Head and Neck Cancer: Treatment, Procedure, Cost and Side Effects

A number of malignant tumors developing in or around the mouth, throat, sinuses, nose, and larynx are referred to as cancer in the head and neck. This is the region where we find the flat cells also known as the squamous cells. Right beneath this lining is the epithelium is the mucosa which is a layer of moist tissue. If the cancer is found only in the squamous layer of cells, it is known as carcinoma. In case this cancer originates in the salivary glands, the tumor will be called adenocarcinoma or mucoepidermoid carcinoma.

The diagnosis is done firstly by conducting a screening as part of your routine dental exam. In specific terms, your dentists will try to find out the irregular changes of tissues in your oral cavity, neck, face, and head, or feel for lumps at the same areas. During mouth examination, he will look for discoloured tissues or sores along with checking for any indications as mentioned previously. There may be the need of a biopsy to determine a suspicious looking area. The treatment methods available for head and neck cancer are the same as any other cancers. Firstly, it involves a surgery to remove the cancerous growth of cells, followed by a chemotherapy or radiation therapy to fully remove the remaining cancerous cells.

The most common types of head and neck cancers may be grouped into five groups, each of which is named by the location of the tumour. Other head and neck cancers can develop, but their diagnosis and treatment are very different.

1. Laryngeal and hypopharyngeal cancer: The voice box is another name for the larynx. The tube-shaped organ in the neck is necessary for breathing, speaking, and swallowing. It is found at the top of the trachea, or windpipe. The gullet is another name for the hypopharynx. The larynx is surrounded by the lower section of the throat.
2. Cancer of the nasal cavity and paranasal sinuses: The nasal cavity is the area immediately behind the nose through which air flows on its journey to the throat. The paranasal sinuses are a group of air-filled cavities that surround the nasal cavity.
3. Nasopharyngeal cancer: It affects the air tube behind the nose in the upper region of the throat.
4. Oropharyngeal carcinoma: is a kind of cancer that affects the mouth and tongue. The oropharynx spans the centre of the throat, from the tonsils to the tip of the voice box.
5. Salivary gland cancer: The salivary gland is in charge of saliva production. Saliva is a liquid that is released into the mouth to keep it moist and includes enzymes that help with digestion.

Summary: Mainly there are five types of head and neck cancers. Each type is categorized on the basis of its region of development.

Head And Neck Cancer symptoms are quite complicated in nature. While sometimes the patient might see it on the surface or experience it in early stage head and neck cancer. Others might not even experience the symptoms at all. Here is the list of head and neck cancer signs:

• Hoarseness or voice changes
• Lump, bump, or mass in the head or neck area
• Unusual nasal discharge
• Pain or difficulty chewing, swallowing, or moving the jaw or tongue
• Blood in the saliva or phlegm
• Unexplained weight loss
• Dentures that no longer fit
• Red or white patch in the mouth
• Persistent sore throat
• Swelling or a sore that does not heal
• Double vision
• Nasal obstruction or persistent nasal congestion
• Foul mouth odour
• Numbness or weakness of a body part in the head and neck region
• Difficulty breathing
• Loosening of teeth
• Frequent nose bleeds
• Jaw pain
• Fatigue
• Ear pain or infection

Summary: The head and neck cancer signs are highly complex. While the patient may see it on the surface or experience it in the early stages of head and neck cancer, it is not always the case with every patient.

Head and neck cancer most common risk factors are alcohol and cigarettes. They are the core causes of cancers of the oropharynx, oral cavity, hypopharynx, and larynx. People who use both nicotine and alcohol have a higher risk of developing these diseases than those who only use one. Tobacco or alcohol use have no effect on salivary gland cancer.

Some types of head and neck cancers, especially oropharyngeal cancers affecting the tonsils or the base of the tongue, have been associated with infection with cancer-causing human papillomavirus (HPV) types, particularly HPV type 16.

Summary: Common head and neck cancer causes are consumption of alcohol and tobacco. Others might include HPV type 16.

Head and neck cancer is diagnosed using a variety of assays. The doctor will start by gathering information about your medical history and noting any symptoms or risk factors.

Following a general examination, the doctor may evaluate aspects such as type, symptoms, age, and so on in order to make the proper diagnosis. The following is a list of tests that may be useful in the diagnosis of head and neck cancer:

• Blood and urine tests
• X-ray/ computed tomography (CT)
• Panoramic radiograph
• Ultrasound
• Endoscopy/ laryngoscopy/ pharyngoscopy /nasopharyngoscopy /panendoscopy
• Biopsy
• Biomarker testing
• Computed tomography scan
• Magnetic resonance imaging (MRI)
• Bone scan
• Positron emission tomography (PET) or PET-CT scan

Summary: A range of tests are used to diagnose head and neck cancer. The doctor will start by gathering information about your medical history and noting symptoms or risk factors.

Various factors contribute to the development of various types of cancer. Researchers are still looking into the factors that trigger this type of cancer, as well as preventative strategies. Although there is no way to completely avoid this condition, there are steps you may take to for head and neck cancer prevention:

• Using sunscreen and lip balm regularly.
• No smoking.
• Avoiding alcohol abuse.
• Practising protected sex.
• Eating a well-balanced diet.
• Maintaining good oral hygiene.

Summary: Different factors have a role in the development of certain cancers. While there is no way to achieve head and neck cancer prevention, you can put your efforts to reduce the risk.

