Head and neck cancer refers to laryngeal, lip and tongue cancers. Head and neck cancers occur inside the sinuses, nose, mouth and salivary glands down through the throat. Although the cancers are different, they are treated similarly, so are considered as a group.
Incidence and mortality
There are approximately 2078 cases of head and neck cancer diagnosed in Australia each year, almost 2% of cancers diagnosed. The risk of being diagnosed by age 85 is 1 in 40 for men and 1 in 137 for women.
For the three head and neck cancers, the risk of being diagnosed by age 85 for all persons for laryngeal cancer is 1 in 275 for all persons. The risk of lip cancer is 1 in 203 persons. Of the group, the smallest risk exists for tongue cancer, which affects 1 in 325 people.
In 2007, there were 414 deaths from head and neck cancers.
Screening
No routine screening tests are used. White plaques or patches in the mouth (leukoplakia) may precede the development of the cancer.
Symptoms and diagnosis
Symptoms depend on the site but include:
- pain
- swelling
- hoarse voice
- difficulty swallowing
- bad breath.
Diagnosis is by a biopsy obtained using an endoscope, needle or surgically.
Staging
The extent of the tumour is defined by the size of the lump and whether there is spread to lymph nodes or further to the lungs or bones. CT, MRI, bone and PET scans are used. Visual examination using an endoscope may be required.
Causes
The main causes are alcohol and tobacco consumption. Some head and neck cancers are related to human papilloma virus infection.
Prevention
The risk of head and neck cancers can be reduced by not smoking (or quitting) and reducing alcohol consumption.
Treatment
The definitive treatment for local disease is surgery to the primary lump and draining the lymph glands. Full dose radiotherapy may be used in sites where functions such as speech can be preserved. Radiotherapy can be given in sequence with chemotherapy (commonly cisplatin, 5 fluorouracil or the taxanes) for more advanced cancer and both can be used for symptom relief with widespread disease.
Prognosis
An individual’s prognosis depends on the type and stage of cancer, as well as their age and general health at the time of diagnosis. At most sites, treatment of small, localised cancer results in at least 75% of patients surviving five years after diagnosis. With more advanced disease at diagnosis this drops to 15%.
For further information, contact Cancer Council Helpline on 13 11 20 (cost of a local call within Australia).