Head and Neck Tumour : An Overview

About Head and Neck Tumour

Head and neck tumour are a broad category of growth that occur in the head and neck region. It is the term used to describe a number of different tumours that develop in or around:

Oral cavity: This includes the lips, tongue, gums, lining of the cheeks and lip, bottom and top of the mouth, and behind the wisdom teeth. The most common type of head and neck cancer.

Salivary glands: The salivary glands produce the saliva that keeps your mouth and throat moist. The main glands are located at the bottom of the mouth and near the jawbone.

Sinuses: Sinuses refer to the hollow spaces in the bones surrounding the nose.

Nasal cavity: Nasal cavity refers to hollow area inside the nose.

Tonsils.

Throat (pharynx).

Voicebox (larynx): The voice box, or larynx, refers to the short passageway formed by cartilage just below the throat (pharynx). It contains the vocal cords, and a small piece of tissue, called the epiglottis, which functions to prevent food from entering the air passages.

Ears.

Lymph nodes in the upper part of the neck.

A tumour can be cancerous or benign. A cancerous tumour is malignant, meaning in which cells of the body grow out of control and spread to other parts of the body. A benign tumour means the tumour can grow but will not spread to other part of the body.

Cancers that afflict the head and neck are treatable if detected early.

What Are the Symptoms of Head and Neck Cancers?

Head and neck cancer can be hard to diagnose, because symptoms are often mild and can mimic less serious conditions. The symptoms of head and neck cancer include but is not limited to:

A lump in the neck

Sore in the mouth that does not heal

Hoarseness or a scratchy throat that does not get better

Constant pain in the neck, jaw, or ears

Numbness or weakness in your face

Trouble breathing, speaking, chewing, or swallowing food

Nosebleeds

Nasal blockage that does not clear

Pain and swelling around the eyes

Problems with sense of smell

Frequent headaches

If you are experiencing any of these symptoms, it is imperative to seek the advice of a medical professional immediately.

What Causes Head and Neck Cancers?

Alcohol and tobacco use are the two most significant risk factors for head and neck cancers, especially cancers of the oral cavity, hypopharynx, and voice box. Individuals who use both tobacco and alcohol, increase their risk of developing these cancers. Most head and neck squamous cell carcinomas of the mouth and voice box are caused by tobacco and alcohol use.

Human papillomavirus (HPV) represents a risk factor for oropharyngeal cancers that involve the tonsils or the base of the tongue. Although HPV can be detected in other head and neck cancers, it appears to be the cause of cancer formation only in the oropharynx. The reasons for this are not completely understood.

Occupational exposure. Occupational exposure to certain substances such as wood dust is a risk factor for nasopharyngeal cancer. Certain industrial exposures, including exposures to asbestos and synthetic fibres, have been associated with cancer of the voice box, but the increase in risk remains controversial.

Radiation exposure. Radiation to the head and neck, for noncancerous conditions or cancer, is a risk factor for cancer of the salivary glands.

Epstein-Barr virus infection. Increases a person’s risk of getting tumour.

Ancestry. Asian ancestry, particularly Chinese ancestry, is a risk factor for nasopharyngeal cancer.

Types of Head and Neck Cancer

There are generally 6 main types of head and neck Cancers. The types are each named according to the part of the body where they developed.

Oral Cancer

These cancers affect your lips and gums, the front two-thirds of your tongue, your cheek and lip linings, under your tongue, and the roof of your mouth

Pharyngeal Cancer

Your pharynx, or throat, stretches from behind your nose to the top of your oesophagus (the tube that carries food to your stomach). It’s divided into three parts:

The nasopharynx (behind your nose), oropharynx (back of your mouth, base of your tongue, and tonsils), and hypopharynx (the bottom part).

Nasopharyngeal cancer is more common in Asia, Africa, and the Mediterranean.

Nasopharyngeal Cancer is reported as the 5th most common cancers in Malaysia based on the 2012-2016 Malaysian Cancer Registry.

Laryngeal Cancer

The Larynx, also called voice box, is at the top of your trachea(windpipe).

Nasal Cavity and Paranasal Sinus Cancer

Cancer cells can grow in the tissue inside and behind your nose (the nasal cavity) and the hollow areas in the bones near it, called the paranasal sinuses.

Salivary Gland Cancer

Found in the floor of your mouth (submandible cancer) and near your jawbone (parotid cancer), these are the glands that make saliva for the mouth.

Thyroid Cancer

Cancer that develops from the thyroid gland that is in front of the voice box

How Is Head and Neck Cancer Diagnosed?

Early detection is key to successful treatment of head and neck cancer.

If your doctor thinks you might have a problem, they will do a detailed examination of your head and neck, and the next step probably will be an endoscopy, laryngoscopy, or nasal endoscopy. Your doctor will use a long, thin tube with a light and lens on it to get a better and closer look at your nasal cavity, mouth, throat all the way down your voice box.

Depending on the location and the type of head and neck cancers, your doctors may do what is called a fine-needle aspiration cytology (FNAC) to take some fluid or tissue to check under a microscope. Your doctors will probably want take a sample of tissue (called a biopsy) for histopathology examination. At times the doctor might need to take out the entire tumour to be examined to determine the pathology. CT scan and an MRI to get a closer look at the area and to help to evaluate the extend of the disease and staging of the cancer. Often times, PET scan will be needed as well.

Treatment of Head and Neck Cancers

To ensure the best treatment options, it is imperative to determine the type of cancer one has. The treatment will depend on the stage, location and size of your cancer. Although many head and neck cancer treatment principles may overlap, treatment is generally site-specific and histology-specific.

Treatment may involve:

Surgery to take out the cancer and any abnormal tissue that may have spread to other areas, including lymph nodes in your neck. The type of surgery you need depends on your specific case.

Radiotherapy and/or chemotherapy treatment can be adjunct to surgery, which kills any remaining cancer cells or stops their growth.

Head and neck cancers remain challenging to treat, requiring a multidisciplinary approach, with surgery, radiotherapy, and systemic therapy serving as key components of the treatment.

This requires Otorhinolaryngologists, and head and neck surgeons to work together with medical oncologists and radiation oncologists to develop an optimal treatment plan for patients.

The journey to recovery from head and neck cancers may involve working with rehabilitation specialists and other experts to cope with side effects, such as hearing loss, difficulty eating, dental problems, thyroid issues, difficulty in breathing or difficulty in speaking.