Cancers occurring in the head and neck region are usually categorised together. They form a diverse group and include cancers of the skin over this region, cancers in the sinuses, nose, mouth, throat, thyroid and salivary glands. Cancers of the brain and eye are usually not classified within the same group.
This depends on the location of the cancer.
Head and neck cancer and its treatment can lead to significant problems functionally and cosmetically even if cured. Prevention is certainly better than cure in this situation and the greatest risk reduction can be achieved by not smoking and not consuming alcohol.
Risk factors for head and neck cancer include:
The total increase in risk with smoking and alcohol together is higher than the sum of their individual risks.
When you have any of the above symptoms, your primary care doctor will refer you to an Otolaryngologist or Head & Neck Surgeon. Your surgeon will first perform a complete head and neck examination, which will usually include examination of the mouth, flexible fibreoptic endoscopy of the nose, pharynx and larynx and examination of the neck.
Depending on the suspected location and type of tumour, the following investigations may be ordered.
A diagnostic operation, panendoscopy, may be necessary on top of the above investigations, to accurately determine the extent of the tumour and examine the rest of the areas at risk for a second cancer, which may exist in up to 10% of patients.
This operation involves examining the entire pharynx and larynx (throat), trachea (windpipe) and oesophagus (food passage) with the aid of rigid scopes under general anaesthesia.
After completion of staging, in some
hospitals, patients may be discussed
in a multidisciplinary tumour board,
comprising surgeons, medical
oncologists, radiation oncologists,
pathologists, radiologists and nuclear
medicine physicians. All treatment
options will be presented to patients,
together with recommendations.
Stage 1 and 2 cancers are considered
early-stage disease and a single
modality of treatment is usually
sufficient. This may be surgery or
radiotherapy. Chemotherapy alone is
not the treatment of choice for head
and neck cancers.
Stage 3 and 4 cancers are considered
advanced-stage disease and require
multiple modality treatment.
This involves various combinations of
surgery, radiation and chemotherapy: