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A Comprehensive Guide To Head and Neck Cancer – CancerMitr
Head and Neck Cancer
Head and neck cancer haunts a large chunk of the Indian population. Fueled by the rampant prevalence of tobacco chewing and smoking habits, this ominous disease has emerged as a formidable adversary, accounting for a staggering 30% of all reported cancers across the country, as revealed by a study, according to a study published in a scientific journal. Amidst the darkness, a flicker of hope emerges. In recent years, there has been a slight but noticeable decrease in the number of head and neck cancer cases, offering a glimpse of a brighter future. This positive change can be credited to spreading awareness, igniting a flame of knowledge that guides us towards healthier lives. By making changes in our habits, we have taken a significant step in freeing ourselves from the grip of this formidable disease.
What is head and neck cancer?
Head and neck cancers are cancer types that appear in a person’s mouth, throat, neck and other parts of the head. Cancer is a condition that is characterized by abnormal division of old and damaged cells. These cells form a lump of tissue called a tumour (cancerous or malignant) which can invade nearby normal tissues, break away from it’s point of origin and spread to other body parts.
Head and neck cancer can show up in any part of the head or neck region.
Also read: Benign & malignant tumours: Why is it essential to understand the distinction
Where does head and neck cancer start?
Looking at the anatomy of a person's head, it's internal regions are as follows;
A cancerous tumour can form in any of the above-mentioned regions. The group of cells that line the mucosal regions of the head and neck are called squamous cells. Cancers that begin in these cells are called squamous cell carcinoma of the head and neck.
Also read: A comprehensive guide to breast cancer
What are the notable signs and symptoms of head and neck cancer?
The symptoms of head and neck cancer vary depending on factors such as how quickly they grow, how far they spread, and the type of cells they affect, mostly squamous cells. Head and neck cancer usually begins with an ulcer in any of the oral cavity or throat. If the ulcer persists for more than two weeks, it is cause for concern.
- Unusually swelling that persists
- Sore that doesn’t heal
- Red (erythroplakia) or white patch (leukoplakia) in the mouth
- Unusual lump or bump in the mouth or neck region (it may or may not be painful)
- Unusual pain in the mouth or neck region
- Sore throat that persists
- Bad smell that doesn’t go away
- Change in voice
- Persistent nasal congestion
- Bleeding from the nose
- Breathlessness or breathing difficulty
- Double vision
- Unusual numbness or weakness in the face, oral cavity or neck region
- Swallowing difficulty
- Pain or difficulty while chewing or talking
- Unusual pain in the jaw
- Blood in the saliva or phlegm
- Loosening of the tooth
- Ear pain
Head and neck cancer also comes with commonly reported symptoms like fatigue, weight loss, and unusual loss of appetite.
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What are the different types of head and neck cancers?
What are the different stages of head and neck cancer?
Head and neck cancer is staged based on the TNM staging system developed by the American Joint Committee on Cancer (AJCC). It checks the tumour’s size (T), whether it has invaded the nearby lymph nodes (N), and if it has spread to other body parts or metastasized (M). The patient’s prognosis and treatment options are decided based on the staging.
Head and neck cancers are categorized under five stages;
What are the different grades of head and neck cancer?
The cancerous tumour is evaluated to determine the patient’s prognosis based on how aggressively it divides. It examines how similar malignant or cancerous cells appear to normal cells. Cancer grades are divided into three;
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How is head and neck cancer diagnosed?
Head and neck cancers are usually observed through physical examination by a dentist, ENT specialist, or general physician. The doctor feels the face, lips, cheeks or neck for unusual lumps, bumps or swelling. Using a mirror and a light, the doctor also inspects the oral cavity, throat, and nose for abnormalities like lumps, sores, or bleeding.
It is a process where medical experts use a thin, flexible tube with a light at the end, called an endoscope, to check the nasal cavity, throat, and food pipe region.
It is an imaging test that involves a liquid containing barium and a series of X-rays. The patient is asked to swallow the barium so that it coats the lining of the food pipe (esophagus), stomach and intestines. In that way, the abnormalities become more visible on an X-ray.
