Head and neck cancer

Among head and neck cancers are a group of malignant ( malignant ) tumors that originate in the head and neck region. The malignancies in the head and neck region have, depending on their place of origin, individual peculiarities. In the majority (over 90% ) are squamous cell carcinomas. Most malignant tumors in the head and neck region are discovered at an advanced stage, which leads to a significant worsening of the prognosis. The therapy is, depending on the location, ENT specialists or oral and maxillo - facial surgeons ( MKG ) made.

The head and neck cancers, among others, the following cancers are expected

  • Oral cancer
  • Nasopharyngeal carcinoma ( nasopharyngeal cancer)
  • Oropharyngeal ( oropharyngeal cancer)
  • Hypopharynx ( throat throat cancer )
  • Cancer of the larynx ( throat cancer )
  • Tracheakarzinom ( trachea cancer)

Epidemiology

Worldwide cancers in the head and neck region are the sixth most common Malignomerkrankung today. This form of cancer is increasingly being observed in the elderly and young women.

Etiology

The main cause of most cancers in the head and neck region is the nicotine abuse in the form of tobacco smoking. Tobacco smoking potentiates the risk of developing some form of head and neck cancer cancer significantly. The probability also increases the more by the excessive consumption of high-proof alcohol, which in this case serves as a solvent for carcinogens present in cigarette smoke.

In some forms of head and neck cancers are other risk factors to be considered:

  • Poor oral hygiene and tooth sharp edges, for example, when oral cancer
  • Approximately 25% of oral squamous cell carcinoma associated with human papilloma virus (HPV). These behave compared to tumors without HPV load benign.
  • A thyroid and Speicheldrüsenneoplasma can be triggered by an increased radiation exposure
  • If a corresponding genetic predisposition of the patient is present, an infection with the Epstein -Barr virus cause nasopharyngeal cancer.
  • Based on current information, the exposure to work-related carcinogens for malignant head and neck tumors of minor importance. A connection due to an increased incidence is currently seen only in carcinomas of the inner nose by certain solvents, or by the inclusion of hardwood dust.

The consumption of betel nuts into some Southeast Asian countries, apparently to an increase of cases of head and neck tumors.

Prophylaxis

The greatest protection against cancers of the head and neck region offers the abandonment of tobacco use. A balanced and vitamin- rich diet and avoiding hot foods to have, as well as regular dental care (and possibly a dental restoration ), a prophylactic effect. However, the administration of beta carotene in smokers for cancer prevention resulted in exactly the opposite: The risk of cancer increased significantly. Similar results were found already in the 1990s with respect to lung cancer in smokers who also received beta -carotene.

Diagnosis

In most cases, the head and neck cancers are detected based on their symptoms of many patients themselves. For permanent swelling of lymph nodes in the neck, difficulty in swallowing with unknown cause and longer lasting Heiserkeiten (from three weeks) an ear-nose -throat doctor should immediately be consulted. In case of persistent swelling or non -healing wounds in the mouth area ( more than 14 days ) should be consulted for clarification of a maxillo -facial surgeon.

The first investigations by clinical inspection, sampling, or at a lower localization with a laryngoscope performed ( laryngoscopy ). If evidence an appropriate initial suspicion, diagnostic imaging methods are generally used.

They are also important for subsequent treatment planning. With the help of so-called tumor staging the extent of the tumor is determined and established whether already lymph node or distant metastases, or even a second tumor are present elsewhere.

As imaging techniques come sonography ( ultrasonography ), magnetic resonance imaging ( MRI), computed tomography ( CT ) and positron emission tomography (PET ) in question. By means of classical X-ray, the chest and contrast medium administration the esophagus to be examined. Also an Ultrasound of the abdomen or a bone scan - can be carried out - depending on the results of the initial diagnosis.

After the imaging procedure, a biopsy is usually performed in order to detect the malignancy of the tumor beyond any doubt.

In accordance with a positive result then an appropriate treatment plan is drawn up with the patient.

Therapy

The therapy can, depending on the tumor site, tumor type and tumor stage, vary. As with many other cancers as well, the three usual forms of therapy surgery, chemotherapy and radiotherapy - usually combined - are used. For tumors of the oral cavity and upper pharynx, however, surgery is the primary treatment method. This is supplemented depending on tumor stage by irradiation and / or chemotherapy.

About the individual treatment methods, we refer to the corresponding single article about the various head and neck cancers.

394858
de