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86-398: Head and neck cancer is a general term encompassing multiple cancers that can develop in the head and neck region. These include cancers of the mouth, tongue, gums and lips ( oral cancer ), voice box ( laryngeal ), throat ( nasopharyngeal , oropharyngeal , hypopharyngeal ), salivary glands , nose and sinuses . Head and neck cancer can present a wide range of symptoms depending on where

172-490: A " great imitator ". People may become anxious or depressed post-diagnosis. The risk of suicide in people with cancer is approximately double. Local symptoms may occur due to the mass of the tumor or its ulceration. For example, mass effects from lung cancer can block the bronchus resulting in cough or pneumonia ; esophageal cancer can cause narrowing of the esophagus , making it difficult or painful to swallow; and colorectal cancer may lead to narrowing or blockages in

258-459: A better outcome than HPV-negative disease, with a 54% better survival rate, but this advantage for HPV-associated cancer applies only to oropharyngeal cancers. People with oropharyngeal carcinomas are at high risk of developing a second primary head and neck cancer. The hypopharynx includes the pyriform sinuses, the posterior pharyngeal wall, and the postcricoid area. Tumors of the hypopharynx frequently have an advanced stage at diagnosis and have

344-474: A concern. This includes that studies have not found a consistent link between mobile phone radiation and cancer risk. The vast majority of cancers are non-hereditary (sporadic). Hereditary cancers are primarily caused by an inherited genetic defect. Less than 0.3% of the population are carriers of a genetic mutation that has a large effect on cancer risk and these cause less than 3–10% of cancer. Some of these syndromes include: certain inherited mutations in

430-424: A correspondingly higher level of prostate cancer. Men of Asian ancestry, with the lowest levels of testosterone-activating androstanediol glucuronide , have the lowest levels of prostate cancer. Facial muscles The facial muscles are just under the skin ( subcutaneous ) muscles that control facial expression. They generally originate from the surface of the skull bone (rarely the fascia), and insert on

516-541: A diagnosis of head and neck cancer also contributes to other negative outcomes. These include physical effects such as an increased risk of developing a second primary cancer or other malignancies, cancer recurrence, and worse prognosis in addition to an increased chance of having a future feeding tube placed and osteoradionecrosis of the jaw. Negative social factors are also increased with sustained alcohol use after diagnosis including unemployment and work disability. The way in which alcohol contributes to cancer development

602-410: A dose dependent relationship with more consumption leading to higher chances of developing cancer. The use of electronic cigarettes may also lead to the development of head and neck cancers due to the substances like propylene glycol , glycerol , nitrosamines , and metals contained therein, which can cause damage to the airways. Exposure to e-vapour has been shown to reduce cell viability and increase

688-407: A large study published 2024. Many dietary nutrients are associated with cancer protection and its development. Generally, foods with a protective effect with respect to oral cancer demonstrate antioxidant and anti-inflammatory effects such as fruits, vegetables, curcumin and green tea . Conversely, pro-inflammatory food substances such as red meat , processed meat and fried food can increase

774-543: A major factor. Stomach acids that flow up through the esophagus can damage its lining and raise susceptibility to throat cancer. People after hematopoietic stem cell transplantation (HSCT) are at a higher risk for oral cancer. Post-HSCT oral cancer may have more aggressive behavior and a poorer prognosis when compared to oral cancer in non-HSCT patients. This effect is supposed to be due to continuous, lifelong immune suppression and chronic oral graft-versus-host disease . Several other risk factors have been identified in

860-424: A persistent earache . Other symptoms can include: a lump in the lip, mouth, or gums; ulcers or mouth sores that do not heal; bleeding from the mouth or numbness; bad breath; discolored patches that persist in the mouth; a sore tongue; and slurring of speech if the cancer is affecting the tongue. There may also be congested sinuses, weight loss, and some numbness or paralysis of facial muscles . Oral cancer affects

946-566: A persistent fever . Shortness of breath, called dyspnea , is a common symptom of cancer and its treatment. The causes of cancer-related dyspnea can include tumors in or around the lung, blocked airways, fluid in the lungs, pneumonia, or treatment reactions including an allergic response . Treatment for dyspnea in patients with advanced cancer can include fans , bilevel ventilation, acupressure / reflexology and multicomponent nonpharmacological interventions . Some systemic symptoms of cancer are caused by hormones or other molecules produced by

