Head and Neck cancers refer to a diverse group of cancers that involve this region of the body with exclusion of cancers of thyroid gland, skin, lymph glands and brain. Roughly 13,000 Americans develop these cancers every year. They are more common in men than in women. Smoking and Tobacco use, along with alcohol, impose a great risk on individuals to develop these cancers. Most of these cancers origin from the tissues that line the airways in nostrils, salivary glands and throat, as well as inside the mouth, gums, tongue and upper part of esophagus.
CAUSES OF HEAD AND NECK CANCERS
Following is a list of factors that increase the risk of these cancer
• Tobacco
• Alcohol
• Viruses
• Industrial exposure to metals, wood dust, textiles, etc.
• Prior Radiation therapy to head and neck area.
• Vitamin A deficiency,
• Iron deficiency
SIGNS AND SYMPTOMS
Patient do not have any signs at very early stages. Sinusitis, obstruction of one nostril, nose bleed, hoarseness, repeated or chronic ear infection, difficulty swallowing and eventually feeling a lump in the neck are among the common manifestation of these cancers.
TREATMENT
Most patients are treated with a combination of Surgery, Chemotherapy and Radiation therapy. Surgery is most appropriate for patients with very early stages of a disease, specially when the location of cancer makes it easy to operate. Aggressive surgery could lead into loss of voice as well as severe disfigurement of the patients. Preservation of voice has to be kept in mind at all times. Even for patients with more advanced disease, combination of chemotherapy and radiation therapy could still cure a good percentage of patients. Certain cancers, i.e. Nasopharyngeal tumors ( located deep and high in the back of airways) are almost never treated with surgery.
Most patients with head and neck cancers are treated with a combination radiation therapy and chemotherapy, which may include 5-FU , Cisplatinum and Cetuximab. 5-FU is given as a continuous infusion over 4-5 days. Cisplatinum and Cetuximab are given in one dose on day one of a 21 to 28 days cycle. The same regimen is repeated every 3-4 weeks. Patients benefit from having a Port-A-Cath for administration of chemotherapy. Most important Side effects of this regimen are:
• Hair loss
• Nausea, Vomiting
• Low white blood counts
• Anemia
• Soreness of the mouth
• Skin rash due to cetuximab
Other drugs may also be used in some sort of combination; Leucovorin, Methotrexate, Bleomycin, Carboplatin, Cytoxan.