It is an imaging test that uses sound waves to create a picture of internal structures and organs.
Biomarkers refer to genes or proteins that reveal certain details about an individual’s health condition, including the presence of cancerous tumours. It is done by taking a sample of the tumour, blood test or urine test.
Medical experts make use of imaging tests such as MRI (Magnetic Resonance Imaging), CT (Computed Tomography), PET (Positron Emission Tomography) scan, and bone scan to check for possible metastasis.
It is a lab test where a sample of the tumour is checked under a microscope. It is the process that confirms whether the tumour is benign, precancerous or malignant. For head and neck cancers, the biopsy is usually done with the help of a thin needle, a process called fine needle aspiration.
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What are the various head and neck cancer treatment methods?
Surgery is the most important and reliable treatment for head and neck cancers. It is a procedure in which the tumour and some healthy tissue are removed to prevent it from spreading and causing more damage. Laser technology is utilized to treat early-stage cancer, particularly cancers of the larynx. Excision is another standard surgical method. If the tumour has spread to the nearby lymph nodes, then lymph node dissection or neck dissection is performed. Suppose a significant portion of the head or neck region, like the jaw, skin, pharynx, or tongue, is surgically removed along with the tumour. In that case, doctors perform plastic surgery to restore a person’s appearance.
It is a treatment process that involves particles like high-energy X-rays to target and destroy cancer cells. It is often given along with other treatment methods, like chemotherapy or surgery, to lessen the size of the tumour.
It is the process that involves the usage of powerful drugs to target and kill cancerous cells. The number of chemotherapy cycles depends on how well the tumour responds to the treatment. Chemotherapy is often given both before and after the surgery to shrink the tumour and kill the tumours in the bloodstream. There is another treatment method where cancerous tumours are targeted and killed, called targeted therapy.
It is the process where the body’s natural defense system is enhanced to target and destroy cancerous cells. As a result, Immunotherapy has a high success rate.
What are the different side effects of head and neck cancer treatment?
Treatment methods like chemotherapy and radiation lead to side effects like hair loss, fatigue, loss of appetite, skin reaction, change in bowel habits, sleeping issues, pain, nausea and vomiting. The biggest challenge associated with head and neck cancer is the change in appearance. Surgical removal of the tumour from head and neck cancer patients can lead to a disfigurement of the face, but it can be restored to some degree through plastic surgery. Other side effects include;
- Loss of hearing
- Change in voice
- Difficulty chewing and swallowing
- Shoulder stiffness
- Difficulty opening mouth
- Breathing difficulty
Above mentioned challenges can be managed through other means. People with swallowing and chewing difficulty can have a tube inserted into their stomach for food consumption. People with breathing difficulty can undergo temporary tracheostomy, where a hole is created in the windpipe to make breathing easier.
What lifestyle changes people with head and neck cancer should make?
- Physical appearance
- Chewing
- Swallowing
- Talking
- Breathing
- They should talk to their doctors about the treatment options and how it will affect them physically, mentally and financially. In addition, talk to family members about what works best and how they can help cope with the health challenges that come with treatment.
- Prior to the treatment, patients are recommended to discontinue tobacco and alcohol consumption. There are treatment options like mental health counselling and medications to help people overcome withdrawal symptoms. Tobacco and alcohol use increase the risk of all cancers. Thus, quitting can help reduce the rate of metastasis.
- Food items rich in Vitamin D and other antioxidants, like oats, cereals, oranges, soy milk, carrots, tomatoes, turmeric, mushroom, and green tea, also help prevent or delay metastasis and recurrence.
- Exercising for 50-60 minutes every week enhances the body’s disease-fighting ability. Brisk walking for 25 minutes every day (at least 5 days a week) reduces the risk of cancer by 18%.
- Low blood sugar content paves the way for faster destruction of cancerous tumours through processes like chemotherapy because they rely on sugar to proliferate.
- People who experience low appetite or chewing/swallowing difficulty can opt for smaller portions of meals that are liquid or semi-solid.
