Head and Neck Cancers

Head and neck cancers include those that occur above the clavicle (collar bone) within the oral cavity and aerodigestive area (upper part of the windpipe), but exclude tumours in the eyes and brain. Most cases of head and neck cancer affect squamous cells, the the thin flat cells that line the surface of the oral cavity, aerodigestive tract, and other organs.

• Risk Factors
• Symptoms
• Diagnosis
• Prevention
• Treatment at UPMC Whitfield Cancer Centre
• Head and Neck Cancers In-Depth from UPMC Cancer Centers

Risk Factors
There are significant risk factors that contribute to head and neck cancers, including genetic factors, and environmental and behavioral factors, such as the use of tobacco products, second hand smoke, and alcohol.

Typically, oral cancer occurs in older individuals between the ages of 65 and 75 and its risk increases with age, though it can also occur in younger individuals. Exposure to the following risk factors can increase risk:

• age: 65 and older
• exposure to known carcinogous industrial toxins (such as asbestos and benzene)
• tobacco use
• overuse of alcohol

Symptoms
Cancers of the head and neck can occur on the following sites:

• lips
• buccal mucosa (the inside lining of the cheeks)
• tongue
• hard palate (front area of the roof of the mouth)
• tonsils
• floor of the mouth (bottom of the mouth)
• retromolar trigone (the area behind the wisdom teeth)
• oropharynx (the tube that connects the nasal cavity to the trachea; includes the back of the tongue, the soft palate, and the tonsils)
• hypopharynx (bottom portion of the pharynx which extends to the esophagus)
• larynx (voicebox)

Early detection of oral cancers can significantly reduce the number of related deaths and begins with regular checkups and appropriate screenings. Screening should be done by your dentist or health care provider.

At the time of screening, your doctor will obtain a relevant medical history and inquire about any tobacco or alcohol use. During screening, the oral cavity is examined for any abnormal changes that may signal the beginnings of cancer. Report any of the following symptoms at the time of your exam:

• unhealed mouth sores that have persisted for greater than two weeks
• lumps on the lips, mouth, or in the throat; or the feeling that something is caught in the throat
• dentures which no longer fit properly or comfortably
• difficulty chewing or swallowing
• swelling in the neck or the jaw
• prolonged hoarseness or a change in the voice
• pain in the ear
• unusual white or red patches

Diagnosis
Symptoms that might indicate head and neck cancer can also be caused by other diseases, so patients experiencing prolonged symptoms, or those at high risk (such as frequent tobacco and alcohol users), might also need to seek the advice of a specialist, usually an otolaryngologist or oral surgeon.

The specialist will assess your medical history and perform a physical examination of the outside of the face and neck and the inside of the mouth and oral cavity. Pending the result of the examination, any present lesions or tumours may be biopsied. A biopsy is the only way to confirm for certain whether cancer is present in tissue.

During a biopsy, a sample of a lesion is taken for microscopic examination by a pathologist (a physician who examines cells for the presence of cancer or other abnormalities). Some biopsies can be performed in the physician's office, but biopsies of tumours in deeper regions of the throat might be done under general anesthesia in an operating room. To complete a diagnosis, imaging studies such as CAT or MRI scans may be performed.

Prevention
The best way to minimize the risk of oral cavity cancers is to make the necessary lifestyle changes. Behavioural changes may include establishing a healthy diet or exercise routine. Eliminating tobacco and alcohol also reduces the risks of acquiring head and neck cancer and of recurrence in those who have been diagnosed with initial oral cancers. Your physician can help you decide the best options that are available to you.

Treatment at UPMC Whitfield Cancer Centre
There are numerous approaches to head and neck cancer treatment, including surgery, chemotherapy, and radiotherapy. The health care and oncology professionals practicing at the UPMC Whitfield Cancer Centre specialize in radiotherapy, and will work with you, your doctor, and other specialists to design the most effective radiation treatment and recovery plans for your particular needs, including:

• IMRT
• IGRT
• Support Services

Head and Neck Cancers In-Depth: Information from UPMC Cancer Centers

UPMC Cancer Centers, based in Pittsburgh, Pennsylvania, is one of the largest integrated community networks of cancer physicians and health care specialists in the United States. Working with the University of Pittsburgh Cancer Institute, the academic and research partner, UPMC Cancer Centers strives to offer patients the latest advances in cancer prevention, detection, diagnosis, and innovative treatment. With the UPMC Whitfield Cancer Centre, UPMC is continuing to fulfill its mission to bring world-class cancer treatment to patients right in their own communities.

• Learn more about head and neck cancers from the experts at UPMC Cancer Centers
  (This link will take you to the website for UPMC Cancer Centers.)