Head and neck cancer

Head and neck cancer develops from tissues in the lip and oral cavity (mouth), larynx (throat), salivary glands, nose, sinuses, or skin of the face. The most common types of head and neck cancer occur in the lips, mouth, and larynx. Symptoms predominantly include a sore that does not heal or a change in the voice. In those with advanced disease, there may be unusual bleeding, facial pain, numbness or swelling, and visible lumps on the outside of the neck or oral cavity. Given the location of these cancers, trouble breathing may also be present. The majority of head and neck cancer is caused by the use of alcohol or tobacco, including smokeless tobacco, with increasing cases linked to the human papillomavirus (HPV). Other risk factors include the Epstein-Barr virus, betel quid, radiation exposure, and certain workplace exposures. About 90% are pathologically classified as squamous cell cancers. The diagnosis is confirmed by a tissue biopsy. The degree of surrounding tissue invasion and distant spread may be determined by medical imaging and blood tests. Not using tobacco or alcohol can reduce the risk of head and neck cancer. The HPV vaccine may reduce the lifetime risk of oral cancer if taken prior to the onset of sexual activity, but confirmation will likely not be known until around 2060. This is because oropharyngeal cancer typically presents in the 4th–6th decade of life, and this is a relatively new vaccine. While screening in the general population does not appear to be useful, screening high-risk groups by examination of the throat might be useful. Head and neck cancer is often curable if it is diagnosed early; however, outcomes are typically poor if it is diagnosed late. Treatment may include a combination of surgery, radiation therapy, chemotherapy, and targeted therapy. Previous diagnosis and treatment of one head and neck cancer confer a higher risk of developing a second head and neck cancer or recurrence. Globally, head and neck cancer accounts for 650,000 new cases of cancer and 330,000 deaths annually on average.

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