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Head and Neck Cancer

What is head and neck cancer?What is head and neck cancer?

Cancers of the head and neck occur when cancerous cells develop and grow in an uncontrolled way forming tumours. Not all tumours in the head and neck are cancerous.⁴

Most head and neck cancers begin in the squamous cells (thin, flat cells that form the surface of the skin, or lining of the throat).⁵

Cancers of the head and neck include the following areas:^4,5

Mouth (oral cavity) – including lips, cheeks, hard palate and the first two thirds of the tongue, as well as the gums and tonsils.
Larynx – is also known as the voice box, and contains the vocal cords used for making sound. The larynx connects the windpipe (tube that connects to the lungs) with the lower part of the throat.
Pharynx – also known as the throat. Cancer can affect any three areas that make up the pharynx including:
- Nasopharynx – this is the upper part of the throat, behind the nose
- Oropharynx – include the base of the tongue to the tonsils in the back of the throat
- Hypopharynx – is the lower region of the throat, including the area behind the voice box.
Nasal cavity and sinuses – the nasal cavity is the area inside the nose. The area behind the nose consists of four sinuses which impact on the sound and tone of speech.
Salivary glands – is where saliva is produced to help digest food and protect against infections. Most of the tumours found here are typically benign (non-cancerous).

Cancers of the brain, thyroid gland, eye and oesophagus are not included in the classification under ‘head and neck’cancer.⁵

Is head and neck cancer hereditary?Is head and neck cancer hereditary?

People who have a first degree relative (such as a sibling or parent) have an increased risk for developing some head and neck cancers.⁴

Some genetic conditions such as Fanconi anaemia and Dyskeratosis congenita (disorders of blood) lead to an increased risk of developing cancers of the throat and mouth. ⁶

Stages of head and neck cancerStages of head and neck cancer

The TNM system is used to classify cancers of the head and neck. Based on this system, specialists can work out the stage (I-IV) of cancer; Stage I and II represent early stage head and neck cancer and Stage III and IV represent advanced stage cancer.⁷

Tumour (T) – describes the size of the tumour and the extent the cancer has invaded into the area where the tumour has started.
Nodes (N) – describes whether the tumour has spread to nearby lymph nodes. Nodes can be graded from N0, where there has been no spread, through to N3, where the cancer has spread to other lymph nodes.
Metastasis (M) – describes whether the cancer has spread to other areas of the body outside of the head and neck area. Metastasis can be graded from M0, where there has been no spread through to M1c, where the cancer has spread to other organs of the body.

Signs and symptoms of head and neck cancerSigns and symptoms of head and neck cancer

Below is a list of some symptoms that are common to head and neck cancers, however other conditions can also cause these symptoms. It is important to discuss your individual symptoms with your doctor. ⁸

A sore that doesn’t heal
Bleeding in the nose/mouth area, or coughing up blood
Pain with chewing or swallowing
Pain of any kind or a lump in the mouth or neck area
Ongoing sinus infections
Ongoing blocked nose
Headaches
Patches of white or redness in the mouth area (i.e. tongue, lining of the mouth, gums)
Loss of senses such as smell, having double vision or difficulty hearing
Weight loss that can not be explained by diet and exercise

Treatment for head and neck cancerTreatment for head and neck cancer

Treatment for head and neck cancer

There are many different types of treatment for head and neck cancer. Your treatment will depend on you and your cancer. For more information and a full list of treatment options, click here.

Frequently asked questionsFrequently asked questions

Are there risk factors for head and neck cancer?

There are a number of factors that you can control in reducing your risk for developing head and neck cancer. These include:¹

Drinking alcohol – alcohol consumption has a dose-response relationship with cancer (meaning the more you drink the higher the risk of developing cancer). The consumption of alcohol has been related to cancers of the larynx, pharynx and oral cavity.²
Smoking – cigarette smoking increases the risk for mouth and larynx cancer.²
Chewing tobacco – chewing tobacco or betel nut increases the risk of oral and oesophagus cancers.^1,2
Infections – being infected by the HPV (human papillomavirus) can increase the risk of oropharyngeal cancer. Epstein-Barr virus (the virus that causes glandular fever) is associated with nasopharyngeal cancer and certain types of salivary gland cancers. .²
Poor oral hygiene – gum disease as well as not looking after your teeth and gums can increase the risk of oral cavity cancers. ^2,3
Exposure to toxins – such as breathing in chemicals like asbestos or wood dust can increase the risk for cancers of the nasal cavity and sinuses.^1,3
Consumption of preserved and salty foods – eating foods high in salt and preservatives in childhood can increase the risk for nasopharyngeal cancer.¹

Other factors which can increase the risk of developing head and neck cancer include: age (more common in people over 40 years), sex (more common in men than women) and genetics (some genetic conditions such as Fanconi anaemia increase the risk of head and neck cancers).^2,3

How common is head and neck cancer?

More than 800 Singaporeans are diagnosed with head and neck cancer each year.The most common type of head and neck cancer in Singapore is nasopharyngeal carcinoma (NPC).

ReferencesReferences

For a full list of references, click here.

Australian Government: Cancer Australia. (2017). What are the risk factors for head and neck cancer? Retrieved on 27^th April 2019 from https://head-neck-cancer.canceraustralia.gov.au/risk-factors
World Health Organisation. (n.d). Cancer Prevention. Retrieved on 27^th April 2019 from https://www.who.int/cancer/prevention/en/
Cancer Council. (2019). Head and neck cancer. Retrieved on 27^th April 2019 from https://www.cancer.org.au/about-cancer/types-of-cancer/head-and-neck-cancer.html#jump_3
Cancer Council. (2017). What is head and neck cancer? Retrieved on 27^th April 2019 from https://www.cancercouncil.com.au/head-and-neck-cancer/?gclid=EAIaIQobChMIqMKO_57v4QIVkA4rCh1DkwTBEAAYASAAEgLKCvD_BwE
Australian Government: Cancer Australia. (2017). Types of head and neck cancer. Retrieved on 27^th April 2019 from https://head-neck-cancer.canceraustralia.gov.au/types
American Cancer Society. (2018). Risk factors for oral cavity and oropharyngeal cancers. Retrieved on 27^th April 2019 from https://www.cancer.org/cancer/oral-cavity-and-oropharyngeal-cancer/causes-risks-prevention/risk-factors.html
Cancer Council. (2017). Staging and prognosis for head and neck cancer. Retrieved on 27^th April 2019 from https://www.cancercouncil.com.au/head-and-neck-cancer/diagnosis/staging-and-prognosis/
Australian Government: Cancer Australia. (2017). What are the symptoms of head and neck cancer? Retrieved on 27^th April 2019 from https://head-neck-cancer.canceraustralia.gov.au/symptoms
Australian Government: Cancer Australia. (2017). Head and neck cancer: treatment options. Retrieved on 27^th April 2019 from https://head-neck-cancer.canceraustralia.gov.au/treatment

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