Cancer is usually classified by the region of the body in which it occurs. There are many types of cancer that originates in the head and neck area, most commonly in the mouth and larynx.
Cancer is a name for a group of over 100 diseases that occur when cells develop abnormal, uncontrolled growth. Cancer of the mouth (or oral cavity) or of the oropharynx is called oral cancer. The oral cavity includes many parts: the lips; the lining inside the lips and cheeks, called the buccal mucosa; the teeth; the bottom (floor) of the mouth under the tongue; the front two-thirds of the tongue; the bony top of the mouth (hard palate); the gums; and the small area behind the wisdom teeth. The oropharynx includes the back one-third of the tongue, the soft palate, the tonsils, and the part of the throat behind the mouth.
Cancer of the larynx is also called laryngeal cancer; this is the cancer of the neck. It can develop in any region of the larynx--the glottis (where the vocal cords are), the supraglottis (the area above the cords), or the subglottis (the area that connects the larynx to the trachea). If the cancer spreads outside the larynx, it usually goes first to the lymph nodes (sometimes called lymph glands) in the neck. It can also spread to the back of the tongue, other parts of the throat and neck, the lungs, and sometimes other parts of the body.
Tumors in the larynx (laryngeal cancer) often begin with seemingly innocent symptoms, like a hoarse or sore throat, a lump in the throat, or an earache. In its first stages, laryngeal cancer rarely causes severe pain. As the tumor grows, it may become difficult to swallow; the patient may experience weight loss, bad breath, or a tendency to choke. A doctor will normally investigate these problems by looking down the patient's throat into the larynx, a procedure known as as a direct or indirect laryngoscopy. If abnormal tissue seems to be present, the doctor will order a biopsy to test for the presence of cancer. Most cancers of the larynx are squamous cell carcinomas, meaning that the cancer has begun in the flat, fish-scale-shaped cells that line the epiglottis, vocal cords, and other parts of the larynx.
Oral cancer can, though not always, appear with more readily visible symptoms than laryngeal cancer such as a sore or lump that won't heal on the lip, mouth, or throat, a white or red patch in the mouth, unusual bleeding, pain or numbness in the mouth, or swelling of the jaw. Other signs of oral cancer are similar to those of laryngeal cancer, such as difficulty swallowing, an earache, a change in the voice, or a sore throat. If there appear to be abnormal areas in or around the oral cavity, then the doctor will generally order a biopsy to test for cancer; most oral cancers are squamous cell carcinomas.
There are several options for treating head and neck cancers; the best treatment or combination of treatments depends upon the tumor's size, location, and degree of spread, as well as the patient's overall health. Treatment usually involves surgery and/or radiation therapy of the affected area. In some cases, chemotherapy, treatment with anticancer drugs, may be used.
For small tumors, a technique called laser surgery using a small, concentrated beam of light may be used to kill the cancer cells just as a scalpel does. In laryngeal surgery, all or part of the larynx may be removed in a procedure known as a laryngectomy; the surgeon performs the operation by cutting an opening (called a stoma) into the throat. This is called a tracheostomy. A partial laryngectomy will preserve the voice, and the tracheostomy is only temporary. However, a complete laryngectomy will remove the entire voice box and the stoma is permanent; the patient (a laryngectomee) must learn to talk in a new way.
Because nearly all treatments for oral and laryngeal cancers are focused on the mouth and throat, it is important for patients to have a complete dental exam before undergoing any treatments.
Many patients and their families want to learn all they can about head and neck cancer and the treatment choices so they can take an active part in decisions about medical care. The doctor is the best person to answer these questions. When discussing treatment, the patient may want to talk with the doctor about research studies of new treatment methods. Such studies, called clinical trials, are designed to improve cancer treatment. More information about clinical trials is in the Clinical Trials section.
Researchers are finding better ways to treat head and neck cancer, and the chances of recovery keep improving. Still, it is natural for patients and their families to be concerned about the future. There are many resources available both on and off the web for patients and their families. Links to some good web sites can be found on our web resources page, or check out our recommended reading list for patients and their families.Source: NCI Cancernet