Head and neck cancer is a disease that can cause symptoms such as sores in the mouth or lips that do not heal, hoarseness, weight loss, difficulty swallowing or speaking, pain or ringing in the ear, lumps in the neck, and persistent pain in the mouth or throat, for example.
There are different types of head and neck cancer, depending on the region affected, including oral cavity cancer, pharyngeal cancer, salivary gland cancer, pharyngeal cancer, thyroid cancer and nasal cavity and paranasal sinus cancer.
In the presence of symptoms that may indicate head and neck cancer, it is recommended to consult an oncologist or otolaryngologist, so that an early diagnosis can be made and the most appropriate treatment can be indicated, which may include chemotherapy, radiotherapy, surgery and immunotherapy. Regular visits to the dentist can help with early identification.
Main symptoms
The main symptoms of head and neck cancer are:
- Wounds in the mouth or lips that do not heal;
- Persistent hoarseness;
- Red or white spots on the tongue, gums, roof of the mouth or cheeks;
- Persistent pain in the mouth, neck or throat;
- Weight loss;
- Difficulty or pain swallowing, speaking or breathing;
- Presence of lumps on the neck;
- Numbness or paralysis of the facial muscles.
Depending on the type and location of this disease, the person may also experience a blocked nose, persistent bleeding or runny nose, growth or swelling of the jaw, lack of appetite, pain or ringing in the ear, difficulty hearing, pain in the face or chin , persistent headache or cough.
How to confirm the diagnosis
The diagnosis of head and neck cancer is made by an oncologist or otolaryngologist, through evaluation of the signs and symptoms presented, and the person’s family and personal history.
If you want to assess your risk of head and neck cancer, make an appointment with the oncologist closest to you:
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To confirm the diagnosis, the doctor examines the region and also orders some imaging tests, such as magnetic resonance imaging, computed tomography, x-rays and PET scans. Endoscopy exams through the mouth or nose may also be recommended.
In addition, the doctor also requests a biopsy, which is an examination carried out by taking a sample of tissue that will be analyzed in the laboratory, to identify whether there are cancer cells.
Read too: Biopsy: what it is, what it is for, types and how it is done
Types of head and neck cancer
Depending on the location and symptoms of this disease, the types of head and neck cancer are:
1. Oral cavity cancer
Oral cavity cancer is a group of tumors that can appear in some regions of the mouth, such as the lips, tongue, gums, inner part of the cheeks or the roof of the mouth.
The main symptoms of oral cancer are wounds or mouth ulcers that take a long time to heal, white or red spots on the gums, tongue or inside the cheeks, swelling of the jaw, bleeding or pain in the mouth.
2. Laryngeal cancer
Laryngeal cancer affects the voice box, a passage formed by cartilage just below the pharynx and which also contains the vocal cords.
Symptoms that may be present with this type of head and neck cancer include difficulty breathing or speaking, hoarseness, pain when swallowing, or ear pain.
Read too: Laryngeal cancer: what it is, symptoms, causes and treatment
3. Pharyngeal cancer
Pharyngeal cancer affects a region that starts behind the nose and goes up to the esophagus, including the nasopharynx, which is the upper part of the pharynx; the oropharynx, which includes the soft palate, the base of the tongue and the tonsils; and the hypopharynx, which is the lower part of the pharynx.
Possible symptoms of pharyngeal cancer include pain when swallowing, pain in the neck or throat that doesn’t go away, pain or ringing in the ear, or difficulty hearing.
4. Salivary gland cancer
Cancer of the salivary glands, which are structures responsible for producing saliva and which are located near the jaw and lower part of the mouth, can cause symptoms such as swelling in the chin or around the jaw, numbness or paralysis of the facial muscles, or pain persistent on the face, chin or neck.
5. Cancer of the nasal cavity and paranasal sinuses
Nasal cavity and paranasal sinus cancer is a type of cancer that arises in the small hollow spaces in the bones of the head, around the nose, and in the space inside the nose.
Symptoms that may arise in this type of head and neck cancer include a blocked nose, chronic sinus infections that do not respond to antibiotic treatment, nosebleeds, frequent headaches, persistent runny nose and pain in the upper teeth.
6. Thyroid cancer
Thyroid cancer is a tumor that appears in the thyroid gland and, in the early stages, causes a lump to appear in the neck.
Most of these tumors are slow-growing and not very aggressive, but there are some types that can increase in size quickly and cause other symptoms such as hoarseness and/or difficulty swallowing.
Read too: Thyroid cancer: what it is, symptoms and treatment
Possible causes
Head and neck cancer is caused by a mutation in the DNA of cells that begin to multiply in an unregulated manner and leads to the appearance of the tumor.
Factors that increase the risk of head and neck cancer are:
- Excessive consumption of alcoholic beverages;
- Smoking, including cigarettes, cigars, pipes, chewing tobacco or snuff, and secondhand smoke;
- HPV virus infection;
- Frequent exposure to wood dust, nickel dust, asbestos, cement or formaldehyde;
- Epstein-Barr virus infection;
- Exposure to radiation;
- Diet low in fruits and vegetables.
In addition, some genetic diseases, such as Fanconi anemia, can also increase the risk of some types of cancer, such as head and neck cancer.
How the treatment is carried out
Treatment for head and neck cancer varies depending on the type and stage of the tumor and includes:
- Chemotherapy: Chemotherapy uses a single drug or a combination of drugs to kill cancer cells, and is most suitable for head and neck cancers in advanced stages;
- Radiotherapy: Radiotherapy can be indicated to treat different types of head and neck cancer, alone, after surgery or together with chemotherapy;
- Surgery: Surgery may be indicated to remove the tumor and a margin of surrounding healthy tissue, or the lymph nodes in the neck, for example;
- Immunotherapy: Immunotherapy drugs, such as pembrolizumab and nivolumab, stimulate the immune system to identify and destroy cancer cells more effectively and are used to treat some types of head and neck cancer that have spread or returned after treatment;
- Nutritional therapy: The diet must be prescribed by a nutritionist, to improve swallowing, help alleviate symptoms of medical treatments and prevent weight loss, and may include enteral diet or parenteral nutrition.
In addition, physiotherapy and speech therapy are also treatments that may be recommended by the doctor to help recover speech and swallowing after treatment.
Is head and neck cancer curable?
Head and neck cancer is curable mainly when it is identified and treated in the early stages. The cure for head and neck cancer also depends on factors such as the type of cancer, age, the person’s general health and the body’s response to treatment.
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