Written by Áine Finn, Community and Online Information Nurse, Marie Keating Foundation
“The most common type of head and neck cancer is squamous cell carcinoma. About 9 out of 10 head and neck cancers (90%) start in squamous cells.4 Treatment will vary depending on the location of the cancer”
Introduction:
In Ireland we see on average 800 new cases of head and neck cancer diagnosed every year. Men are at a higher risk of the disease,1 with men being more than twice as likely to develop it (4.6%) compared to women (1.8%).1 The risk of head and neck cancers increase as we get older with the majority occurring over the age of 50 years, however they can also develop in people younger.2
Types of Head and Neck Cancers:
Head and neck cancer can be used as an umbrella term to describe a number of different cancers that can develop in the soft tissues of the head and neck. They can include cancers such as:
– Laryngeal cancer – cancer of the larynx or voice box
– Nasopharyngeal cancer –cancer in the area where the nose and back of the throat meet.
– Mouth and Oropharyngeal cancer – area of the mouth including the lips, gums and sides of the mouth and the oropharyngeal area (area of the throat just behind the mouth)
– Nasal and Paranasal Sinus cancer – space behind the nose or within the bones close to the nasal cavity.
– Oesophageal cancer – cancer of the oesophagus an area where food is transported from the mouth to the stomach, also known as the gullet or food pipe.
– Salivary gland cancer – there are three main salivary glands in the mouth along with 100s of smaller ones in the mouth and throat.
– Throat cancer – cancer developing in any part of the throat.
– Tongue Cancer – cancer at the front or back of the tongue
– Tonsillar Cancer – cancer occurring in the tonsils of the mouth
– Ear cancer – cancer developing in any of the three areas of the ear, the inner, middle or outer sections.3
The most common type of head and neck cancer is squamous cell carcinoma. About 9 out of 10 head and neck cancers (90%) start in squamous cells.4 Treatment will vary depending on the location of the cancer.
Risk Factors and Causes:
We do not know the cause of most head and neck cancers however there are certain factors that can increase our risk.5 The three main cause of head and neck cancers are tobacco and alcohol and the human papillomavirus (HPV).
Tobacco
This includes cigarettes, cigars and pipes as well as smokeless or chewable forms of tobacco.
Alcohol
No alcohol is best however when consuming alcohol the recommendation is to try not to exceed the weekly recommended guidance.6 The risk of alcohol consumption can be further increased when alcohol and tobacco are used together. This is due to an increased absorption of harmful chemicals from both tobacco and alcohol into the cells in our body when combined.
HPV (Human Papillomavirus)
The human papillomavirus is a very common virus which most people will be exposed to at some point in their life. It is spread through close skin to skin contact, usually during sexual activity such as sexual intercourse, anal sex or oral sex. There are over 100 different strains of HPV and they can be classified as low-risk strains and high-risk strains. Our own immune system can play a role in clearing this virus, with the majority of people able to clear it within two years. However, with high-risk strains of this virus, if we are unable to effectively clear the virus ourselves, it can increase the risk of developing some mouth and oropharyngeal cancers.5, 7
Other risk factors:
Age:
As previously mentioned, the risk of head and neck cancers increases with age with the majority of people diagnosed over 50 years of age.2
Sex:
Men are more than twice as likely to develop head and neck cancers compared to women. Head and neck cancers are the 5th most common cancer in men excluding non-melanoma skin cancer.1
Weakened immune system: When our immune system is weakened, we are at an increased risk for being unable to clear HPV. People who are on immunosuppressant drugs or those with a weakened immune system can be at an increased risk of developing some head and neck cancers.7
UV Exposure:
Exposure to harmful ultraviolet (UV) rays from the sun or from sunbeds can increase the risk of cancer of the mouth in particular of the lips. Therefore, it is important to apply sunscreen to protect our lips from harmful UV rays and to avoid sunbed use.2, 7
Signs and symptoms
– Hoarseness
– Persistent sore throat
– Pain to the ear, head or neck
– Difficulty swallowing or food getting caught or stuck
– A lump to the mouth, throat or head
– Numbness or issues with moving the tongue
– New changes to your gums, cheeks or tongue such as red or white patches,
– Mouth ulcers or blisters that don’t heal
– Loose tooth that is unexplained
– Droop in the side of your face
– Gums that don’t fully heal -after dental work.2, 8
Head and neck cancers can be treated successfully if caught in time. Therefore, it is important that if a person has any one or combination of the above symptoms, especially if they persist for more than three weeks, that they seek medical advice. People can also help to reduce their risk by regular dental checkups and by self-checks at home on a regular basis.2
Treatment:
Treatment is dependent upon a number of factors including the stage and grade of the cancer, the type and location as well as the general health of the person. The main treatment options for head and neck cancers are:
– Surgery
– Chemotherapy
– Radiotherapy
– Combination of chemotherapy and radiotherapy
– Targeted therapies
– Immunotherapies9, 10, 11, 12
References available on request
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