Head and Neck Malignancy

Head and neck malignancies encompass cancers that originate in the mouth, throat, nose, salivary glands, thyroid, and larynx (voice box) in the region. These cancers can impact vital functions such as breathing, swallowing, speaking, and facial movement. Arising from the complexity of head and neck region, multidisciplinary treatment approach is necessary to restore both function and quality of life.

Types of Head and Neck Malignancies

Oral Cancers

Found on the lips, tongue, gums, inner cheeks, and roof of the mouth

Signs include non-healing sores, bleeding, and difficulty eating.

Oropharyngeal Cancer

Affects the back of the throat, tonsils, and soft palate, often linked to HPV.

Symptoms include sore throat, voice changes, and difficulty swallowing.

Laryngeal Cancer

Occurs in the voice box, affecting breathing and speech.

Hoarseness and chronic coughing are common indicators.

Nasopharyngeal Cancer

Found in the upper throat behind the nose.

Causes nasal blockage, nosebleeds, and headaches.

Salivary Gland Tumors

Affect the parotid, submandibular, or sublingual glands.

Symptoms include swelling and facial numbness.

Thyroid Cancer

Manifests as a lump in the neck and may affect hormone production.

Causes

Tobacco and Alcohol Use

Primary risk factors for most head and neck cancers.

HPV Infection

Strongly linked to oropharyngeal cancers.

Sun Exposure

Associated with lip cancers.

Environmental Hazards

Exposure to chemicals and industrial pollutants.

Genetics and Family History

Some individuals are predisposed to these cancers.

Poor Oral Hygiene and Diet Deficiency

Contributing factors, particularly for oral cancers.

Diagnosis

Physical Examination

Doctors assess visible lumps or sores in the mouth and throat.

Endoscopy

A flexible camera is used to examine deeper tissues in the throat and larynx.

Imaging Studies

CT, MRI, and PET scans help determine tumour size and spread.

Biopsy

Tissue samples are examined to confirm malignancy.

HPV Testing

Used for detecting HPV-positive oropharyngeal cancers.

Ultrasound and Fine Needle Aspiration

Common for diagnosing thyroid cancers.

Treatment

Surgery

Removes the tumour along with affected tissues or lymph nodes.
Reconstructive surgery restores function after removal of large tumours.
Minimally invasive surgeries are used for early-stage cancers.

Radiation Therapy

External beams of radiation target the tumour cells.
Techniques like IMRT (Intensity-Modulated Radiation Therapy) limit damage to surrounding tissues.
Can be combined with surgery or chemotherapy for better outcomes.

Chemotherapy

Drugs destroy rapidly growing cancer cells.
Commonly used for advanced cancers or when surgery is not feasible.
Can be used in conjunction with radiation (chemoradiation).

Targeted Therapy

Focuses on specific molecules driving cancer growth, like EGFR inhibitors (e.g., cetuximab).
Less toxic compared to chemotherapy, with fewer side effects.

Immunotherapy

Boosts the immune system to fight cancer cells effectively.
Checkpoint inhibitors such as nivolumab are used for HPV-positive or treatment-resistant cancers.

Rehabilitation And Support

Speech Therapy: Helps patients regain speech after surgery or radiation.

Nutritional Support: Critical for maintaining strength during treatment.
Psychological support and counselling are essential to manage emotional well-being.

Conclusion

Head and neck malignancies are treatable with early diagnosis and a comprehensive care approach. Multidisciplinary treatment—including surgery, radiation, chemotherapy, and immunotherapy—improves the chances of recovery. Rehabilitation services such as speech and nutritional therapy are essential for restoring function and ensuring a good quality of life. Patients are encouraged to seek timely medical advice, especially if they have risk factors such as smoking, alcohol use, or HPV exposure.

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