Annoying sores in your mouth or trouble breathing could be early signs of a form of head and neck cancer.
What form the cancer is in will determine treatment, according to Dr. Jamal Ahmed, Marshfield Clinic Health System otolaryngologist and head and neck surgeon.
Head and neck cancer variations
Head and neck cancers comprise nearly 4% of all cancers in the United States, according to the National Cancer Institute.
The most common type of a head and neck cancer is a malignant tumor that forms from the inner lining of the upper aero digestive tract (i.e. mouth, throat, esophagus, or voice box), according to Dr. Ahmed.
“Most often these are squamous cell carcinomas,” Dr. Ahmed said. “Other types of cancers in the head or neck include cancers from the thyroid gland, skin cancers (such as melanomas), salivary gland cancers and cancers from the skull base or orbits.”
Causes and symptoms
While many head and neck cancers are caused by tobacco and alcohol use and human papillomavirus (HPV), other common risk factors include radiation exposure, Epstein-Barr virus infection (also known as human herpesvirus 4), genetics and ancestry. In addition, exposure to asbestos and synthetic fibers increase risk of head and neck cancer.
Symptoms present differently depending on the area of the head and neck where cancer develops. In the oral cavity, symptoms could include red or white patches on the gums, tongue or mouth lining. Trouble breathing or speaking or pain while swallowing are common with cancers of the voice box (larynx). Cancer that forms in the salivary glands has associated symptoms of swelling along the chin or jawbone, numbness and even muscle paralysis near the area.
“Cancers that arise from the mouth can behave differently than cancers that arise from the throat, and the treatment can be different as a result,” said Dr. Ahmed. “Squamous cell carcinomas tend to start in the lining of the upper aero digestive tract and form a lump or tumor, which then can spread to lymph nodes and then to other parts of the body.”
Head and neck cancer treatment
Treatment for most head and neck cancers include surgery, radiation, chemotherapy or a combination, Dr. Ahmed said.
“For example, it is common to undergo surgical removal of a tongue cancer as well as removal of lymph nodes in the neck, and sometimes patients require radiation treatment if there is evidence that this is aggressive disease,” he said. “Sometimes radiation is combined with chemotherapy if there are risk factors for recurrence. Other times, patients receive only treatment with radiation or radiation combined with chemotherapy. Immunotherapy is being used more frequently in the setting of recurrent or metastatic squamous cell carcinoma of the upper aero digestive tract, and in melanoma.”
Living well after diagnosis
Patients diagnosed with head and neck cancers have an increased risk of developing a new cancer.
“An individual patient’s risk of recurrence is a very complicated question with lots of different factors to consider, including the patient’s stage, other health problems, family history, treatment history, biological details of the cancer, etc.,” Dr. Ahmed said. “Cancers from the lining of the mouth and throat tend to be aggressive cancers, and throat cancers caused by HPV tend to be more responsive to treatment of all kinds.”
If you have head and neck concerns, talk with your provider.