Head and Neck Malignancy
Head and neck malignancies encompass cancers that originate in the mouth, throat, nose, salivary glands, thyroid, and lymph nodes within the region. These cancers can impair vital functions such as breathing, swallowing, speaking, and facial movement. Given the complexity of this region, a multidisciplinary treatment approach is necessary to restore function and enhance the quality of life.
Types of Head and Neck Malignancies
Oral Cancers
- Found on the lips, tongue, gums, inner cheeks, and roof of the mouth
- Affects the back of the throat, tonsils, and soft palate, often linked to HPV.
Oropharyngeal Cancer
- Signs include non-healing sores, bleeding, and difficulty eating.
- Symptoms include sore throat, voice changes, and difficulty swallowing.
Laryngeal Cancer
- Occurs in the voice box, affecting breathing and speech.
- Hoarseness and chronic coughing are common indicators.
Nasopharyngeal Cancer
- Found in the upper throat behind the nose.
- Causes nasal blockage, nosebleeds, and headaches.
Salivary Gland Tumours
- Affect the parotid, submandibular, or sublingual glands.
- Manifests as a lump in the neck and may affect hormone production.
Thyroid Cancer
- Symptoms include swelling and facial numbness.
Causes
Tobacco and Alcohol Use: Primary risk factors for most head and neck cancers.
HPV Infection: Strongly linked to oropharyngeal cancers.
Sun Exposure: Associated with lip cancers.
Environmental Hazards: Exposure to chemicals and industrial pollutants.
Genetics and Family History: Some individuals are predisposed to these cancers.
Poor Oral Hygiene and Diet Deficiency: Contributing factors, particularly for oral cancers.
Diagnosis
Physical Examination: Doctors assess visible lumps or sores in the mouth and throat.
Endoscopy: A flexible camera is used to examine deeper tissues in the throat and larynx.
Imaging Studies: CT, MRI, and PET scans help determine tumour size and spread.
Biopsy: Tissue samples are examined to confirm malignancy.
HPV Testing: Used for detecting HPV-positive oropharyngeal cancers.
Ultrasound and Fine Needle Aspiration: Common for diagnosing thyroid cancers.
Treatment
Surgery
- Removes the tumour along with affected tissues or lymph nodes.
- Reconstructive surgery restores function after removal of large tumours.
- Minimally invasive surgeries are used for early-stage cancers.
Radiation Therapy
- External beams of radiation target the tumour cells.
- Techniques like IMRT (Intensity-Modulated Radiation Therapy) limit damage to surrounding tissues.
- Can be combined with surgery or chemotherapy for better outcomes.
Chemotherapy
- Drugs destroy rapidly growing cancer cells.
- Commonly used for advanced cancers or when surgery is not feasible.
- Can be used in conjunction with radiation (chemoradiation).
Targeted Therapy
- Focuses on specific molecules driving cancer growth, like EGFR inhibitors (e.g., cetuximab).
- Less toxic compared to chemotherapy, with fewer side effects.
Immunotherapy
- Boosts the immune system to fight cancer cells effectively.
- Checkpoint inhibitors such as nivolumab are used for HPV-positive or treatment-resistant cancers.
Rehabilitation and Support
- Speech Therapy: Helps patients regain speech after surgery or radiation.
- Nutritional Support: Critical for maintaining strength during treatment.
- Psychological support and counselling are essential to manage emotional well-being.
Conclusion
Head and neck malignancies are treatable with early diagnosis and a comprehensive care approach. Multidisciplinary treatment—including surgery, radiation, chemotherapy, and immunotherapy—improves the chances of recovery. Rehabilitation services such as speech and nutritional therapy are essential for restoring function and ensuring a good quality of life. Patients are encouraged to seek timely medical advice, especially if they have risk factors such as smoking, alcohol use, or HPV exposure.
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