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Cancer of the
head and neck is not one disease, but many. Cancer of the throat, for
example, behaves very differently from cancer of the tongue. It also
requires different treatment. We will talk these differences in a moment.
Most head and neck cancers begin in the squamous cells that line the
surfaces in the head and neck. Because of this, head and neck cancers
are often referred to as squamous cell carcinomas. Other head and neck
cancers begin in glandular cells are called adenocarcinomas
Tobacco (including smokeless tobacco) and alcohol use are the most important
risk factors for head and neck cancers, particularly those of the mouth
and throat. 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.
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Oral Cavity
- The oral cavity includes the lips, the front two-thirds
of the tongue, the gums, the lining inside the cheeks
and lips, the floor of the mouth, the hard palate, and
the region of the tonsils.
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Salivary Glands
- The salivary glands are in several places:
under the tongue, in front of the ears, and under the
jawbone, Paranasal sinuses and nasal cavity.
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Paranasal Sinuses
- Small hollow spaces in the bones of the head surrounding the nose.
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Pharynx
- The pharynx is a hollow tube about 5 inches long that
starts behind the nose and leads to the esophagus (the
tube between the mouth and stomach).
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Nasopharynx
- The nasopharynx, the upper part of the pharynx,
is behind the nose.
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Oropharynx
- The middle part of the pharynx. The oropharynx
includes the soft palate (the back of the mouth), the
base of the tongue, and the tonsils.
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Hypopharynx
- The hypopharynx is the lower part of the pharynx above
the voice box.
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Larynx
- Also called the voice box.
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Physical appearance,
the ability to speak, and the ability to eat can be severely affected
by head and neck cancer and its treatments. For that reason, patients
with head and neck cancers are usually treated by a team of specialists.
The specialists vary, depending on the location and extent of the cancer.
The medical team may include oral surgeons; ear, nose, and throat surgeons
medical oncologists, radiation oncologists, prosthedontists; dentists;
plastic surgeons; dietitians; social workers; nurses; physical therapists;
and speech-therapists.
A biopsy is necessary to determine the exact type of tumor. This is
followed by a careful head and neck examination—often with a flexible
scope—to look for areas of cancer spread. Scans of the neck and other
body sites are also done to be sure the cancer is confined to the head
and neck area. Only then can a course of treatment be designed. Options
include Surgery, Chemotherapy, and Radiation Therapy.
Surgery: The surgeon may remove the cancer and some of the healthy
tissue around it. Lymph nodes in the neck are usually also removed.
Surgeons are skilled at reconstructing the head and neck using tissue
from the chest or back to minimize changes in the patient’s appearance,
speech, and swallowing ability. However, changes are usually still evident,
especially if the voice box must be removed. While useful voice can
often be restored, it does not have a natural sound.
Click here to Meet our Head and Neck Surgeons
Radiation therapy: This treatment involves the use of high-energy
x-rays to kill cancer cells. Radiation therapy affects the cancer cells
only in the treated area. But, the head and neck is a very difficult
area on which to take radiation. Patients who receive radiation to the
head and neck may experience skin redness, irritation, and sores in
the mouth and throat. In the years after radiation, Loss of taste and
saliva can cause weight loss and dental disease. Here at St. Joseph’s
Cancer Center we use the drug Ethyol as a protector against radiation
effects. Ask your physician about this medicine.
Chemotherapy: Anticancer drugs are used both to kill cancer
cells throughout the body and in combination with radiation to make
it more effective. Drugs used to treat head and neck cancers are usually
given by injection into the bloodstream. The side effects of chemotherapy
depend on the drugs that are given. In general, anticancer drugs affect
rapidly growing cells, including blood cells that fight infection, and
cells that line the mouth and the digestive tract. As a result, patients
may have side effects such as lower resistance to infection, sores in
the mouth and on the lips, loss of appetite, nausea, vomiting, diarrhea,
and hair loss this type of treatment. Click here to
Meet our Medical Oncologists
Patients who have been treated for head and neck cancer have an increased
chance of developing a new cancer, usually in the head and neck, esophagus,
or lungs. The chance of a second cancer is higher for people who smoke.
If you smoke, its time to quit!. Studies have shown that continuing
to smoke increases the chance of a second primary cancer for up to 20
years after the original diagnosis.
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