Head and neck cancers refer to a broad umbrella term covering malignancies that arise within nose and sinuses, oral cavity (mouth), pharynx (throat), larynx (voice box) and salivary glands. Some authorities would also include skin cancers that arise in the face, head and neck regions especially when they spread to the neck lymph nodes or salivary glands in this category. Cancers of the thyroid, although within the head and neck region, are a distinct entitiy and hence is covered elsewhere.
These cancers can be classified according to the tissue of origin, so those arising out of lining tissue such as mucous membranes or skin are called carcinomas, those arising out of connective tissues are called sarcomas and those arising within lymph tissues are lymphomas.
The key patient presentations of head and neck mucosal carcinomas are features such as non-healing ulcers/sores of the mouth or throat, white patches that persist in the mouth, persistent sore throat, difficulty swallowing, persistent hoarse voice, deep seated ear pain, unexplained nose bleeds, unexplained facial pain or numbness as well as a persistent lymph node (gland) in the neck, which is a very sinister sign. Smoking, excess alcohol intake, immune suppression, a family history are all risk factors. There is an increasing evidence of the role of the human papilloma virus (HPV) in head and neck cancers in non-smokers.
Once your treating doctor is suspicious, a full comprehensive ear, nose, throat and head and neck examination including fibreoptic endoscopy would be performed by your specialist. This will be done with you awake under local anaesthetic and does not couse any significant discomfort.
If any suspicious signs are then detected, a biopsy and imaging (CT scans or ultrasound) would often be required.
If a cancer is indeed diagnosed, your specialist should treat them within a multi-disciplinary team that comprises of surgeons, oncologists, dentists and allied health profesionals as well as specialist cancer nurses. These specialist teams are available within large teaching hospitals and have expertise, experience and interest in the treatment of your cancer and will ensure the state of the art care is made available. If your specialist is not part of such a team, then a referral will be made to one of the cancer networks to handle your care.
The treatment required would often include surgery, radiotherapy or chemotherapy and may include multiple modalities to optimise your outcome. Again, your treating team will provide the recommendation and support you through the treatment course.
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