Head and neck cancers are on the rise in our country. Worldwide, head and neck cancer (HNC) is the seventh most common cancer overall (the fifth most common in men and the 12th most common in women).Head and neck cancer (HNC) is very common in India, constituting 30% of all cancers. In males head  neck cancer is more common than in females.

Dr. Gopal Pemmaraju is a Consultant Radiation and clinical oncologist at Nanavati Max Superspeciality hospital ,Mumbai. For the past 8 years, he has being working in this field.

All you need to know about head and neck cancer

Dr Gopal Pemmaraju says, “Head and neck cancer is a broad term. It is divided into two different parts depending on the anatomical sites where head and neck cancer occur. These are - 

• Nasopharynx
• Different sinus cancer like sphenoid sinus, maxillary sinus
• Cancer of lip, buccal mucosa or tongue
• Cancer of supraglottis, larynx and pharynx

There are many histopathological features with different cancers. Depending on the anatomical sites and types of cancer, there are different treatment options for the same. The treatment options are as follows- 

• Radiation
• Chemotherapy
• Surgery 
• Targeted therapy

Depending on the site or histopathological variant, the treatment varies.”

Warning signs of head and neck cancer

Dr Gopal Pemmaraju informs, “The warning signs of head and neck cancer are as follows- 

• Non-healing ulcers on tongue, buccal mucosa, lips or throat

• Swelling in the oral cavity, neck, lymph node enlargement

• Change of voice due to cancer of larynx or nasal cavity

• Difficult in breathing due to growth may result in noisy breathing 

• Pain while swallowing especially when tumor is present in posterior wall of the throat

• Irritation in throat while taking spicy and oily food 

• Unexplained pain 

• Weight loss as the nutrients are taken up by cancer cells 

• Bleeding due to blood vessels rupturing.”

Causes of head and neck cancer 

Dr Gopal Pemmaraju states, “The causes of head and neck cancer are as follows- 

• Chronic irritation due to chronic exposure to carcinogens like tobacco or toxic fumes especially seen in industrial worker
• Chronic irritation of the buccal mucosa may lead to carcinoma 
• HPV i.e Human Papillomavirus - This causes cancer of the oropharynx.”

Detection of head and neck cancer

Dr Gopal Pemmaraju tells, “The detection of head and neck cancer is as follows- 

• Do not neglect warning signs 
• Ulcer in oral cavity 
• Swelling of neck 
• Proliferative growth inside the oral cavity 
• Persistent unexplained cough 
• Weight loss more than 10% in last 2-3 months 

You must immediately consult a doctor nearby or an oncologist for early detection of the cancer. Early detection leads to good prognosis. Neglecting cancer at early stages may lead to complications at higher stages, it may spread to lymph nodes or the surrounding structures may get affected. This may result in extensive surgery or tracheostomy or total laryngectomy. Proper management of cancer at the best earlier point, prognosis will be better with many treatment options.”

Growth of head and neck cancer

Dr Gopal Pemmaraju informs, “There are many risk factors for head and neck cancer which are as follows- 

• Histopathological variant- Some histopathological variants are very aggressive like the squamous cell carcinoma. This may spread to distant sites like lungs, nodes, skull bases infiltrating the important structures. 
• Nutritional and immune status of the patient- If the patient is immunologically weak with unexplained weight loss, there can be deficiency in vitamins, minerals and amino acids. 
• Genetic mutations- Depending on the genetic mutation of varying degrees, aggressiveness of the cancer may vary. 

Reduced risk of reoccurrence of the head and neck cancer

Dr Gopal Pemmaraju says, “30-40% patients of head and neck cancer even after complete treatment do have recurrence of cancer. There is no thumb rule to minimize this. However, we can reduce the risk of recurrence of head and neck cancer with the following- 

• Minimizing exposure to toxins like tobacco, toxic fumes 
• Maintain proper nutrition and diet with vitamins and minerals 
• Exercise.”

With all these precautions, 50-60% of the risk can be minimized. We cannot change the mutations which have already occurred. But, by taking proper care, maintaining a healthy lifestyle can help minimize the recurrence of cancer.” 

Rapid fire 

How many head and neck cancer patients receive the radiation therapy? Dr Gopal Pemmaraju states,”Around 70% of the cancer patients need radiation at one point or the other. It may be adjuvant or neoadjuvant or palliative set-up.”

Where do we stand against the fight in head and neck cancer? Dr Gopal Pemmaraju states,”With advent of medical advancement in the field of treatment, many chemotherapeutic agents, surgeries and targeted therapies have come up, Around 70-80% of the head and neck tumors can be treated, managed and kept under control with minimal side effects.”

Are there any side effects of radiation therapy for head and neck cancer? Dr Gopal Pemmaraju states,”Radiation therapy has side effects because along with the tumor we target, some radiation also affects the normal structures. The side effects are as follows- small ulcers, difficulty in swallowing, irritation or pain in the oral cavity. We have many advanced techniques through which radiation effects can be minimized. There are some acute and late side effects. All these are temporary