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1032-539: A role. Oncoviruses (viruses that can cause human cancer) include: Bacterial infection may also increase the risk of cancer, as seen in Parasitic infections associated with cancer include: Radiation exposure such as ultraviolet radiation and radioactive material is a risk factor for cancer. Many non-melanoma skin cancers are due to ultraviolet radiation, mostly from sunlight. Sources of ionizing radiation include medical imaging and radon gas. Ionizing radiation

1118-406: A separate disease by many experts. Most oropharyngeal cancers begin in the oropharynx (throat), the middle part of the throat that includes the soft palate , the base of the tongue , and the tonsils . Cancers of the tonsils are more strongly associated with human papillomavirus infection than are cancers of other regions of the head and neck. HPV-positive oropharyngeal cancer generally has

1204-723: A weak immune system. The incidence of HPV-related head and neck cancer is increasing, especially in the Western world. In the United States, the incidence of HPV-positive oropharyngeal cancer has overtaken HPV-positive cervical cancer as the leading HPV related cancer type. An increased incidence has particularly affected males. As a result, recent changes have resulted in the HPV vaccine being offered to adolescent boys between 12-13 (previously only offered to girls between this age due to cervical cancer risks) and men under 45 who have sex with men in

1290-565: Is chewed ) is a cause of oral cancer . Increased risk of oral cancer caused by smokeless tobacco is present in countries such as the United States but particularly prevalent in Southeast Asian countries where the use of smokeless tobacco is common. Smokeless tobacco is associated with a higher risk of developing head and neck cancer due to the presence of the tobacco-specific carcinogen N'-nitrosonornicotine . Cigar and pipe smoking are also important risk factors for oral cancer. They have

1376-448: Is a risk factor for head and neck cancer. In terms of nutritional supplements, antioxidants such as vitamin E and beta-carotene might reduce the toxic effect of radiotherapy in people with head and neck cancer but they can also increase recurrence rates, especially in smokers. Betel nut chewing is associated with an increased risk of head and neck cancer. When chewed with additional tobacco in its preparation (like in gutka ), there

1462-416: Is about 2. The corresponding relative risk is 1.5 for lung cancer, and 1.9 for prostate cancer . For breast cancer, the relative risk is 1.8 with a first-degree relative having developed it at 50 years of age or older, and 3.3 when the relative developed it when being younger than 50 years of age. Taller people have an increased risk of cancer because they have more cells than shorter people. Since height

1548-446: Is an environmental factor causing approximately 16–18% of cancers worldwide. These infectious agents include Helicobacter pylori , hepatitis B , hepatitis C , human papillomavirus infection , Epstein–Barr virus , Human T-lymphotropic virus 1 , Kaposi's sarcoma-associated herpesvirus and Merkel cell polyomavirus . Human immunodeficiency virus (HIV) does not directly cause cancer but it causes immune deficiency that can magnify

1634-591: Is an even higher risk, especially for oral and oropharyngeal cancers. People who develop head and neck cancer may have a genetic predisposition for the condition. There are seven known genetic variations ( loci ) which specifically increase the chances of developing oral and pharyngeal cancer. Family history, that is having a first-degree relative with head and neck cancer, is also a risk factor. In addition, genetic variations in pathways involved in alcohol metabolism (for example alcohol dehydrogenase ) have been associated with an increased head and neck cancer risk. It

1720-537: Is generally not a transmissible disease . Exceptions include rare transmissions that occur with pregnancies and occasional organ donors . However, transmissible infectious diseases such as hepatitis B , Epstein-Barr virus , Human Papilloma Virus and HIV , can contribute to the development of cancer. Exposure to particular substances have been linked to specific types of cancer. These substances are called carcinogens . Tobacco smoke , for example, causes 90% of lung cancer. Tobacco use can cause cancer throughout

1806-413: Is genetically determined to a large extent, taller people have a heritable increase of cancer risk. Some substances cause cancer primarily through their physical, rather than chemical, effects. A prominent example of this is prolonged exposure to asbestos , naturally occurring mineral fibers that are a major cause of mesothelioma (cancer of the serous membrane ) usually the serous membrane surrounding

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1892-703: Is in the tonsils , where HPV DNA is found in 45–67% of the cases, and it is less often in the hypopharynx (13–25%), and least often in the oral cavity (12–18%) and larynx (3–7%). Positive HPV16 status is associated with a improved prognosis over HPV-negative oropharyngeal cancer due to better response to radiotherapy and chemotherapy . HPV can induce tumors by several mechanisms: There are observed biological differences between HPV-positive and HPV-negative head and neck cancer, for example in terms of mutation patterns. In HPV-negative disease, genes frequently mutated include TP53 , CDKN2A and PIK3CA . In HPV-positive disease, these genes are less frequently mutated, and

