial numbness, paralysis or pain
  • Swelling under the chin or around the jawbone

 

Please note that these symptoms are not always due to cancer, and may be caused by other underlying health issues. However, should you experience any symptoms, and they last for long periods or intensify with time, do make an appointment to be screened as soon as you can.

Stages​

The stages for each type of cancer deviate. Generally, the stages for head and neck cancers are as follows:

Stages 1 and 2: The cancer is considered to be at its early stages, and a single modality of treatment is usually sufficient.

Stages 3 and 4: Classified as cancer in advanced stages, multiple treatment modalities are required.

Screening & Diagnosis​

Regular screening may help in early detection of cancer. During screening, the doctor may order one or more of the following imaging tests to determine if a patient has cancer, and the severity or stage of the cancer:

Fine Needle Aspiration Cytology (FNAC)
Cells are extracted using a needle for testing, or from lymph node if tumour is deep.

Nasopharyngolaryngoscopy
Using an endoscope, a flexible and lighted tube, attached to a camera and inserted into a patient’s mouth or nose, the doctor takes pictures to further examine the abnormal cells.

Biopsy (extraction of tissue sample)
When the suspected cancerous tissue is located in a place that is difficult to reach, the doctor may suggest doing a biopsy, which involves making a small cut in the suspected area to extract samples.

Imaging Tests
These tests, which include X-Rays, MRI, CT and PET scans, can detect any abnormal mass in the head and neck regions. Some examples of tests are Head MRI, CT scan of the sinuses, CT scan of the head, Panoramic Dental X-Ray and Dental Cone Beam CT.

Bone Scan
A radioactive tracer looks at the inside of the bones – it is injected into a patient’s vein. Detected with a special camera, the tracer can show doctors if the cancer has spread to the bones.

Treatment​

The doctor will recommend treatment based on the type of cancer, as well as its size, location, growth rate, and patient’s general state of health. The cancer can then be treated via one or a combination of these treatments:

  • Chemotherapy to shrink or kill the cancer cells
  • Radiation therapy to destroy cancer cells
  • Surgery to remove tumours