Head and neck cancer

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maneesha Nandimandalam, M.B.B.S.[2]

Head and Neck cancer Microchapters

Patient Information

Overview

Classification

Brain tumor
Oral cancer
Nasopharyngeal cancer
Hypopharyngeal cancer
Glomus tumor
Salivary gland tumor
Laryngeal cancer
Thyroid cancer
Parathyroid cancer
Esophageal cancer

Causes

Differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]

Classification

  • Head and neck cancers comprise of a group of malignancies arising from the oral cavity, pharynx and larynx, paranasal sinuses, nasal cavity or salivary glands with squamous cell carcinoma representing the most common histology.

'Head and neck squamous cell carcinomas (HNSCC's) make up the vast majority of head and neck cancers, and arise from mucosal surfaces throughout this anatomic region. These include tumors of the nasal cavities, paranasal sinuses, oral cavity, nasopharynx, oropharynx, hypopharynx, and larynx.

Oral cavity

Squamous cell cancers are common in the oral cavity, including the inner lip, tongue, floor of mouth, gingivae, and hard palate. Cancers of the oral cavity are strongly associated with tobacco use, especially use of chewing tobacco or "dip", as well as heavy alcohol use. Cancers of this region, particularly the tongue, are more frequently treated with surgery than are other head and neck cancers.

Surgeries for oral cancers include

  • Maxillectomy (can be done with or without Orbital exenteration
  • Mandibulectomy (removal of the mandible or lower jaw or part of it)
  • Glossectomy (tongue removal, can be total, hemi or partial)
  • Radical neck dissection
  • Moh's procedure
  • Combinational e.g. glossectomy and laryngectomy done together.

The defect is covered/improved by using another part of the body and/or skin grafts and/or wearing a prosthesis.

Nasopharynx

Nasopharyngeal cancer arises in the nasopharynx, the region in which the nasal cavities and the Eustachian tubes connect with the upper part of the throat. While some nasopharyngeal cancers are biologically similar to the common HNSCC, "poorly differentiated" nasopharyngeal carcinoma is distinct in its epidemiology, biology, clinical behavior, and treatment, and is treated as a separate disease by many experts.

Surgeries for nasal cancer (cancer of the nose)

  • Surgery to removal the entire nose or part of the nose. Removal of all of the nose is called a total rhinectomy, for part of the nose it is called a partial rhinectomy. Afterwards to cover the defect, a new nose can be made by using another part of the body and/or a nose prosthesis is made.

Oropharynx

Oropharyngeal cancer begins in the oropharynx, the middle part of the throat that includes the soft palate, the base of the tongue, and the tonsils. Squamous cell cancers of the tonsils are more strongly associated with human papillomavirus infection than are cancers of other regions of the head and neck.

Hypopharynx

The hypopharynx includes the pyriform sinuses, the posterior pharyngeal wall, and the postcricoid area. Tumors of the hypopharynx frequently have an advanced stage at diagnosis, and have the most adverse prognoses of pharyngeal tumors. They tend to metastasize early due to the extensive lymphatic network around the larynx.

Larynx

Laryngeal cancer begins in the larynx or "voice box." Cancer may occur on the vocal cords themselves ("glottic" cancer), or on tissues above and below the true cords ("supraglottic" and "subglottic" cancers respectively). Laryngeal cancer is strongly associated with tobacco smoking.

Surgeries can include partial laryngectomy (removal of part of the larynx) and total laryngectomy (removal of the whole larnyx). If the whole larynx has been removed the person is left with a permanent tracheostomy opening and learns to speak again in a new way with the help of intensive teaching and speech therapy and/or an electronic device.

Also anyone who has had a glossectomy (tongue removal) will be taught to speak again in a new way and have intensive speech therapy

Trachea

Cancer of the trachea is a rare malignancy which can be biologically similar in many ways to head and neck cancer, and is sometimes classified as such.

Most tumors of the salivary glands differ from the common carcinomas of the head and neck in etiology, histopathology, clinical presentation, and therapy, Other uncommon tumors arising in the head and neck include teratomas, adenocarcinomas, adenoid cystic carcinomas, and mucoepidermoid carcinomas. Rarer still are melanomas and lymphomas of the upper aerodigestive tract.

[1][2][3][4]

References

  1. Howren MB, Christensen AJ, Karnell LH, Funk GF (2013). "Psychological factors associated with head and neck cancer treatment and survivorship: evidence and opportunities for behavioral medicine". J Consult Clin Psychol. 81 (2): 299–317. doi:10.1037/a0029940. PMC 3587038. PMID 22963591.
  2. Giraldi L, Leoncini E, Pastorino R, Wünsch-Filho V, de Carvalho M, Lopez R; et al. (2017). "Alcohol and cigarette consumption predict mortality in patients with head and neck cancer: a pooled analysis within the International Head and Neck Cancer Epidemiology (INHANCE) Consortium". Ann Oncol. 28 (11): 2843–2851. doi:10.1093/annonc/mdx486. PMC 5834132. PMID 28945835.
  3. Ojo B, Genden EM, Teng MS, Milbury K, Misiukiewicz KJ, Badr H (2012). "A systematic review of head and neck cancer quality of life assessment instruments". Oral Oncol. 48 (10): 923–937. doi:10.1016/j.oraloncology.2012.03.025. PMC 3406264. PMID 22525604.
  4. Wen Y, Grandis JR (2015). "Emerging drugs for head and neck cancer". Expert Opin Emerg Drugs. 20 (2): 313–29. doi:10.1517/14728214.2015.1031653. PMC 5678969. PMID 25826749.

Case Studies

Case#1

Related chapters

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