-Posting last reviewed by Dr. Mancell, September 2020.
In observance of Oral, Head, and Neck Cancer Awareness Week, Dr. Jered Mancell of Prairie Lakes Ear, Nose, Throat and Facial Plastic Surgery Clinic has answered common questions on the topic. If you are experiencing any of the mentioned symptoms Dr. Mancell is available to see patients with no referral from your doctor.
What are the most common types of head and neck cancers?
The two most common sites of head and neck cancer are the oral cavity (mouth) and larynx (throat). The most common type of cancer of the head and neck is squamous cell carcinoma (SCCa), but multiple of forms of cancer can present here.
I am a smoker, does this increase my risks of head or neck cancer?
Risk factors for head and neck cancer are well documented. The two most significant risk factors include tobacco (smoking or smokeless) and alcohol. At least 75% of head and neck cancers are attributed to the use of one or both of these products. When individuals habitually use both tobacco and alcohol, their risk for developing head and neck cancers increases even more. Other risk factors include; human papilloma virus (HPV) exposure, radiation exposure, sun exposure (lip cancer), poor oral hygiene, immune suppression, preserved/cured foods, and Epstein-Barr virus.
The oral cavity (mouth) and larynx (throat) are the most common sites of head and neck malignancy, can you explain each of these further and also what are some signs/symptoms to watch for?
The oral cavity is the most common site of head and neck malignancy. The oral cavity includes the lips, gums, hard palate, the inside of the cheeks, and the front 2/3 of the tongue. SCCa is the culprit in more than 90% of these cancers. Other forms include basal cell carcinoma (BCCa), lymphoma, salivary gland cancers, and melanoma. Oral cancers most frequently involve the lips followed by the tongue. Cancers of the lip are often related to sun exposure may include SCCa, BCCa and melanoma. Cancers of the tongue are most often related to tobacco, alcohol, and/or HPV. Signs and symptoms may include: non healing lesions, ill-fitting dentures, difficulty swallowing, pain with swallowing, tight jaw, bad breath, numbness of the teeth, and a persistent neck mass.
The larynx (throat) is the second most common site of head and neck malignancy. The larynx includes the vocal folds ("voice box") and the areas above and below. Laryngeal cancers account for approximately 1-5% of all cancers. The most common form of laryngeal cancer is SCCa but other forms of cancer can present here as well. Risk factors include; tobacco and alcohol use, radiation, HPV, and chronic exposure to metal, plastics, paint, wood dust and asbestos. Signs and symptoms may include; voice changes (hoarseness), difficulty swallowing, pain with swallowing, coughing up blood, ear pain, unexplained weight loss, a persistent neck mass, and the sensation of something stuck in the throat.
If I suspect that I may have cancer of the head or neck, what instruments and/or steps will help with the detection?
In addition to special imaging (CT's and MRI's), otolaryngologists (ENT's) have special endoscopes and instruments to evaluate these areas for malignancy. If diagnosed, these cancers are stages based on the size of the tumor, whether or not the cancer has spread to the nearby lymph nodes, and whether or not the cancer has spread to more distant areas of the body. Staging helps direct treatment which can include surgery, radiation therapy, chemotherapy or a combination thereof. Although the treatment of head and neck cancer has improved significantly, prevention is the best approach.
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