Incidence, diagnoses of head, neck cancers

Cancer is a disease of abnormal cells growing in any part of the human body.

Head and neck cancers include cancers of the mouth, tongue, uvular, thyroid and larynx (laryngeal cancer).

April 13-19 this year was observed as Oral, Head and Neck Cancer Awareness (OHANCAW) Week.

Instituted by the Head and Neck Cancer Alliance and supported by the American Academy of Otolaryngology-Head and Neck Surgery, the day affords the opportunity for people to pay attention to their head health.

The incidence of head and neck cancers vary in different parts of the world. Variations may perhaps be as a result of a combination of environmental factors and genetic predispositions.

The incidence of head and neck cancer in Ghana is unknown. In the United Kingdom, it is reported that 12,000 people are diagnosed with head and neck cancer yearly.

Men are three times likely to develop head and neck cancers than women. Cigarette smoking and alcohol consumption are the chief causes of cancer of the larynx, although there is evidence that life-long non-smokers can and do develop laryngeal cancer. 

Even though laryngeal cancer occurs frequently in middle-aged or elderly individuals and rare under 30 years of age, there is evidence that the incidence is increasing in younger individuals. This is because much younger cases are reported in the literature.

Symptoms

What are the symptoms of head and neck cancers? Head and neck cancers can have several symptoms. These may include, persistent hoarseness or voice change; persistent coughs; the swelling of the throat; lump in the neck or a mass that is painless; foul breath, otherwise known as halitosis; and white or red patches in the mouth/sore tongue/non-healing mouth ulcers.

Other symptoms are painful or difficulty in swallowing; blocked or bloody discharge from the nose; pain in the throat and trouble in breathing or wheezing.

If these symptoms go on for two or three weeks, seek medical help.

Self-screening

Look for ulcers in your mouth after brushing your teeth. Notice any numbness, sensitivity or dental changes in the mouth. Observe it for two to three weeks. If the changes persist, please see your dentist or doctor.

For the neck, check both sides of the neck for bumps or lumps. If you find any bumps or lumps in either sides of your neck, please see your doctor.

The thyroid gland is shaped like a butterfly and is located at the front of your neck. It makes hormones that regulate the way your body uses energy and that helps your body work normally.

With your head tilted back, take a sip of water and swallow, doing that in front of a mirror.

You will see your thyroid gland will rise, with the shape becoming more visible. Look out for any asymmetry, enlargement or lumps. See your doctor if you observed any of these (i.e. thyroid enlargement, asymmetry or lumps).

However, not everyone may have obvious symptoms. Doctors may find a lump or nodule in the neck during a routine physical exam.

Diagnosis

All cancers are diagnosed after biopsy of the tumour. A biopsy is a simple procedure in which a small piece of the tissue is removed, usually with a needle, and then checked in the laboratory. Before deciding on the treatment option, further information about the volume and dimension of the tumour is required among other things.

Treatment

The ultimate aim of all cancer treatment is to save lives. Head and neck surgeons have procedures they follow for treatment of each cancer type based on the volume of the tumour.

Treatment options may include radiotherapy, surgery, chemotherapy or a combination of some of the aforementioned options.

What treatment you need depends on your age, the type of cancer one has and the stage of the disease.

The stage refers to how severe the disease is and how far, if at all, the cancer has spread. Often, the team responsible for the care of clients with head and neck cancer is made up of the head and neck surgeon, clinical oncologist, clinical psychologist, dietician and a speech and language therapist (specialised in voice).

Most cancers in their early stages respond well to treatment. Early diagnosis saves lives!

Speech and Language Therapist/Clinical Tutor

University of Ghana/Korle bu Teaching Hospital