- Patients who find it difficult to sleep can opt for warm almond milk before sleep. Blue lights from mobile phones tend to affect a person’s ability to fall asleep, so it is better to switch them off at least 30 minutes before sleep.
- To reduce sun exposure, patients can opt for sunscreen, caps, umbrellas, and long-sleeved shirts.
What are the supportive therapies for head and neck cancer patients?
Supportive therapies for cancer patient is meant to improve their quality of life. However, therapy depends on the kind of cancer treatment and it’s side effects. Supportive therapy for cancer patients focuses on enhancing the patient’s physical appearance and aiding important processes like chewing, swallowing, talking and breathing.
Head and neck cancer patients who experience severe palatal defects due to the progress of cancer or as a result of treatment processes like surgery or radiation therapy.
Patients who find it difficult to open/close or move their mouth are provided with various rehabilitation techniques, notably the therabite. Therabite is the equipment used to assist people suffering from painful or limited jaw movement or trismus.
For patients who find it difficult to talk normally after treatment. Professionals assist patients by teaching them how to move their jaw muscles, neck, and shoulders effectively.
Head and neck cancer treatment may lead to the loss of smell if the radiation therapy is too close to the nose. Medical experts involved in olfactory rehabilitation assist in strategies that boost nasal airflow, like nasal airflow-inducing manoeuvre.
Patients who experience head, neck, jaw, or body pain can undergo various rehabilitation methods like therapeutic exercises, aquatic therapy, electric stimulation, acupuncture, acupressure, massages, and medication.
Patients who experience the buildup of fluid in their body (lymphedema) can undergo various treatment options, including lymphatic massages, exercises, and use compression garments to manage the same.
Patients who have gum disease or had their teeth removed during radiation therapy or surgery can have themselves treated. Patients who have had the roof of their mouth removed can have a special type of dental plate called an obturator, which is provided by a restorative dentist.
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Patients can increase their confidence and self-esteem through cancer care products like cervical collar/neck support, hair care, skin care, wigs, etc.
Click here for cancer care products.
Head and neck cancer patients should consume food items rich in vitamins (especially vitamin D), protein, and calcium. A suitable onco-dietician can assist the patient regarding the same.
Click here for diet and nutrition assistance.
As mentioned in the above paragraph, spending at least 10 minutes exercising every day helps delay cancer metastasis and prevents recurrence in some patients.
Click here for physiotherapy and fitness assistance.
A cancer diagnosis is devastating. Cancer patients and their families can benefit from the services of mental health counsellors.
Click here for mental health assistance.
Patients might require medical equipment like oxygen cylinders, air-bed or ICU setup at their homes after surgery or radiation.
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People who experience breathing difficulties or have undergone tracheostomy can make use of breathing exercises in yoga and meditation.
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What are the important follow-up care steps after head and neck cancer treatment?
- Patients should communicate with their doctors about the long-term effects of the treatment and can seek options for improving their health.
- It is imperative for one to be mindful of symptoms like ulcers, sore throat, and breathing and swallowing difficulty after treatment and while being in remission. It may not mean cancer recurrence, but it is better to get these symptoms treated as soon as possible.
- HPV vaccination is recommended for patients and their families as it is a leading cause of throat cancer. Spouses of head and neck cancer patients should get themselves tested for possible HPV infection and get treated accordingly.
- The medical expert tells how frequently a cancer patient must undergo physical exams and blood testing. The oncologist examines patients for cancer recurrence and secondary cancer development.
- Patients are expected to keep a health record in addition to routine check-ups to ensure seamless follow-ups. Doctors strive to keep track of whether breast cancer is detected in routine blood tests.
In Conclusion
Hollywood actor Michael Douglas once remarked that cancer didn’t bring him to his knees; it brought him to his feet. Surviving stage IV tongue cancer in his early 60s, he has become a passionate advocate for early detection and treatment. His inspiring story reminds us that with determination, we can overcome even the toughest challenges.
When it comes to head and neck cancer, early detection is easier due to its noticeable impact on our mouths, noses, and throats. By raising awareness and offering support, we can create a society that conquers cancer. Remember, every small step we take as individuals matters greatly in this fight.
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