Head & Neck

While the exact cause of these cancers is often unclear, several risk factors increase susceptibility. These include tobacco use (smoking, chewing, snuff), excessive alcohol consumption, prolonged exposure to toxic chemicals or dust particles, and infection with viruses such as human papillomavirus (HPV) or Epstein-Barr virus (EBV). Non-melanoma skin cancer is also prevalent in the head and neck region due to prolonged exposure to the sun. Apart from environmental factors, some cancers may also be genetic in nature.

Additional risk factors include poor oral hygiene, ill-fitting dentures, chronic iron deficiency, infections of the nose or nasal passages, and occupational exposures such as inhaling wood dust or exposure to nickel.

Understanding and mitigating these risk factors are crucial in reducing the likelihood of developing head and neck cancer.

Early detection of head and neck cancer symptoms is crucial for effective treatment and maintaining good health. Symptoms to be aware of, that may warrant further investigation, include:

• Persistent sores or growths in the mouth or on the tongue

• Painless swelling in the neck or face

• Nasal issues like chronic sinus problems or bloody discharge

• Blood in saliva or phlegm

• Decreased hearing or continuous ear pain,

• Skin changes such as non-healing ulcers or sores

Typically, patients also present with local symptoms like pain, difficulty swallowing, voice changes (or hoarseness lasting more than a fortnight), or the sensation of a lump. In advanced stages, cancers may spread to nearby lymph nodes, manifesting as a lump in the neck. While these symptoms do not always indicate cancer, persistent symptoms require medical attention to determine the cause and appropriate next steps in diagnosis and treatment.

Prompt medical attention is crucial for symptoms such as non-healing ulcers in the mouth, painful swallowing, voice changes, or neck lumps, as early detection significantly improves treatment outcomes.   Approximately 75% of oral cancers can be detected through a physical examination by a physician; dentists can also identify cancerous lesions. Diagnostic tools such as clinical evaluation, blood tests, imaging (X-ray, MRI, CT scan), arteriograms, endoscopy, and biopsy for histopathological confirmation, are essential for diagnosis and planning appropriate treatment strategies.  

Successful management relies on a coordinated effort among various healthcare professionals including surgeons, radiation oncologists, medical oncologists, general practitioners, dentists, speech therapists, physiotherapists and dieticians, leading to a positive outcome.

Early diagnosis, personalised treatment plans, and ongoing multidisciplinary care are essential in maximising patient outcomes and supporting patients and their families throughout their treatment journey.  

Treatment options depend on the type, stage, and location of the cancer and may include complex surgical procedures (e.g. resection of tumors, neck lymph nodes, skin and mucosal cancers; neck lymph node dissections); surgeries involving salivary glands and the thyroid gland; radiation therapy; chemotherapy; or a combination of these.

Treatment of head and neck cancer aims to achieve more than just tumour removal; it also focuses on restoring functions like swallowing, eating and speaking. Following surgical removal of tumours, patients may need reconstructive surgery and speech therapy to address both cosmetic and functional concerns. These interventions are essential for enhancing quality of life and promoting recovery after treatment for head and neck cancers.

Some lifestyle changes can potentially lower the risk of developing head and neck cancer. These include avoiding tobacco, limiting alcohol consumption, protecting against HPV and following a healthy diet.