Head and Neck Cancer
Head and neck cancer is not a single disease. It's a collection of cancers that begin in the mouth, throat, nose, voice box, sinuses, or even the tongue. These cancers most often begin in the cells that cover the moist surfaces of the head and neck region — such as the mouth or throat — and they can spread if they're not caught early.
Head and neck cancers are extremely prevalent in India, particularly among men. In fact, 1 in every 33 Indian men can develop it during their lifetime. All this is primarily due to chewing tobacco, smoking, alcohol consumption, or infection with HPV. That's why awareness is important.
the signs are
- A swelling or lump in the neck
- Difficulty swallowing
- Hoarseness or voice change
- A mouth ulcer or non-healing sore
- Ear pain or ringing sensation
- Blocked nose or recurrent nosebleeds
- A sore that just doesn't heal, especially inside the mouth
Patients may ignore these in the early stages, thinking it's just a throat infection or ulcer — but these small signs can be life-saving if caught early.
Now let's talk about the types of head and neck cancer you might come across in practice.
The most prevalent one is Squamous Cell Carcinoma. It occurs in approximately 90% of all head and neck cancers. It starts with the flat squamous cells that cover locations such as the mouth, throat, and larynx. Tobacco and alcohol use are the largest perpetrators of this type — particularly when used together.
Then there is Adenocarcinoma. This is less frequently occurring, and it accounts for some 5 to 10% of head and neck cancers. It begins in the glandular tissue, and its etiology may be due to HPV infection, previous radiation exposure, or — once again — smoking.
The other subtype is Cutaneous Squamous Cell Carcinoma, or cSCC. It is basically a skin cancer but can manifest in the head and neck area. Although it can begin on the surface, some of its subtypes can be aggressive in their behavior, depending on pathology.
And lastly, we have Lymphomas in this area — they constitute 5 to 10% of head and neck tumors. These originate from the lymphoid system, and we usually find them in association with Epstein-Barr Virus (EBV), chronic inflammation, or intense family history.
Let us learn about the Staging of Head and Neck Cancer
Stage 0 is when the cancer has not penetrated to the surface. It is still in the epithelial layer — that is, very early and not invasive into deeper tissues.
Stage 1 is a small, localized tumor — 2 centimeters or smaller, and no evidence of spread to lymph nodes or distant sites.
Stage 2 signifies that the tumor has increased in size — between 2 and 5 centimeters, but is yet to move from the initial location.
Stage 3 is where the tumor is either more than 4 centimeters in size, or has begun moving towards adjacent lymph nodes, usually on the same side of the Stage 4 is the most advanced. In this stage, the cancer might have spread from the local area — perhaps to other organs like the lungs, bones, or liver.
Now let's discuss grading, which informs us about how severe or quick-growing the cancer could be — depending on how the cells appear under a microscope.
Grade 1, or low-grade cancer, is very much like normal cells. These tumors are typically slow-growing and less aggressive.
Grade 2, or intermediate-grade, indicates the cells are more irregular. They grow faster than grade 1 but not as aggressively as grade 3.
Grade 3, or high-grade, means that the cancer cells appear very abnormal. These tumors will grow more quickly and are more likely to spread more quickly.
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