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.
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The exams and tests conducted may vary depending on the symptoms. Examination of a sample of tissue under the microscope is always necessary to confirm a diagnosis of cancer :
- Urine and blood test /Physical examination : Lumps in the cheeks, lips, neck and gums are examined by performing a physical examination of a patient. Abnormalities are also noticed by inspecting throat, nose, tongue and mouth. Cancer can be diagnosed by performing urine and blood tests.
- Endoscopy :It is the use of a thin, lighted tube called an endoscope to examine areas inside the body. The type of endoscope the Surgical Oncologist uses depends on the area being examined. For example, a laryngoscope is inserted through the mouth to view the larynx; an esophagoscope is inserted through the mouth to examine the esophagus; and a nasopharyngoscope is inserted through the nose so that the surgical oncologist can see the nasal cavity and nasopharynx.
- Laboratory tests : examine samples of blood, urine, or other substances from the body.
- X-ray : This helps in creating pictures of the structures within the body by using little radiation. The abnormalities of the swallowing passage can be identified by a barium swallow.
- CT scan : A series of detailed pictures of areas inside the head and neck created by a computer linked to an x-ray machine.
- Magnetic Resonance Imaging (MRI) : The detailed images of the body that include base of the tongue and the tonsils are produced by performing an MRI that makes use of magnetic fields.
- PET scan : PET scan uses sugar that is modified in a specific way so it is absorbed by cancer calls and appears as dark areas on the scan.
- Biopsy : A small amount of tissue is removed for examining under a microscope for diagnosing head and neck cancer.
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Chemotherapy, surgery and radiation therapy are the three main types of treatment for administering head and neck cancer. Surgery or radiation therapy is considered as the primary treatments while chemotherapy is usually used as an adjuvant or additional treatment. Primary cancer can be easily treated with the help of radiation therapy. Radiation therapy can also effectively treat the neck. A neck dissection is also sometimes necessary for removing involved lymph nodes in the neck when the amount of disease in the neck nodes is very wide.
Surgery is considered as a very important treatment that can be done either before or after the radiation therapy. Radiation therapy is given afterward when it is necessary to remove the primary tumor surgically. The tumor is first tried to shrink by using radiotherapy and surgery is followed by radiotherapy.
Following radiation therapy procedures are used for treating head and neck cancer :
- Intensity-Modulated Radiation Therapy (IMRT):The specific areas inside the tumor or malignant tumors are targeted by this high-precision radiotherapy that makes use of computer-controlled x-ray accelerators that delivers precise radiation doses. The high intensity radiation beam is focused on the tumor so as to damage it without disturbing any surrounding healthy cells.
- External Beam Therapy (EBT) : Through this therapy, a high-energy beam x-rays are delivered at the location of the tumor. The tumor site is the target of this beam and it can destroy cancer cells while sparing nearby healthy tissues. There is no placement of radioactive sources in the body of a patient.
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