1978-546: Is known that prior exposure to radiation of the head and neck is associated with an increased risk of cancer, particularly thyroid, salivary gland and squamous cell carcinomas, although there is a time-delay of many years and the overall risk is still low. Some head and neck cancers, and in particular oropharyngeal cancer, are caused by the human papillomavirus (HPV), and 70% of all head and neck cancer cases are related to HPV. Risk factors for HPV-positive oropharyngeal cancer include multiple sexual partners, anal and oral sex and

2064-581: Is more common in Japan due to its high-salt diet while colon cancer is more common in the United States. Immigrant cancer profiles mirror those of their new country, often within one generation. Worldwide, approximately 18% of cancer deaths are related to infectious diseases . This proportion ranges from a high of 25% in Africa to less than 10% in the developed world. Viruses are the usual infectious agents that cause cancer but bacteria and parasites may also play

2150-403: Is not inherited , such as lifestyle, economic, and behavioral factors and not merely pollution. Common environmental factors that contribute to cancer death include tobacco use (25–30%), diet and obesity (30–35%), infections (15–20%), radiation (both ionizing and non-ionizing, up to 10%), lack of physical activity , and pollution. Psychological stress does not appear to be a risk factor for

2236-474: Is not a particularly strong mutagen . Residential exposure to radon gas, for example, has similar cancer risks as passive smoking . Radiation is a more potent source of cancer when combined with other cancer-causing agents, such as radon plus tobacco smoke. Radiation can cause cancer in most parts of the body, in all animals and at any age. Children are twice as likely to develop radiation-induced leukemia as adults; radiation exposure before birth has ten times

2322-407: Is not fully understood. It is thought to be related to permanent damage of DNA strands by a metabolite of alcohol called acetaldehyde . Other suggested mechanisms include nutritional deficiencies and genetic variations. Tobacco smoking is one of the main risk factors for head and neck cancer. Cigarette smokers have a lifetime increased risk for head and neck cancer that is 5 to 25 times higher than

2408-427: Is predominantly used in the production of Teflon , is known to cause two kinds of cancer. Chemotherapy drugs such as platinum-based compounds are carcinogens that increase the risk of secondary cancers Azathioprine , an immunosuppressive medication , is a carcinogen that can cause primary tumors to develop. Diet, physical inactivity , and obesity are related to up to 30–35% of cancer deaths. In

2494-727: Is seen in patients with HPV-positive head and neck cancer as well. It has also been demonstrated that passive smoking , both at work and at home, increases the risk of head and neck cancer. A major carcinogenic compound in tobacco smoke is acrylonitrile . Acrylonitrile appears to indirectly cause DNA damage by increasing oxidative stress , leading to increased levels of 8-oxo-2'-deoxyguanosine (8-oxo-dG) and formamidopyrimidine in DNA. (see image). Both 8-oxo-dG and formamidopyrimidine are mutagenic . DNA glycosylase NEIL1 prevents mutagenesis by 8-oxo-dG and removes formamidopyrimidines from DNA. Smokeless tobacco (including products where tobacco

2580-608: Is signalled. Loss of pRb leads to deregulation of cell proliferation and apoptosis. Both mechanisms therefore leave cell proliferation unchecked and increase the chance of carcinogenesis . Epstein–Barr virus (EBV) infection is associated with nasopharyngeal cancer . Nasopharyngeal cancer caused by EBV commonly occurs in some countries of the Mediterranean and Asia, where EBV antibody titers can be measured to screen high-risk populations. The presence of gastroesophageal reflux disease (GERD) or laryngeal reflux disease can also be

2666-554: Is strongly associated with tobacco smoking . Surgery can include laser excision of small vocal cord lesions, partial laryngectomy (removal of part of the larynx), or total laryngectomy (removal of the whole larynx). If the whole larynx has been removed, the person is left with a permanent tracheostomy. Voice rehabilitation in such patients can be achieved in three important ways: esophageal speech, tracheoesophageal puncture, or electrolarynx. One would likely require intensive teaching, speech therapy, and/or an electronic device. Cancer of

