Head and neck cancer: How your voice, smile, and breath could be under siege
They usually arise in the squamous cells of the lining that covers the moist, mucosal surfaces within the head and neck region. Collectively, head and neck cancers account for approximately 4% of all Indian and worldwide cancers. If they are caught early, most head and neck cancers are very curable, but because of the intricate anatomy and late detection in most cases, treatment can be difficult and may affect important functions like speaking, breathing, and swallowing.
Common head and neck cancers
* Oral cavity cancer: Involves the lips, front two-thirds of the tongue, gums, inner cheeks, floor of the mouth, and the hard palate.
* Pharyngeal cancer: Occurs in the throat (pharynx), including the nasopharynx (at the back of the nose), oropharynx (mid-part of the throat, including tonsils and base of tongue), and hypopharynx (lower part of the throat).
* Laryngeal cancer: Develops in the voice box.
* Nasal cavity and paranasal sinus cancer: Occurs in the cavities behind the nose.
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* Salivary gland cancer: Although less common, may arise in glands that make saliva.
Common risk factors associated with head and neck cancer
There are several environmental, lifestyle, and biological conditions that contribute to head and neck cancer. They are:
1.
Tobacco use
One of the strongest risk factors, tobacco—whether in smoked or smokeless forms—is responsible for most head and neck cancers. Chronic irritation and DNA damage results from long-term exposure to tobacco carcinogens within the cells lining the mouth, throat, and larynx, substantially increasing cancer risk.
2. Alcohol consumption
Heavy and chronic alcohol consumption, particularly when supplemented with tobacco smoking, raises the risk exponentially. Alcohol serves as a solvent that facilitates carcinogens in tobacco to enter tissue more readily. Synergistic action of tobacco and alcohol is especially potent in oropharyngeal and oral cavity cancers.
3. Human Papillomavirus (HPV) infection
HPV, especially the high-risk type 16, is a leading cause of oropharyngeal cancers, notably in the tonsils and tongue base.
As opposed to tobacco-caused cancers, HPV-related head and neck cancers tend to occur among younger persons and non-smokers and could have a more favorable prognosis.
4. Poor dental health and oral hygiene
Poor dental hygiene, chronic denture irritation due to ill-fitting dentures, and gum disease can predispose to oral cancers. Inadequate dental care can postpone early detection of suspicious lesions.
5. Diet and nutrition deficiency
A diet poor in vegetables and fruits—high in antioxidants and nutrients—can enhance susceptibility to oral cavity and pharyngeal cancers.
Inadequate consumption of vitamin A and iron has been most commonly linked with mucosal degeneration and carcinogenesis.
6. Occupational exposure
Exposure to some industrial chemicals like asbestos, wood dust, formaldehyde, and nickel compounds has been associated with cancers of the sinuses, nasal cavity, and larynx. Construction, chemical, textile, and leather workers are possibly at risk.
7. Radiation exposure
Prior radiation therapy to the head and neck region, usually for benign disease in childhood or another cancer, will raise the long-term risk of thyroid and salivary gland cancers.
8. Epstein-Barr Virus (EBV) Infection
EBV is strongly linked with nasopharyngeal carcinoma, especially in Southeast Asian populations. Nasopharyngeal cancer occurs more frequently in areas such as northeastern India, southern China, and North Africa.
9. Age and gender
The risk of head and neck cancer increases with age, typically affecting individuals over 40. Men are two to three times more likely than women to develop these cancers, primarily due to higher rates of tobacco and alcohol use.
10. Genetic predisposition
Although less common, certain inherited genetic syndromes such as Fanconi anemia and dyskeratosis congenita can predispose individuals to head and neck cancers at a young age.
Head and neck cancers are eminently preventable through life-style modifications, earlier screening, and immunization (in the case of HPV). Public awareness regarding risk factors—specifically tobacco and alcohol abstinence, safe sex, and frequent dental check-ups—is the cornerstone of prevention of incidence and enhancing outcomes.
Dr Harish Verma, Associate Director - Surgical Oncology at CK Birla Hospital, Gurugram
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