Head and Neck Cancers
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Head and Neck CancersWhat are Head and Neck Cancers?Read more...
Hormone TherapyWhat is Hormone Therapy?Read more...
IMRTIntensity Modulated Radiation TherapyRead more...
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What are Head and Neck Cancers?
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. Some head and neck cancers begin in other types of cells. For example, cancers that begin in glandular cells are called adenocarcinomas.
Cancers of the head and neck are further categorized by the area of the head or neck in which they begin. These areas are described below and labeled in the image of head and neck cancer regions.
Oral cavity - includes the lips, the front two-thirds of the tongue, the gums, the 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 of the gum behind the wisdom teeth.
Pharynx - the pharynx (throat) is a hollow tube about 5 inches long that starts behind the nose and leads to the esophagus. It has three parts -
Larynx - the larynx, also called the voicebox, is a short passageway formed by cartilage just below the pharynx in the neck. The larynx contains the vocal cords. It also has a small piece of tissue, called the epiglottis, which moves to cover the larynx to prevent food from entering the air passages.
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.
Salivary glands - the major salivary glands are in the floor of the mouth and near the jawbone. The salivary glands produce saliva.
Cancers of the brain, the eye, the esophagus, and the thyroid gland, as well as those of the scalp, skin, muscles, and bones of the head and neck, are not usually classified as head and neck cancers.
Sometimes, cancerous squamous cells can be found in the lymph nodes of the upper neck when there is no evidence of cancer in other parts of the head and neck. When this happens, the cancer is called metastatic squamous neck cancer with unknown (occult) primary.
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Causes of Head and Neck Cancer
Tobacco (including smokeless tobacco, sometimes called "chewing tobacco" or "snuff") and alcohol use are the most important risk factors for head and neck cancers, particularly those of the oral cavity, oropharynx, hypopharynx, and larynx. Eighty-five percent of head and neck cancers are linked to tobacco use. People who use both tobacco and alcohol are at greater risk for developing these cancers than people who use either tobacco or alcohol alone.
Symptoms of Head and neck Cancer
Types of Head and Neck Cancer
There are several different types of head and neck cancer, categorized according to the specific tissue or organ where the cancer originates - from cancerous lesions on the lower lip to paranasal sinus tumors deep within the skull.
Tumors of the Nasal Cavity and Paranasal Sinuses - the nasal cavity is the passageway just behind the nose. When we breathe through our nose, air passes through the nasal cavity en route to the pharynx and tracheobronchial tree, which leads into the lungs. The paranasal sinuses are air-filled cavities around the nose.
Nasopharyngeal Cancer - the nasopharynx is the upper part of the throat behind the nose - the nostrils lead into it, and openings on the sides of the nasopharynx connect to the ears.
Cancers of the Oral Cavity - the oral cavity includes all the various parts of the mouth: the lips; the lining inside the lips and cheeks (the buccal mucosa); the bottom of the mouth; the front of the tongue; the front part of the top of the mouth (the hard palate); the gums; and the area behind the wisdom teeth (the retromolar trigone).
Tumors of the Oropharynx - the oropharnyx is the part of the throat at the back of the mouth (the throat is technically known as the pharynx). It's a 5 inch, hollow tube that extends all the way from the nose down to the top of the trachea (the windpipe that leads to the lungs). Parts of the oropharnyx include the back of the tongue, the soft palate (the back part of the roof of the mouth), the tonsils and the part of the throat behind the mouth.
Hypopharyngeal Tumors - the hypopharynx is the bottom part of the pharynx, or throat. The pharynx is a 5-inch hollow tube that extends from the nose, down the neck to the esophagus. Both air and food pass through the pharynx. The air continues on through the trachea to the bronchi and lungs. Food continues on to the esophagus and digestive system.
Laryngeal Cancer - the larynx is more commonly known as the "voicebox." It's a 2 inch, tube-shaped organ in the neck. Air passes through the larynx on its way into or out of the lungs, and when we talk the vocal cords inside of the larynx tighten up and vibrate, producing sound.
Salivary Gland Cancer - salivary glands are located throughout the oral cavity. They are responsible for making saliva, a substance that keeps the mouth moist and aids in digestion.
Diagnosis of Head and Neck Cancer
Urine and blood test /Physical examination - lumps in the cheeks, lips, neck and gums are examined by performing a physical examination of a patient. Abnormalities are also noticed by inspecting throat, nose, tongue and mouth. Cancer can be diagnosed by performing urine and blood tests.
Biopsy - a small amount of tissue is removed for examining under a microscope for diagnosing head and neck cancer.
X-ray - this helps in creating pictures of the structures within the body by using little radiation. The abnormalities of the swallowing passage can be identified by a barium swallow.
Endoscopy - the inside of the body can be viewed by using flexible and light tube known as an endoscope. The head and neck areas are examined by inserting this tube through the nose into the throat.
Ultrasound - the picture of the internal organs is created by performing an ultrasound that uses sound waves.
Bone Scan - radioactive tracer is used for looking inside the bones. This tracer is injected into the vein of a patient. This is detected by a special camera as it gets collected in the bone areas. Gray color appears representing a healthy bone and dark color represents the injured areas due to cancer.
Computed Tomography Scan - a tumor or abnormalities of the head and neck are viewed by performing computed tomography (CAT or CT) scan.
Positron Emission Tomography (PET) Scan - by the means of this scan, the pictures of tissues and organs within the body are created. The injection of a radioactive substance is done into the body of a patient. The tissues and organs that use most of the energy absorb this radioactive substance. It is the tendency of the cancer to use energy actively thereby absorbing more radioactive substance.
Magnetic Resonance Imaging (MRI) - the detailed images of the body that include base of the tongue and the tonsils are produced by performing an MRI that makes use of magnetic fields.
Panorex - the x-ray of lower and upper jawbones is performed for detecting cancer or for evaluating teeth before chemotherapy or radiation therapy.
Head and Neck Cancer Treatment
Chemotherapy, surgery and radiation therapy are the three main types of treatment for administering head and neck cancer. Surgery or radiation therapy is considered as the primary treatments while chemotherapy is usually used as an adjuvant or additional treatment. Primary cancer can be easily treated with the help of radiation therapy. Radiation therapy can also effectively treat the neck. A neck dissection is also sometimes necessary for removing involved lymph nodes in the neck when the amount of disease in the neck nodes is very wide.
Surgery is considered as a very important treatment that can be done either before or after the radiation therapy. Radiation therapy is given afterward when it is necessary to remove the primary tumor surgically. The tumor is first tried to shrink by using radiotherapy and surgery is followed by radiotherapy.
Intensity-Modulated Radiation Therapy (IMRT) - the specific areas inside the tumor or malignant tumors are targeted by this high-precision radiotherapy that makes use of computer-controlled x-ray accelerators that delivers precise radiation doses. The high intensity radiation beam is focused on the tumor so as to damage it without disturbing any surrounding healthy cells.
External Beam Therapy (EBT) - through this therapy, a high-energy beam x-rays are delivered at the location of the tumor. The tumor site is the target of this beam and it can destroy cancer cells while sparing nearby healthy tissues. There is no placement of radioactive sources in the body of a patient.
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