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Head and neck cancers refer to a diverse group of malignancies that originate in various areas of the head and neck, including the mouth, throat, nose, sinuses, larynx (voice box), and salivary glands. These cancers often begin in the squamous cells that line the mucosal surfaces of these regions and are thus commonly referred to as head and neck squamous cell carcinomas (HNSCCs). Early detection is crucial for effective treatment and can significantly impact prognosis.
Rehabilitation may include speech therapy, physical therapy, and nutritional support, especially after surgeries affecting the mouth or throat. Joining support groups, both in-person and online, can help with coping emotionally and adjusting to daily life post-treatment.
Prognosis depends on the cancer’s type, stage, and location, with HPV-positive cancers generally having a better outlook. Early-stage cancers have a higher survival rate, with 5-year survival rates varying between 60% and 90% for localized cancers. For advanced or metastatic cases, survival rates are lower, emphasizing the importance of early detection.
Symptoms vary depending on the cancer location, but common symptoms include:
Persistent Sore Throat or Hoarseness: Difficulty swallowing or a hoarse voice that doesn’t improve may indicate cancer in the throat or larynx.
Lump or Swelling: A painless lump in the neck, jaw, or mouth can signal cancer.
Unhealed Mouth Sores: Persistent ulcers or sores in the mouth, especially if painful, could indicate oral cancer.
Difficulty Swallowing or Breathing: Obstruction or narrowing of the throat can cause swallowing or breathing difficulties.
Unexplained Weight Loss: Rapid weight loss without clear cause may occur with head and neck cancers.
Bleeding or Numbness: Frequent nosebleeds or numbness in the mouth or face.
Ear Pain or Hearing Loss: Pain or loss of hearing, especially if associated with throat cancer.
Bad Breath: Persistent bad breath, particularly with oral cavity cancers.
Diagnosing head and neck cancer involves a range of exams and tests:
Physical Examination: A thorough examination of the mouth, throat, and neck for lumps, swelling, or abnormalities.
Endoscopy: A small, flexible tube with a camera (endoscope) is used to examine the affected area, such as the throat or larynx.
Imaging Tests: CT scans, MRI, PET scans, and X-rays help to visualize the tumor’s size, location, and extent of spread.
Biopsy: A tissue sample is taken from the tumor site and examined under a microscope to confirm cancer. Fine-needle aspiration (FNA) may be used for lumps in the neck.
HPV Testing: For oropharyngeal cancers, testing for HPV is essential, as HPV-positive cancers respond differently to treatment and generally have a better prognosis.
Treatment depends on the type, location, and stage of the cancer, as well as the patient’s overall health:
Surgery: Early-stage cancers are often treated with surgery to remove the tumor, which may include part or all of the affected area (e.g., partial glossectomy for tongue cancer). Neck dissection may also be done to remove lymph nodes with cancer.
Radiation Therapy: Radiation is often used to treat smaller tumors or after surgery to eliminate residual cancer cells. External beam radiation is most common, but brachytherapy (internal radiation) may also be used for certain cases.
Chemotherapy: Drugs like cisplatin are used to kill cancer cells, either alone or in combination with radiation for advanced cancers. Chemotherapy is particularly useful when cancer has spread beyond the head and neck.
Targeted Therapy: Cetuximab, a targeted therapy drug, blocks specific proteins that help cancer cells grow. It is often used with radiation or chemotherapy for advanced cases.
Immunotherapy: Pembrolizumab and nivolumab are immunotherapy drugs that help the immune system recognize and attack cancer cells, mainly for advanced or recurrent head and neck cancers.
Photodynamic Therapy (PDT): This is a newer approach for early-stage cancers, involving light-sensitive drugs and a laser to destroy cancer cells.
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