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 assquamous cell carcinomas. Some head and neck cancers begin in other types of cells. For example, cancers that begin in glandular cells are called adenocarcinomas.
• Nasaopharyngeal Cancer :The nasopharynx is the airway passageway at the upper part of the nose at the back of the nose.
• Salivary Gland Cancer : Saliva produced by the salivary gland is the fluid that is released within the mouth in order to keep the mouth moist. Mouth helps in breaking down the food as it contains certain enzymes
• Hypopharyngeal and Laryngeal Cancer : A tube shaped organ located in the neck used for swallowing, breathing and talking is the larynx. The hypopharnx, also referred to as gullet, is the lower part of the throat surrounding the larynx.
• Oropharyngeal and Oral Cancer : Both tongue and the mouth is included in the oral cavity. The middle part of the throat is included in oropharynx.
• Paranasal Sinus and Nasal Cavity Cancer : The air-filled areas surrounding the nasal cavity is known as the paranasal sinuses. The space at the back of the nose from where air passes on the way to the throat is known as the nasal cavity.
If a person has symptoms and signs of head and neck cancer, the doctor will take a complete medical history, noting all symptoms and risk factors. In addition, the following tests may be used to diagnose head and neck cancer:
• Physical exam. The doctor will feel your neck and check yourthyroid, larynx, and lymph nodes for abnormal lumps or swelling. To see your throat, the doctor may press down on your tongue.
• Indirect laryngoscopy. The doctor looks down your throat using a small, long-handled mirror to check for abnormal areas and to see if your vocal cords move as they should. This test does not hurt. The doctor may spray a local anesthesia in your throat to keep you from gagging. This exam is done in the doctor's office.
• Direct laryngoscopy. The doctor inserts a thin, lighted tube called a laryngoscope through your nose or mouth. As the tube goes down your throat, the doctor can look at areas that cannot be seen with a mirror. A local anesthetic eases discomfort and prevents gagging. You may also receive a mild sedative to help you relax. Sometimes the doctor uses general anesthesia to put a person to sleep. This exam may be done in a doctor's office, an outpatient clinic, or a hospital.
• CT scan. An x-ray machine linked to a computer takes a series of detailed pictures of the neck area. You may receive an injection of a special dye so your larynx shows up clearly in the pictures. From the CT scan, the doctor may see tumors in your larynx or elsewhere in your neck.
Each and every Head and Neck cancer patient is evaluated by a special team of surgical oncologists (Head & Neck unit), medical oncologists, Radiation Oncologists, Onco-pathologists and Imaging Specialists. Depending on the age, general condition, type of pathology and stage of the disease
Treatment Available for Head and Neck Cancers
The treatment plan for an individual patient depends on a number of factors, including the exact location of the tumor, the stage of the cancer, and the person's age and general health. The patient and the surgical oncologist should consider treatment options carefully. They should discuss each type of treatment and how it might change the way the patient looks, talks, eats, or breathes.
Surgery is one of the main treatments for mouth, head and neck cancers. The aim of surgery is to remove the cancer cells. If the cancer is found early, surgery can often cure it. Depending on where the tumour is found, your surgeon may need to remove skin, muscle or bone along with your cancer. This can be replaced by skin or muscle or prosthesis. Surgery may also affect how you eat or drink or how you look. A plastic surgeon might also work with your surgeon to reconstruct the affected area to give you the best possible function and appearance. This is called reconstructive surgery.
Radiotherapy is the use of high-energy rays to kill or shrink the cancer cells. Radiotherapy can be used alone or with other treatments like surgery or chemotherapy. If given after surgery, it can destroy any cancer cells left behind. There are two main ways to give radiotherapy: external beam radiation and internal radiation.
External beam radiation aims high-energy X-rays at a cancer to cure or control it. These X-rays come from a machine called a linear accelerator. The treatment does not hurt but you must lie very still during it. For most mouth, head and neck cancers, a ‘mask’ is needed. These masks are moulded from plastic to the shape of your face and make sure your head keeps still during treatment.
Internal radiotherapy involves giving radiotherapy from within your body. Usually an implant containing a source of radiation is put directly into the tumour and left in place for several days. It will release radiation and kill the cancer cells. Internal radiotherapy is also known as brachytherapy. The implant is usually put in under general anaesthetic.
Chemotherapy is the use of drugs to cure or control cancer. Chemotherapy drugs can be given on their own or with each other. Chemotherapy can also be given before or after radiotherapy and surgery. The drugs are either injected into the bloodstream or given in tablet form. Your doctor will decide the type and dose of your chemotherapy based on the size and location of the tumour, if it has spread, and your general health. Some drugs used for mouth, head and neck cancer are carboplatin and Taxol. See the booklet Understanding Chemotherapy, which you can download from our "Important cancer information booklets" list on the right hand side of this page, for more information about chemotherapy.
Biological therapies are drugs that block the growth of cancer cells by interfering with molecules needed for the cancer to grow. Unlike chemotherapy, biological therapy can tell the difference between cancer cells and normal cells. Biological therapy can be given on its own or with chemotherapy drugs.
Minimally invasive surgical techniques are used when possible to remove tumors that are located near structures involved in sensory and physical functioning. In many cases, patients can recover more quickly when treated with minimally invasive surgery compared with traditional, open surgery.
• Endoscopic Laser Surgery :This technique may be used to remove tumors in the larynx or pharynx (throat) while preserving the structures involved in speech and swallowing. The surgeon inserts a thin, lighted tube called an endoscope through the patient's mouth and into the throat. Surgeons remove the tumor using a special laser that is attached to the endoscope. Endoscopic laser surgery is often performed on an outpatient basis with a safe, fast-acting anesthetic that wears off quickly after the procedure.
• Minimally Invasive Video-Assisted Thyroidectomy (MIVAT): A tiny video camera that is attached to an endoscope is used to remove thyroid tumors through a small incision.
• Robotic Surgery : Tumors of the tongue and tonsils can be removed with the aid of small robotic arms that are placed in the mouth, avoiding the need to make a large incision or to split the jawbone.
You may want to ask some questions before your treatment begins:
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