Metastasis or spread of head and neck cancer is mainly located between the head and neck. But there are certain sections of this region that get affected. Here is the list of sections through which head and neck cancer metastasis:

• Submental
• Submandibular
• Parotid
• Upper cervical
• Middle cervical
• Lower cervical
• Supraclavicular fossa
• Posterior triangle (accessory chain)

Summary: Metastasis or spread of head and neck cancer is mainly located between certain sections of the head and neck. The cancer of such form spreads through these areas only.

After proper consultation with your doctor, you will be guided towards a specialist like an otolaryngologist, maxillofacial surgeon, plastic surgeon, radiation oncologist, and medical oncologist to treat this disease. These people specialize in surgery, radiation therapy, and chemotherapy-related to mouth cancer. Other health care professional include a speech pathologist, dentist, mental health counselor, audiologist and nutritionist.

Surgical treatment for the removal of cancerous cells is the most common treatment for head and neck cancer. At times, the surgeon removes the lymph nodes and other tissues from the neck as well. Patients may also have a combination treatment of surgery along with radiation therapy. Radiation therapy or radiotherapy is a kind of local therapy that affects the treated area only. It is used alone for patients who are unable to afford surgery or for treating small tumors. In some cases, it is done before surgery to shrink the tumor by killing cancer cells. In order to treat head and neck cancer, there are two types of radiation treatment used.

These are external and internal radiation (implant radiation). External radiation comes from a machine and internal radiation comes from radioactive materials put in thin plastic and needles which are directly placed in the tissue. Chemotherapy is the usage of anticancer drugs to destroy cancer cells. This systematic therapy is associated with the drugs entering the bloodstream and affecting the cancerous cells throughout the body. It is usually given by injection.

A patient who has a small tumor or is unable to tolerate or afford surgery is eligible for radiation therapy. Someone with locally advanced disease is eligible for surgery.

A patient who is older than 75 years is not eligible for the treatment. Also, pregnant women are not eligible.

Cancer does not go away by itself. To be treated, any type of cancer must be handled by a cancer specialist. Furthermore, it is not always possible to recover from head and neck cancer. Cancer may be classified as advanced or end-stage head and neck cancer if it cannot be cured or controlled.

Hospice care may be beneficial for people with advanced cancer who have a life expectancy of fewer than six months.

Summary: Cancer does not go on its own. Any sort of cancer must be handled by a cancer specialist in order to be treated well.

Side effects of the treatment include soreness, pain or redness in the mouth and throat, loss of senses of taste, hoarseness, and skin colour change on the head and neck as tanned or sunburnt which eventually fades away.

It is very important that the patient receives proper follow-up care after the treatment. Even if it seems that the cancer has been completely destroyed or removed, the disease has a tendency to return because of the undetected cancerous cells remaining in the body. Recurrence of cancer cells is regularly monitored by the doctor. Your doctor will recommend you to keep investigating your mouth and come for screening exams regularly. He may do a blood test, x-rays or a complete physical examination. Doctors also urge you to strictly stop the usage of tobacco and consumption of alcohol to prevent recurrence of head and neck cancer.

It may take more than a year depending upon the severity of the disease. Side effects may still remain.

The cost of treatment ranges from Rs. 3,00,000 to Rs. 3,50,000.

No the results of the treatment for head and neck cancer are not permanent as the cancer cells can return in case they were not detected earlier.

Dietary needs of head and neck cancer are quite specific as per each individual. Depending on the type of cancer, its location, treatment, and once feasibility of consuming food, the patient’s diet chart is prepared. Here is the list of some common food items that might be good for the patient with head and neck cancer to fulfill their dietary needs:

• Low sodium canned soups
• Oatmeal packets
• Trail mix or nuts (if you can chew and swallow well)
• Mashed or baked potatoes
• Peanut butter crackers
• Cottage cheese with canned fruit
• Whole grain cereals
• Hard-boiled eggs
• Pre-made nutritional drinks
• Yoghurt, pudding, or applesauce
• Pre-made smoothies
• Hummus dip
• Pasta salads, tuna salads, egg salads

Summary: Dietary requirements for people with head and neck cancer vary greatly from person to person. The patient's diet chart is developed based on the type of cancer, its location, treatment, and the patient's ability to consume food.

Alternative treatments for head and neck cancer include turmeric (curcuma longa), mint, thyme, basil and green tea. The usage of these herbs will provide benefit in easing the symptoms associated with head and neck cancer.

Head and neck cancer recovery can be easy for the patient if detected in the early stages. So it's very important for individuals to acknowledge early-stage head and neck cancer. If one is diagnosed with head and neck cancer, it is important to get urgent medical aid.

Summary: When head and neck cancer is detected early, the patient's recovery might be quite simple. You should seek medical care as soon as possible if you have been diagnosed with head and neck cancer.

There is no physical activity that can aid head and neck cancer treatment. However, you may always get advice from your doctor on how to keep your physical health in good shape.

Summary: There is no other solution for head and neck cancer treatment. Maintaining excellent physical health may be made easier with a healthy workout regimen.

Head and neck cancer medicine is constantly being tested. The goal of medication-based therapy is to eliminate cancer cells. To reach cancer cells all around the body, medication can be injected straight into the bloodstream.

Medications are usually given either in an intravenous (IV) tube, which is put into a vein with a needle, or as a pill or capsule that is swallowed (orally).

Summary: Head and neck cancer medicine are still under research, however, there are some therapeutics that might help the patients to manage and destroy cancer.

Conclusion: The term ""head and neck cancer"" refers to a category of cancers that affect the head and neck area of the body. These groupings are divided into subcategories based on their frequency and character. On the same premise, diagnosis and therapy are recommended. Bad lifestyle choices are the primary cause of such malignancies. Although there are drugs and therapies with high effectiveness rates, researchers are still hunting for cancer cures that are less harmful.