Head and neck cancers

Learning of a head and neck cancer diagnosis can be difficult and overwhelming. Turn to the experts at Atrium Health Floyd and Harbin Clinic to help you understand your condition and make an informed decision about the best treatment for you.

What are head and neck cancers?

Head and neck cancers refers to a broad category of cancers occurring in the head or neck region, including the nasal cavity, sinuses, skin, lips, mouth, salivary glands, throat, tonsils or larynx. Most head and neck cancers begin in the squamous cells that line the moist surfaces of these areas.

Cancers of the head and neck are categorically different than cancers of the brain.

Causes of head and neck cancers

The causes of head and neck cancers can be as diverse as the cancers themselves. Some causes include:

Lifestyle choices

Lifestyle can influence the chances of head and neck cancer. Examples include tobacco and alcohol use or contracting human papillomavirus (HPV). These examples are particularly influential in the development of cancer in the mouth or throat.

Environmental exposure

Ranging from natural exposures, like prolonged exposure to the sun without sun block, to pollutants or radiation in the atmosphere, head and neck cancers can be caused by invisible factors that may be unconsidered or even unknown at the time of exposure.

Metastasis

Metastatic cancer is a cancer that begins in one part of the body and spreads elsewhere. Through this, any cause for cancer elsewhere in the body may eventually cause the cancer to reach the head and neck region.

Head and neck cancer symptoms

Head and neck cancers are diverse and may manifest a wide array of symptoms, including:

• Changes in appetite or digestion
• Difficult swallowing
• Ear pain
• Headaches
• Lumps or sores
• Nasal congestion
• Voice loss or changes

Types of head and neck cancer

There are multiple types of cancer that affect locations in the head and neck, including:

• Esthesioneuroblastoma affects the upper part of the nasal cavity, obstructing breathing, reducing the sense of smell or causing nosebleeds.
• Thyroid cancer can create pain in the throat or neck, difficulty swallowing or breathing, voice changes, nodules or goiters.
• Parathyroid cancer, which is positioned close to the thyroid, has its own distinct cancer that can disrupt hormone levels, create fatigue, disrupt thinking and cause digestive problems. Noncancerous tumors called adenomas may also form in this area.
• Nasal cavity and paranasal sinus cancer includes those which develop within the nose and surrounding bones.
• Laryngeal cancer occurs in the voice box, or larynx, and can impair the ability to speak, swallow or breathe comfortably.
• Oral cavity cancer includes those affecting the gums, tongue, lips, hard palette, floor of the mouth or behind the wisdom teeth.
• Skin cancer can affect the face, neck and scalp.
• Salivary gland cancer can impair swallowing, create pain while eating or make it difficult to move the affected side of the face.
• Pituitary carcinoma may cause unusual growths behind the nose at the base of the brain and increase or decrease hormone production.
• Throat cancer applies to three distinct types of cancer, categorized by the area affected: nasopharynx, or the upper throat behind the nose; oropharynx, the middle throat behind the mouth, the base of the tongue and tonsils; and hypopharynx, or the lower throat, above the esophagus and windpipe.

Diagnosing head and neck cancers

Many avenues of diagnosis are available when head and neck cancer is a possibility. Your doctor may recommend one or more of the following tests, including:

• Barium swallow tests
• Biopsy
• Blood tests
• CT scan
• Endoscopy
• Imaging tests
• MRI
• Positron emission tomography
• Physical examination
• Review of medical or family history
• Ultrasound
• X-ray

Complications of head and neck cancers

Head and neck cancers can disfigure the face and neck and impact sight, speech, swallowing, and the sense of smell.

Head and neck cancer treatments

Treatment for head and neck cancer depends on the type, location and progression (stage) of your cancer but can include any combination of surgery, radiation therapy and chemotherapy. Your Atrium Health Floyd and Harbin Clinic cancer care team will develop a treatment plan tailored to your condition based on testing results and health history.

Treatment of head and neck cancer includes:

• Chemotherapy uses drugs to kill cancer cells or slow their growth.
• Immunotherapy works by leveraging immune checkpoint inhibitors, targeted antibodies, adoptive cellular therapy and therapeutic vaccines.
• Radiation therapy uses high-energy rays such as gamma rays or protons to target and kill cancer cells.
• Surgical treatments typically aim to remove (excise) cancerous growths. Commons head and neck cancer procedures include laryngectomy, lymphadenectomy, thyroidectomy, transoral robotic surgery and skull base surgery.
• Targeted therapy interferes with specific molecules essential for cancer growth. These include epidermal growth factor receptor (EGFR) inhibitors, small molecule inhibitors and monoclonal antibodies.