Head and Neck Cancer

Head and neck cancers represent a diverse group of malignancies that arise in the tissues and organs of the head and neck region, including the mouth, throat, larynx (voice box), nose, sinuses, and salivary glands. The majority of these cancers are squamous cell carcinomas, which originate from the lining of the mucosal surfaces. Key risk factors encompass tobacco use, alcohol consumption, and human papillomavirus (HPV) infection, particularly for oropharyngeal cancers. Additional factors include poor oral hygiene, occupational exposures (e.g., to asbestos or wood dust), and Epstein-Barr virus (EBV) in nasopharyngeal carcinoma. Symptoms vary based on the cancer’s location but may include a persistent sore throat, hoarseness, difficulty swallowing, a lump in the neck, or mouth sores that fail to heal.

Common Therapies for Head and Neck Cancer

Treatment is based on the cancer’s location, stage, and HPV status, and often involves a combination of modalities:

1. Surgery

   • Often the first-line treatment for accessible tumors

   • May involve removal of part of the oral cavity, throat structures, or lymph nodes (neck dissection)

   • Reconstructive surgery may be needed to restore function and appearance

     
     

2. Radiation Therapy

   • Used alone in early-stage cancers or with chemotherapy (chemoradiation) in advanced cases

   • Also used postoperatively to reduce recurrence risk

     
     

3. Chemotherapy

   • Commonly used in combination with radiation (chemoradiotherapy) for advanced-stage disease

   • Drugs include Cisplatin, Carboplatin, 5-FU, Docetaxel

   • Also used for recurrent or metastatic disease

     
     

4. Targeted Therapy

   • Cetuximab: An EGFR inhibitor used in combination with radiation or chemotherapy, especially in patients who cannot tolerate Cisplatin

     
     

5. Immunotherapy

   • Checkpoint inhibitors: Nivolumab and Pembrolizumab (anti-PD-1 antibodies)

   • Approved for recurrent or metastatic disease, especially in patients with PD-L1–positive tumors

     
     

6. HPV-Associated Cancers

   • HPV-positive oropharyngeal cancers generally have a better prognosis and may be treated with slightly less aggressive regimens in clinical trials

     
     

Multidisciplinary care, including speech therapy, dental care, and nutrition support, is critical due to the complexity of head and neck cancer treatment and its impact on functions like speaking, swallowing, and breathing.