Head & Neck Cancer

• Head and neck cancer arises in the head or neck region (in the nasal cavity, sinuses, lips, mouth [oral cavity], salivary glands, throat [oropharynx/hypopharynx], or larynx [voice box]).
• Most head and neck cancers begin in the squamous cells that line the mucosal surfaces in the head and neck. Head and neck cancers are identified by the area in which they begin.
• Tobacco and alcohol use are the most important risk factors for head and neck cancers.
• Typical symptoms of head and neck cancer include a lump or sore (for example, in the mouth) that does not heal, a sore throat that does not go away, difficulty swallowing, and a change or hoarseness in the voice.
• The treatment plan for an individual patient depends on a number of factors, including the exact location of the tumor, the stage of the cancer, and the person's age and general health.
• Rehabilitation and regular follow-up care are important parts of treatment for patients with head and neck cancer.

Oral Cavity

Cancer of the oral cavity is cancer that forms in tissues of the lip or mouth. This includes the front two thirds of the tongue, the upper and lower gums, the lining inside the cheeks and lips, the bottom of the mouth under the tongue, the bony top of the mouth, and the small area behind the wisdom teeth. There will be an estimated 22,900 new cases of cancer of the oral cavity in the United States in 2008 and an estimated 5,390 deaths.

Symptoms of cancer of the oral cavity include, but are not limited to, skin lesion, lump or ulcer on the tongue, lip or other mouth area that is usually small and most often pale colored (but may be dark or discolored). An early sign may be a white patch (leukoplakia) or a red patch (erythroplakia) on the soft tissues of the mouth. These sores are usually painless initially, but a burning sensation or pain may be present with more advanced lesions. Tongue problems, swallowing difficulty, pain and parasthesias are additional symptoms associated with cancer of the oral cavity.

Surgical excision (removal) of the tumor is usually recommended if the tumor is small enough, and if surgery is likely to result in a functionally satisfactory result. Radiation therapy is often used in conjunction with surgery, or as the definitive radical treatment, especially if the tumour is inoperable.

Owing to the vital nature of the structures in the head and neck area, surgery for larger cancers is technically demanding. Reconstructive surgery may be required to give an acceptable cosmetic and functional result. Bone grafts and surgical flaps are used to help rebuild the structures removed during excision of the cancer.

Survival rates for oral cancer depend on the precise site, and the stage of the cancer at diagnosis. Overall, survival is around 50% at five years when all stages of initial diagnosis are considered. Survival rates for stage 1 cancers are 90%, hence the emphasis on early detection to increase survival outcome for patients.