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2752-418: Is supplied by the facial nerve. Although it is mostly in the neck and can be grouped with the neck muscles by location, it can be considered a muscle of facial expression due to its common nerve supply. The stylohyoid muscle , stapedius and posterior belly of the digastric muscle are also supplied by the facial nerve, but are not considered muscles of facial expression. The facial muscles are derived from

2838-463: Is the appearance of white patches or spots in the mouth, can develop into cancer in about 1⁄3 of cases. A significant proportion of people with head and neck cancer will present to their physicians with an already advanced stage disease. This can either be down to patient factors (delays in seeking medical attention), or physician factors (such as delays in referral from primary care, or non-diagnostic investigation results). A person usually presents to

2924-457: Is then typically further investigated by medical imaging and confirmed by biopsy . The risk of developing certain cancers can be reduced by not smoking, maintaining a healthy weight, limiting alcohol intake, eating plenty of vegetables, fruits, and whole grains , vaccination against certain infectious diseases, limiting consumption of processed meat and red meat , and limiting exposure to direct sunlight. Early detection through screening

3010-409: Is useful for cervical and colorectal cancer . The benefits of screening for breast cancer are controversial. Cancer is often treated with some combination of radiation therapy , surgery, chemotherapy and targeted therapy . Pain and symptom management are an important part of care. Palliative care is particularly important in people with advanced disease. The chance of survival depends on

3096-475: The Epstein–Barr virus , chewing betel quid (paan), radiation exposure , poor nutrition and workplace exposure to certain toxic substances. About 90% are pathologically classified as squamous cell cancers . The diagnosis is confirmed by a tissue biopsy . The degree of surrounding tissue invasion and distant spread may be determined by medical imaging and blood tests . Not using tobacco or alcohol can reduce

3182-402: The bowel , affecting bowel habits. Masses in breasts or testicles may produce observable lumps. Ulceration can cause bleeding that can lead to symptoms such as coughing up blood (lung cancer), anemia or rectal bleeding (colon cancer), blood in the urine (bladder cancer), or abnormal vaginal bleeding (endometrial or cervical cancer). Although localized pain may occur in advanced cancer,

3268-584: The immune system and endocrine system . More than half of the effect from the diet is due to overnutrition (eating too much), rather than from eating too few vegetables or other healthful foods. Some specific foods are linked to specific cancers. A high-salt diet is linked to gastric cancer . Aflatoxin B1 , a frequent food contaminant, causes liver cancer. Betel nut chewing can cause oral cancer. National differences in dietary practices may partly explain differences in cancer incidence. For example, gastric cancer

3354-452: The lungs , liver , brain, and the bones . While some cancers can be cured if detected early, metastatic cancer is more difficult to treat and control. Nevertheless, some recent treatments are demonstrating encouraging results. The majority of cancers, some 90–95% of cases, are due to genetic mutations from environmental and lifestyle factors. The remaining 5–10% are due to inherited genetics . Environmental refers to any cause that

3440-451: The nasopharynx , the region in which the nasal cavities and the Eustachian tubes connect with the upper part of the throat. While some nasopharyngeal cancers are biologically similar to the common head and neck cancers, "poorly differentiated" nasopharyngeal carcinoma is lymphoepithelioma , which is distinct in its epidemiology , biology, clinical behavior, and treatment and is treated as

3526-576: The six hallmarks of cancer . These characteristics are required to produce a malignant tumor. They include: The progression from normal cells to cells that can form a detectable mass to cancer involves multiple steps known as malignant progression. When cancer begins, it produces no symptoms. Signs and symptoms appear as the mass grows or ulcerates . The findings that result depend on cancer's type and location. Few symptoms are specific . Many frequently occur in individuals who have other conditions. Cancer can be difficult to diagnose and can be considered

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3612-460: The tumor microenvironment . Oncogenes build up an inflammatory pro-tumorigenic microenvironment. Hormones also play a role in the development of cancer by promoting cell proliferation . Insulin-like growth factors and their binding proteins play a key role in cancer cell proliferation, differentiation and apoptosis , suggesting possible involvement in carcinogenesis. Hormones are important agents in sex-related cancers, such as cancer of

3698-511: The UK. Over 20 different high-risk HPV subtypes have been implicated in causing head and neck cancer. In particular, HPV-16 is responsible for up to 90% of oropharyngeal cancer in North America. Approximately 15–25% of head and neck cancers contain genomic DNA from HPV, and the association varies based on the site of the tumor. In the case of HPV-positive oropharyngeal cancer , the highest distribution

