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Head And Neck Cancers >> Features Archieve >> Medical Articles

This section GaramChai features Medical articles by Dr.Kumaresh Krishnamoorthy

Head And Neck Cancers

What is cancer?
Normally, cells grow and divide to form new cells in an orderly way. Sometimes, however, cells do not die. Instead, they continue to divide and create new cells that the body does not need. The extra cells form a mass of tissue, called a growth or tumor. Cancer growth invades normal structures near the growth and spreads to other parts of the body. Metastasis is the spread of cancer beyond one location in the body.

What kinds of cancers are considered cancers of the head and neck?
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 as squamous cell carcinomas.

Cancers of the head and neck are further identified by the area in which they begin:

  • Oral cavity. The oral cavity includes the lips, the front two-thirds of the tongue, the gums, the buccal mucosa (lining inside the cheeks and lips), the floor (bottom) of the mouth under the tongue, the hard palate (bony top of the mouth), and the small area behind the wisdom teeth.
  • Salivary glands. The salivary glands produce saliva. There are many salivary glands; the major ones are in the floor of the mouth, and near the jawbone.
  • Paranasal sinuses and nasal cavity. The paranasal sinuses are small hollow spaces in the bones of the head surrounding the nose. The nasal cavity is the hollow space inside the nose.
  • Pharynx. The pharynx is a hollow tube about 5 inches long that starts behind the nose and leads to the foodpipeq and the trachea (the tube that goes to the lungs). The pharynx has three parts:
    Nasopharynx: The upper part of the pharynx behind the nose.
    Oropharynx: It is the middle part of the pharynx. The oropharynx includes the soft palate (the back of the mouth), the base of the tongue, and the tonsils.

Hypopharynx: It is the lower part of the pharynx.

  • Larynx. The larynx, also called the voice box, is a short passageway just below the pharynx in the neck. The larynx contains the vocal cords.
  • Lymph nodes in the upper part of the neck. Sometimes, squamous cancer cells are found in the lymph nodes of the upper neck. When this happens, the cancer is called metastatic squamous neck cancer.

Cancers of the thyroid as well as those of the scalp, skin, muscles, and bones of the head and neck are also grouped with cancers of the head and neck.

What are the major contributing factors for head and neck cancers?
The major causes for head and neck cancers are tobacco and alcohol use, including cigarettes, snuff, chewing tobacco, betel leaf, lime, areca nut, paan and gutka. Combining tobacco and alcohol use poses an even greater risk. Other causes include: Viruses (herpes simplex virus, Epstein-Barr virus and the human papilloma viruses) Occupation (workers in nickel refining, asbestos and wood- and leather-working industries) Radiation exposure (radium watch dial painting and thorotrast ingestion). This exposure can come from diagnostic x-rays or from radiation therapy for noncancerous conditions or cancer. Poor oral hygiene, use of mouthwash that has high alcohol content, diet deficient in Vitamin A and beta-carotene are possible, but not proven, risk factors.

What are the warning signs of head and neck cancers?
Having any of the following symptoms for more than two weeks warrants a visit to a head and neck specialist:
A sore on the lip or in the mouth that does not heal for more than 3 weeks
A lump on the lip or in the mouth or throat that persist for more than 3 weeks
A white (leukoplakia) or red patch on the gums, tongue or lining of the mouth
Unusual bleeding, pain or numbness in the mouth
A sore throat or a feeling that something is caught in the throat that lasts for more than a month or that does not respond to antibiotics
Difficulty or pain with chewing or swallowing
Swelling of the jaw that causes dentures to fit poorly or become uncomfortable
A change in the voice or hoarseness lasting more than 3 weeks
Pain in the ear without evidence of local ear problems
Slurred speech
Loose teeth not associated with any gum problems
Unintended weight loss
Swelling, numbness, paralysis of the muscles in the face or pain that does not go away in the face, chin, or neck.
Chronic sinus infections that do not respond to treatment with antibiotics
Bleeding through the nose, frequent headaches, swelling or other trouble with the eyes.
These symptoms may be caused by cancer or by other, less serious conditions. Sometimes there are no warning signs.

What can be done to reduce the risk of developing a second new cancer?

People who have been treated for head and neck cancer have an increased chance of developing a new cancer, usually in the head and neck, food pipe or lungs. The chance is higher for people who smoke and drink alcohol. Patients who do not smoke should never start. Those who smoke should do their best to quit.

Dr.Kumaresh Krishnamoorthy, M.S (ENT)
Head and Neck Surgery Fellowship (Buffalo, USA)
Neurotology & Skull Base Surgery Fellowship (Cincinnati, USA)
Senior Consultant in ENT - Head and Neck Surgeon and Skull Base Surgeon
Apollo Hospitals, 154/11, Bannerghatta Road, BANGALORE 560 076, INDIA
Phone: 91-(0) - 99002 36819





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