Head and Neck Cancers
Head and neck cancers originate in the throat, larynx (voice box), pharynx, salivary glands, or oral cavity (lip, mouth, tongue). In 1999, there were 500,000 cases of head and neck cancers worldwide. Most head and neck cancers involve squamous cells, which are cells that line the mouth, throat, or other structures. Also, these cancers are often preceded by non-cancerous sores or an unusual patch of white tissue that cannot be rubbed off, called a leukoplakia.
A cancer that has not spread to deeper tissue layers is non-invasive, referred to as carcinoma in-situ. However, head and neck cancers do tend to spread, particularly to lymph nodes in the neck. On initial diagnosis, more than 70% of patients have cancer that has advanced locally, regionally, and/or to distant locations in the body. Furthermore, 10% to 15% of individuals with a cancer of the head and neck will have a second cancer that may or may not present with symptoms. The esophagus is the most frequent site in which additional primary cancers are discovered.
Diagnosis of head and neck cancers usually involves several tests to help determine the stage of the cancer. The size and extent to which the cancer has spread from its site of origin is referred to as the stage. A procedure called an endoscopy is performed to obtain a biopsy, determine the local extent of the cancer, and look for additional cancers. An endoscope is a lighted tube, which is used to examine the throat, larynx, and upper esophagus. A biopsy involves the removal of a small sample of the suspected cancer. The samples are then examined under a microscope to determine if cancer is present. Additional procedures may including blood tests, a chest x-ray, and sometimes additional surgery for lymph node evaluation. Computed tomographic (CT) scans, magnetic resonance imaging (MRI) scans, ultrasound, and positron emission tomography (PET) scans are often valuable for detecting the extent to which the cancer has spread to the lymph nodes and to further identify the extent of cancer at the primary location.
Patients with head and neck cancers should consider being carefully evaluated in a medical center that treats many patients with these cancers. Patients with head and neck cancer require a multidisciplinary team approach that is often only available at specialty medical centers. A multidisciplinary team may be comprised of a head and neck surgeon, a radiation oncologist, a medical oncologist, a pathologist, a dentist, and social services personnel. Evaluation and treatment by an experienced team is essential for determining optimal treatment.
Treatment for head and neck cancers depend on the stage and location, and is addressed under the following sections: Cancer of the Throat, Cancer of the Larynx, Cancer of the Salivary Glands, and Cancer of the Oral Cavity. These sections consist of general overviews of treatment for each specific type of head and neck cancer. Treatment may consist of surgery, radiation, chemotherapy, biological therapy, or a combination of these treatment techniques. Multi-modality treatment, which is treatment using two or more techniques, may be the most promising approach for increasing a patient’s chance of cure or prolonging a patient’s survival. However, circumstances unique to each patient’s situation may influence how these general treatment principles are applied and whether the patient decides to receive treatment. The potential benefits of receiving treatment must be carefully balanced with the potential risks. The information on this website is intended to help educate patients about their treatment options and to facilitate a mutual or shared decision-making process with their treating cancer physician.