3784-745: The United States have mirrored smoking patterns, with increases in smoking followed by dramatic increases in lung cancer death rates and, more recently, decreases in smoking rates since the 1950s followed by decreases in lung cancer death rates in men since 1990. In Western Europe, 10% of cancers in males and 3% of cancers in females are attributed to alcohol exposure, especially liver and digestive tract cancers. Cancer from work-related substance exposures may cause between 2 and 20% of cases, causing at least 200,000 deaths. Cancers such as lung cancer and mesothelioma can come from inhaling tobacco smoke or asbestos fibers, or leukemia from exposure to benzene . Exposure to perfluorooctanoic acid (PFOA), which

3870-479: The United States, excess body weight is associated with the development of many types of cancer and is a factor in 14–20% of cancer deaths. A UK study including data on over 5 million people showed higher body mass index to be related to at least 10 types of cancer and responsible for around 12,000 cases each year in that country. Physical inactivity is believed to contribute to cancer risk, not only through its effect on body weight but also through negative effects on

3956-424: The areas of the mouth, including the inner lip, tongue , floor of the mouth , gums , and hard palate . Cancers of the mouth are strongly associated with tobacco use, especially the use of chewing tobacco or dipping tobacco , as well as heavy alcohol use. Cancers of this region, particularly the tongue, are more frequently treated with surgery than other head and neck cancers. Lip and oral cavity cancers are

4042-414: The body (such as through inhalation) and require years of exposure to produce cancer. Physical trauma resulting in cancer is relatively rare. Claims that breaking bones resulted in bone cancer, for example, have not been proven. Similarly, physical trauma is not accepted as a cause for cervical cancer, breast cancer or brain cancer. One accepted source is frequent, long-term application of hot objects to

4128-404: The body including in the mouth and throat, larynx , esophagus , stomach, bladder, kidney, cervix, colon/rectum, liver and pancreas . Tobacco smoke contains over fifty known carcinogens, including nitrosamines and polycyclic aromatic hydrocarbons . Tobacco is responsible for about one in five cancer deaths worldwide and about one in three in the developed world. Lung cancer death rates in

4214-673: The body. These contrast with benign tumors , which do not spread. Possible signs and symptoms include a lump, abnormal bleeding, prolonged cough, unexplained weight loss, and a change in bowel movements . While these symptoms may indicate cancer, they can also have other causes. Over 100 types of cancers affect humans. Tobacco use is the cause of about 22% of cancer deaths. Another 10% are due to obesity , poor diet , lack of physical activity or excessive alcohol consumption . Other factors include certain infections, exposure to ionizing radiation , and environmental pollutants. Infection with specific viruses, bacteria and parasites

4300-401: The body. It is possible that repeated burns on the same part of the body, such as those produced by kanger and kairo heaters (charcoal hand warmers ), may produce skin cancer, especially if carcinogenic chemicals are also present. Frequent consumption of scalding hot tea may produce esophageal cancer. Generally, it is believed that cancer arises, or a pre-existing cancer is encouraged, during

4386-527: The breast, endometrium , prostate, ovary and testis and also of thyroid cancer and bone cancer . For example, the daughters of women who have breast cancer have significantly higher levels of estrogen and progesterone than the daughters of women without breast cancer. These higher hormone levels may explain their higher risk of breast cancer, even in the absence of a breast-cancer gene. Similarly, men of African ancestry have significantly higher levels of testosterone than men of European ancestry and have

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4472-413: The cancer developed. These can include an ulcer in the mouth that does not heal, changes in the voice , difficulty swallowing , red or white patches in the mouth , and a neck lump . The majority of head and neck cancer is caused by the use of alcohol or tobacco (including smokeless tobacco ). An increasing number of cases are caused by the human papillomavirus (HPV). Other risk factors include

4558-457: The developing world. The global total economic costs of cancer were estimated at US$ 1.16 trillion (equivalent to $ 1.62 trillion in 2023) per year as of 2010 . The word comes from the ancient Greek [καρκίνος] Error: {{Transliteration}}: transliteration text not Latin script ( help ) , meaning 'crab' and 'tumor'. Greek physicians Hippocrates and Galen , among others, noted the similarity of crabs to some tumors with swollen veins. The word

