What is head and neck cancer?
Head and neck cancer are a general term that refers to a range of different cancers that start developing in the head and neck region of the body. This includes the oral cavity, tongue, palate, jaw, salivary glands, throat (larynx) and the nose.
Most head and neck cancers start in the squamous cells that line the mouth, nose or throat. These are called Squamous Cell Carcinomas (SCCs).
Cancer can occur when abnormal cells grow and spread quickly, forming a mass called a tumour. Tumours can be non-cancerous (benign) or cancerous (malignant). Sometimes cancer cells break away from the original tumour and travel to other areas of the body, where they keep growing and go on to form new tumours. This is called metastasis.
Cancer can occur in any tissue or organ in the head and neck. Head and neck cancer are a term used to describe a range of malignant tumours that can appear in the mouth, throat, larynx (voice box), nose, sinuses and around the eyes. Cancers are treated according to the location of the primary tumour, or where the cancer started in the body. It is important to know the exact medical name of the cancer you have so you can find the right information. The treatment for sinus cancer is not the same as for oropharyngeal cancer, for example. If you are not sure what your cancer is called, you can ask your doctor or nurse to write it down for you.
In 2017 the Western Australian incidence rate for Head & Neck Cancer was 584 people. Of those 584 people unfortunately the mortality rate was 115.
In 2019 there were 5,212 new cases of Head & Neck Cancer diagnosed in Australia and this accounts for 3.4% of all cancers diagnosed. That number is expected to increase in 2020. In 2019 it is estimated that there are 17,000 people living with Head & Neck Cancer in Australia.
On the plus side the survivability rate for Head & Neck Cancer has increased from 63% in 2015 to 71% in 2019.
According to Cancer Council statistics, approximately 4,000 Australian people (2,920 men and 1,080 women) are diagnosed with a head and neck cancer each year.
While worldwide, head and neck cancer are the sixth most frequently occurring cancer. Men are two to three times more likely to develop this type of cancer than women. However, the incidence of head and neck cancer in women is now increasing.
Head and neck cancer are most common in people over the age of 40, but there has been a recent increase in younger people developing the disease.
Types of Head and Neck Cancer
Oral cancer or Mouth
Oral ormouth cancer – refers to cancers that start anywhere in the mouth (lips, inside cheeks, front two thirds of tongue, floor of mouth, jaw and gums).
Oral cancer is divided into six sections:
Pharyngeal cancer refers to cancer that begins in the throat (pharynx). The pharynx runs from the back of the nose to the gullet (or oesophagus) and the windpipe (or trachea).
The pharynx is divided into three sections:
Nasopharynx = cavity behind the nose and above the soft palate.
Oropharynx = area from the soft palate and tongue base to the back of the mouth including the tonsils.
Hypopharynx = the lowest part of the throat behind the voice box or larynx.
Air passes through the nasopharynx as you breathe in and out.
Both food and air pass through the oropharynx and hypopharynx. Food goes into the stomach via the oesophagus, while air goes into the trachea to get to the lungs.
Cancers will be classified as nasopharyngeal, oropharyngeal or hypopharyngeal depending on where in the pharynx they develop.
Laryngeal cancer refers to cancers that start in the voice box (larynx). The larynx is the short passageway that connects the lower part of the pharynx (hypopharynx) with the windpipe (trachea). It contains the vocal cords (glottis) which vibrate when air passes through them to produce sound. Above the vocal cords is the epiglottis which prevents food from going into the trachea when you swallow. Below the vocal cords is the subglottis. Under the larynx, in front of the trachea is the thyroid gland.
Nasal cancer or Para nasal sinus cancer
Nasal cancer or Para nasal sinus cancer includes cancer starting in the nose, nasal cavity or the sinuses.
The term “throat cancer” is not very specific. It includes cancers in many different parts of the head and neck area. These areas include the nasopharynx located behind the nose, the oropharynx, which includes the tonsils and base of tongue, as well as the voice box and the inlet to the esophagus
Some patients with head and neck cancer first show up to a doctor’s office because they feel a “swollen gland” or lump in the neck. It is important to note that a lump in the neck is not necessarily cancer. Lymph nodes can be enlarged for many reasons, including inflammation and infection. Also, there are several benign (non-cancerous) tumours that can be discovered in the neck (e.g., schwannomas, neurofibromas, paragangliomas and others). Most lumps in the neck are not cancer. However, if a lump doesn’t go away after about two weeks, particularly if your doctor has tried some type of treatment, it’s worth getting it checked out by a specialist. The term “neck cancer” is not a very specific term. In most cases it refers to cancer cells that have spread into lymph nodes within the neck from a primary tumour site.
What are the risk factors for Head and Neck Cancer?
A risk factor is any factor that is associated with increasing someone’s chances of developing a certain condition, such as cancer.
Some risk factors are modifiable, such as lifestyle or environmental risk factors, and others cannot be changed, such as genetic or inherited factors.
Having one or more risk factors does not mean that you will develop cancer. Many people have at least one risk factor but will never develop cancer, while others with cancer may have had no known risk factors. Even if a person with cancer has a risk factor, it is usually hard to know how much that risk factor contributed to the development of their disease.
The main factors that are associated with a higher risk of developing head and neck cancer are:
Smoking and alcohol consumption
Smoking and alcohol consumption are the main risk factors for most types of head and neck cancers, except for salivary gland cancer. Research indicates that at least 75% of head and neck cancers are caused by a combination of cigarette smoking and alcohol consumption.
Smoking cigarettes, cigars or pipes is associated with an increased risk of head and neck cancer, especially of the larynx.
Alcohol use may lead to an increased risk especially in heavy drinkers (three or more drinks per day). Smoking and using alcohol greatly increase your risk.
Infection with some types of human papillomavirus (HPV) (Oral Sex with Females)
Infection with some types of human papillomavirus (HPV), especially for cancers involving the tonsils, the tongue including the base of the tongue, the paranasal sinuses and the nasal cavity.
Infection with Epstein–Barr virus
Infection with Epstein–Barr virus (the virus that causes glandular fever), for nasopharyngeal cancer and salivary gland cancer.