Dr Eric Ortiz | Head of Medical Oncology of the CIF
The term Head and neck cancer refers to tumors that develop in sites such as the mouth, pharynx, larynx, nasal cavity, paranasal sinuses, thyroid, and salivary glands. Together they represent approximately 3.6% of all reported cancers and about 2% of deaths attributed to cancer. Of all of them, in our country, the most common are the oral cavity (44%), larynx (31%), pharynx (25%).
It is considered to tobacco use A s the main risk factor associated with the appearance of these tumors, people who have a higher risk of developing this disease have used tobacco for more than 35 years. The risk increases when tobacco consumption is combined with alcohol consumption, thus close to the 75% of head and neck tumors are related to these two factors.
Most cases of head and neck cancer occur in mens with an average age of 60 years, although the age of appearance has been reduced mainly in oropharyngeal cancer (area that covers the part of the throat, “angina” and base of the tongue). In recent years, this type of cancer has increased in young non-smokers, due to a higher incidence of throat infection due to human papillomavirus (HPV). As serious as it may seem, it is these latter cases that are associated with a better prognosis compared to cases related to tobacco use.
HPV is a virus of which more than 150 types have been identified. Most of them infect the skin and are responsible for the formation of warts, some types are sexually transmitted, that is, they are transmitted through contact with the genitals. In most cases, the immune system can fight infections caused by these viruses, but in some people the infection can remain for a long time without symptoms and develop cancer at the infected site. HPV has been classified into two large groups: low risk and high risk (HPV 16 and HPV 18); this depends on the probability of generating premalignant lesions such as red ulcers (erythroplakia) or whitish plaques (leukoplakia) or even cancer.
The cancers most related to HPV infection are: cervical cancer, anal canal cancer, oral cavity cancer, and doropharynx cancer.
Generally, the Symptoms and signs presented in head and neck cancer are related to an ulcer or “lump” that presents a gradual growth (the discomfort presented depends on the affected structures), changes in the voice (hoarseness), or chronic cough. For the above, many times these types of conditions take time to be detected as they are confused with upper respiratory tract infections, foreign bodies or allergic processes.
Some symptoms and signs produced by head and neck tumors according to the site of involvement are:
- Oral cavity: painless ulcers, canker sores, pain in the mouth, tumor or “lump” that increases in size and causes discomfort when eating; loosening of teeth may also occur.
- Throat (oropharynx, hypopharynx): sore throat, pain when swallowing, ear pain, hoarseness, difficulty swallowing or a feeling of blockage, neck tumor.
- Larynx: hoarseness may be the first symptom, difficulty swallowing, ear pain, chronic cough may also occur.
Tobacco and alcohol consumption can also affect other structures such as respiratory and upper digestive tract Therefore, these patients also have an increased probability compared to the general population of presenting (at the same time, before or after) lung or esophageal cancer.
In case of detecting any abnormality in any of the commented sites, it is important see a specialist (otolaryngologist) that can assess the injury or injuries presented and request the necessary studies to reach a diagnosis. If cancer originating in any of the structures of the head or neck is confirmed, the management and follow-up should be carried out by a multidisciplinary team where experts in oncology (surgeon oncologist, medical oncologist, radiation oncologist) with experience in head and neck tumors participate.
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