4644-607: The development of head and neck cancer. These include occupational environmental carcinogen exposure such as asbestos , wood dust , mineral acid , sulfuric acid mists and metal dusts. In addition, weakened immune systems, age greater than 55 years, poor socioeconomic factors such as lower incomes and occupational status, and low body mass index (<18.5 kg/m2) are also risk factors. Poor oral hygiene and chronic oral cavity inflammation (for example secondary to chronic gum inflammation ) are also linked to an increased head and neck cancer risk. The presence of leukoplakia , which

4730-455: The effect. Medical use of ionizing radiation is a small but growing source of radiation-induced cancers. Ionizing radiation may be used to treat other cancers, but this may, in some cases, induce a second form of cancer. It is also used in some kinds of medical imaging . Prolonged exposure to ultraviolet radiation from the sun can lead to melanoma and other skin malignancies. Clear evidence establishes ultraviolet radiation, especially

4816-429: The general population. The ex-smoker's risk of developing head and neck cancer begins to approach the risk in the general population 15 years after smoking cessation . In addition, people who smoke have a worse prognosis than those who have never smoked. Furthermore, people who continue to smoke after diagnosis of head and neck cancer have the highest probability of dying compared to those who have never smoked. This effect

4902-445: The genes BRCA1 and BRCA2 with a more than 75% risk of breast cancer and ovarian cancer , and hereditary nonpolyposis colorectal cancer (HNPCC or Lynch syndrome), which is present in about 3% of people with colorectal cancer , among others. Statistically for cancers causing most mortality, the relative risk of developing colorectal cancer when a first-degree relative (parent, sibling or child) has been diagnosed with it

4988-479: The initial tumor is usually painless. Some cancers can cause a buildup of fluid within the chest or abdomen . Systemic symptoms may occur due to the body's response to the cancer. This may include fatigue, unintentional weight loss, or skin changes. Some cancers can cause a systemic inflammatory state that leads to ongoing muscle loss and weakness, known as cachexia . Some cancers, such as Hodgkin's disease , leukemias , and liver or kidney cancers , can cause

5074-471: The involved side. Paralysis is the loss of voluntary muscle action; the facial nerve has become damaged permanently or temporarily. This damage can occur with a stroke , Bell palsy , or parotid salivary gland cancer (malignant neoplasm) because the facial nerve travels through the gland. The parotid gland can also be damaged permanently by surgery or temporarily by trauma. These situations of paralysis not only inhibit facial expression but also seriously impair

5160-441: The lungs. Other substances in this category, including both naturally occurring and synthetic asbestos-like fibers, such as wollastonite , attapulgite , glass wool and rock wool , are believed to have similar effects. Non-fibrous particulate materials that cause cancer include powdered metallic cobalt and nickel and crystalline silica ( quartz , cristobalite and tridymite ). Usually, physical carcinogens must get inside

5246-459: The most adverse prognoses of pharyngeal tumors. They tend to metastasize early due to the extensive lymphatic network around the larynx . Laryngeal cancer begins in the larynx , or "voice box", and is the second most common type of head and neck cancer encountered. Cancer may occur on the vocal folds themselves ("glottic" cancer) or on tissues above and below the true cords ("supraglottic" and "subglottic" cancers, respectively). Laryngeal cancer

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5332-416: The most commonly encountered types of head and neck cancer. Surgeries for oral cancers include: The defect is typically covered or improved by using another part of the body and/or skin grafts and/or wearing a prosthesis . Paranasal sinus and nasal cavity cancer affects the nasal cavity and the paranasal sinuses . Most of these cancers are squamous cell carcinomas . Nasopharyngeal cancer arises in

5418-519: The mouth or throat ( mucositis ), dry mouth ( xerostomia ), and difficulty swallowing ( dysphagia ). General symptoms include difficulty sleeping, tiredness, depression, nerve damage ( peripheral neuropathy ). Gastrointestinal symptoms are typically nausea and vomiting. Symptoms predominantly include a sore on the face or oral cavity that does not heal, trouble swallowing, or a change in voice. In those with advanced disease, there may be unusual bleeding, facial pain, numbness or swelling, and visible lumps on

5504-411: The mouth) can be biopsied with a local anaesthetic . Lesions less readily available can be biopsied either with the patient awake or under a general anaesthetic depending on local expertise and availability of specialist equipment. The cancer will also need to be staged (accurately determine its size, association with nearby structures, and spread to distant sites). This is typically done by scanning

