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Dr Mastura Md Yusof, Consultant Clinical Oncologist, Cancer Centre @ PHKL, Pantai Hospital Kuala Lumpur

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Of late, there have been many news articles pertaining to cancer, the big C is no longer a taboo subject. This is a war we need to fight together to win.

The most common cancer affecting women worldwide and in Malaysia is breast cancer ......

Dr Mastura Md Yusof, Consultant Clinical Oncologist, Cancer Centre @ PHKL, Pantai Hospital Kuala Lumpur

Forum Let's Talk Cancer

The Star
12th January 2016

WHAT IS CANCER? > FIVE MOST COMMON CANCERS AFFECT MALAYSIAN > HEAD & NECK CANCER

Head & Neck Cancer

What is Head & Neck Cancer?

Head and neck cancers comprise many different forms, including brain, eyes, spine, salivary gland, thyroid, sinuses, mouth, throat (pharynx) and voice box (larynx).

Head and neck cancers often spread to the lymph nodes closest to the affected area. Cancers of the head and neck are further identified by the area in which they begin:

  • Oral cavity
    Squamous cell cancers are common in the oral cavity including the lips, the front two-thirds of the tongue, the gingiva (gums), the buccal mucosa (lining inside the cheeks and lips), the floor (bottom) of the mouth under the tongue, the hard palate (bony top of the mouth), and the small area behind the wisdom teeth.
  • Salivary glands
    The salivary glands produce saliva, the fluid that keeps mucosal surfaces in the mouth and throat moist. There are many salivary glands; the major ones are in the floor of the mouth, and near the jawbone.
  • Paranasal sinuses and nasal cavity
    The paranasal sinuses are small hollow spaces in the bones of the head surrounding the nose. The nasal cavity is the hollow space inside the nose.
  • Pharynx
    The pharynx is a hollow tube about 5 inches long that starts behind the nose and leads to the esophagus (the tube that goes to the stomach) and the trachea (the tube that goes to the lungs). The pharynx has three parts:

    • Nasopharynx- the upper part of the pharynx, is behind the nose.
    • Oropharynx - the middle part of the pharynx. The oropharynx includes the soft palate (the back of the mouth), the base of the tongue, and the tonsils.
    • Hypopharynx - the lower part of the pharynx.

  • Larynx
    The larynx, also called the voice box, is a short passageway formed by cartilage just below the pharynx in the neck. The larynx contains the vocal cords. It also has a small piece of tissue, called the epiglottis, which moves to cover the larynx to prevent food from entering the air passages.
  • Lymph nodes in the upper part of the neck
    Sometimes, squamous cancer cells are found in the lymph nodes of the upper neck, even when there may be no evidence of cancer in other parts of the head and neck. When this happens, the cancer is called metastatic squamous neck cancer with unknown (occult) primary.

What Causes Head & Neck Cancer?

  • Heavy alcohol consumption.
  • Smoking or chewing tobacco.
  • Occupational exposures such as nickel refining, exposure to textile fibers, and woodworking.
  • Asbestos exposure and petroleum industry chemicals.
  • Excessive consumption of processed meats and red meat.
  • High consumption of salted fish, salted eggs, pork/beef liver.
  • Being over the age of 55 years.
  • Human papillomavirus (HPV)& Epstein-Barr virus.

What are the Symptoms of Head & Neck Cancer?

Symptoms of several head and neck cancer sites include a lump or sore that does not heal, a sore throat that does not go away, difficulty swallowing, and a change or hoarseness in the voice.

Other symptoms may include the following:

  • Oral cavity: A white or red patch on the gums, tongue, or lining of the mouth; a swelling of the jaw that causes dentures to fit poorly or become uncomfortable; and unusual bleeding or pain in the mouth.
  • Nasal cavity and sinuses: Sinuses that are blocked and do not clear, chronic sinus infections that do not respond to treatment with antibiotics, bleeding through the nose, frequent headaches, swelling or other trouble with the eyes, pain in the upper teeth, or problems with dentures.
  • Salivary glands: Swelling under the chin or around the jawbone; numbness or paralysis of the muscles in the face; or pain that does not go away in the face, chin, or neck.
  • Oropharynx and hypopharynx: Ear pain.
  • Nasopharynx: Trouble breathing or speaking, frequent headaches, pain or ringing in the ears, or trouble hearing.
  • Larynx: Pain when swallowing, or ear pain.
  • Metastatic squamous neck cancer: Pain in the neck or throat that does not go away.