5590-450: The neck for any masses, examining inside the mouth for any abnormalities and assessing the rest of the pharynx and larynx with a nasendoscope . Further investigations will be directed by the symptoms discussed and any abnormalities identified during the exam. Neck masses typically undergo assessment with ultrasound and a fine-needle aspiration (FNA, a type of needle biopsy). Concerning lesions that are readily accessible (such as in

5676-496: The non-ionizing medium wave UVB , as the cause of most non-melanoma skin cancers , which are the most common forms of cancer in the world. Non-ionizing radio frequency radiation from mobile phones, electric power transmission and other similar sources has been described as a possible carcinogen by the World Health Organization 's International Agency for Research on Cancer . Evidence, however, has not supported

5762-462: The onset of cancer, though it may worsen outcomes in those who already have cancer. Environmental or lifestyle factors that caused cancer to develop in an individual can be identified by analyzing mutational signatures from genomic sequencing of tumor DNA. For example, this can reveal if lung cancer was caused by tobacco smoke, if skin cancer was caused by UV radiation, or if secondary cancers were caused by previous chemotherapy treatment. Cancer

5848-425: The original is called the primary tumor. Almost all cancers can metastasize. Most cancer deaths are due to cancer that has metastasized. Metastasis is common in the late stages of cancer and it can occur via the blood or the lymphatic system or both. The typical steps in metastasis are: Different types of cancers tend to metastasize to particular organs. Overall, the most common places for metastases to occur are

5934-532: The outside of the neck or oral cavity. Head and neck cancer often begins with benign signs and symptoms of the disease, like an enlarged lymph node on the outside of the neck, a hoarse-sounding voice , or a progressive worsening cough or sore throat. In the case of head and neck cancer, these symptoms will be notably persistent and become chronic. There may be a lump or a sore in the throat or neck that does not heal or go away. There may be difficulty or pain in swallowing. Speaking may become difficult. There may also be

6020-422: The patient with a combination of magnetic resonance imaging (MRI), computed tomography (CT) and/or positron emission tomography (PET). Exactly which investigations are required will depend on a variety of factors such as the site of concern and the size of the tumour. Cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of

6106-581: The physician complaining of one or more of the typical symptoms. These symptoms may be site specific (such as a laryngeal cancer causing hoarse voice ), or not site specific (earache can be caused by multiple types of head and neck cancers). The physician will undertake a thorough history to determine the nature of the symptoms and the presence or absence of any risk factors. The physician will also ask about other illnesses such as heart or lung diseases as they may impact their fitness for potentially curative treatment. Clinical examination will involve examination of

6192-869: The previous decade increases of 26% and 21%, respectively. The most common types of cancer in males are lung cancer , prostate cancer , colorectal cancer , and stomach cancer . In females, the most common types are breast cancer , colorectal cancer, lung cancer, and cervical cancer . If skin cancer other than melanoma were included in total new cancer cases each year, it would account for around 40% of cases. In children, acute lymphoblastic leukemia and brain tumors are most common, except in Africa, where non-Hodgkin lymphoma occurs more often. In 2012, about 165,000 children under 15 years of age were diagnosed with cancer. The risk of cancer increases significantly with age, and many cancers occur more commonly in developed countries. Rates are increasing as more people live to an old age and as lifestyle changes occur in

6278-403: The process of healing, rather than directly by the trauma. However, repeated injuries to the same tissues might promote excessive cell proliferation, which could then increase the odds of a cancerous mutation. Chronic inflammation has been hypothesized to directly cause mutation. Inflammation can contribute to proliferation, survival, angiogenesis and migration of cancer cells by influencing

6364-441: The rate of cell death via apoptosis or necrosis with or without nicotine. This area of study requires more research, however. Similarly, additional research is needed to understand how marijuana possibly promotes head and neck cancers. A 2019 meta-analysis did not conclude that marijuana was associated with head and neck cancer risk. Yet individuals with cannabis use disorder were more likely to be diagnosed with such cancers in

6450-618: The risk due to other infections, sometimes up to several thousand fold (in the case of Kaposi's sarcoma ). Importantly, vaccination against hepatitis B and human papillomavirus have been shown to nearly eliminate risk of cancers caused by these viruses in persons successfully vaccinated prior to infection. These environmental factors act, at least partly, by changing the genes of a cell. Typically, many genetic changes are required before cancer develops. Approximately 5–10% of cancers are due to inherited genetic defects. Cancer can be detected by certain signs and symptoms or screening tests. It

6536-522: The risk of developing head and neck cancer. An increased adherence to the Mediterranean diet is also related to a lower risk of cancer mortality and a reduced risk of developing multiple cancers including head and neck cancer. Elevated levels of nitrites in preserved meats and salted fish have been shown to increase the risk of nasopharyngeal cancer. Overall, a poor nutritional intake (often associated with alcoholism) with subsequent vitamin deficiencies

6622-561: The risk of head and neck cancer. Regular dental examinations may help to identify signs before the cancer develops. The HPV vaccine helps to prevent HPV-related oropharyngeal cancer . Treatment may include a combination of surgery, radiation therapy , chemotherapy , and targeted therapy . In the early stage head and neck cancers are often curable but 50% of people see their doctor when they already have an advanced disease. Globally, head and neck cancer accounts for 650,000 new cases of cancer and 330,000 deaths annually on average. In 2018, it

6708-430: The second branchial/ pharyngeal arch . They, like the branchial arches, originally derive from neural crest cells. In humans, they typically begin forming around the eighth week of embryonic development. An inability to form facial expressions on one side of the face may be the first sign of damage to the nerve of these muscles. Damage to the facial nerve results in facial paralysis of the muscles of facial expression on

6794-447: The skin of the face. When they contract, the skin moves. These muscles also cause wrinkles at right angles to the muscles’ action line. The facial muscles are supplied by the facial nerve (cranial nerve VII), with each nerve serving one side of the face. In contrast, the nearby masticatory muscles are supplied by the mandibular nerve , a branch of the trigeminal nerve (cranial nerve V). The facial muscles include: The platysma

6880-416: The trachea is a rare cancer usually classified as a lung cancer . Most tumors of the salivary glands differ from the common head and neck cancers in cause, histopathology , clinical presentation, and therapy. Other uncommon tumors arising in the head and neck include teratomas , adenocarcinomas , adenoid cystic carcinomas , and mucoepidermoid carcinomas . Rarer still are melanomas and lymphomas of

6966-400: The tumor, known as paraneoplastic syndromes . Common paraneoplastic syndromes include hypercalcemia , which can cause altered mental state , constipation and dehydration, or hyponatremia , which can also cause altered mental status, vomiting, headaches, or seizures. Metastasis is the spread of cancer to other locations in the body. The dispersed tumors are called metastatic tumors, while

7052-578: The tumour suppressor gene p53 and pRb (protein retinoblastoma) are commonly inactivated by HPV oncoproteins E6 and E7 respectively. In addition, viral infections such as HPV can cause aberrant DNA methylation during cancer development. HPV-positive head and neck cancers demonstrate higher levels of such DNA methylation compared to HPV-negative disease. E6 sequesters p53 to promote p53 degradation, while E7 inhibits pRb. Degradation of p53 results in cells being unable to respond to checkpoint signals that are normally present to activate apoptosis when DNA damage

7138-461: The type of cancer and extent of disease at the start of treatment. In children under 15 at diagnosis, the five-year survival rate in the developed world is on average 80%. For cancer in the United States, the average five-year survival rate is 66% for all ages. In 2015, about 90.5 million people worldwide had cancer. In 2019, annual cancer cases grew by 23.6 million people, and there were 10 million deaths worldwide, representing over

7224-502: The upper aerodigestive tract. Alcohol and tobacco use are major risk factors for head and neck cancer. 72% of head and neck cancer cases are caused by using both alcohol and tobacco. This rises to 89% when looking specifically at laryngeal cancer. There is thought to be a dose-dependent relationship between alcohol use and development of head and neck cancer where higher rates of alcohol consumption contribute to an increased risk of developing head and neck cancer. Alcohol use following

7310-477: Was introduced in English in the modern medical sense around 1600. Cancers comprise a large family of diseases that involve abnormal cell growth with the potential to invade or spread to other parts of the body. They form a subset of neoplasms . A neoplasm or tumor is a group of cells that have undergone unregulated growth and will often form a mass or lump, but may be distributed diffusely. All tumor cells show

7396-530: Was the seventh most common cancer worldwide, with 890,000 new cases documented and 450,000 people dying from the disease. The usual age at diagnosis is between 55 and 65 years old. The average 5-year survival following diagnosis in the developed world is 42–64%. Head and neck cancers can cause a broad range of symptoms, many of which occur together. These can be categorised local (head and neck cancer-specific), general and gastrointestinal symptoms. Local symptoms include changes in taste and voice, inflammation of

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