Head and neck cancers are classified by the area in which the disease starts. Cancer of the oral cavity can affect the lips, gums, front of the tongue, floor of the mouth (the area under the tongue), the hard palate and the small section of tissue behind the wisdom teeth. Salivary gland cancer affects the glands that produce saliva. Cancer of the nasal passages affects the paranasal sinuses (the small cavities in the bone surrounding the nose) and the breathing passages in the nose. Pharyngeal cancer occurs in the section of the swallowing tube from behind the nose to the esophagus (the tube that goes to the stomach). This area includes the soft palate, base of the tongue and tonsils. Laryngeal cancer, or cancer of the voice box, affects the area containing the vocal cords.

The most important risk factor for head and neck cancer is use of tobacco (including smoking and smokeless tobacco). The National Cancer Institute says about 85 percent of all head and neck cancers can be linked to tobacco use. People who use tobacco and alcohol are at even greater risk because chemicals from the two products work in synergy to create a greater risk than either of them alone.

According to the American Academy of Otolaryngology - Head and Neck Surgery estimates 55,000 Americans will develop some type of head and neck cancer this year. About 13,000 will die from it.

General symptoms of head and neck cancer include a lump or sore that doesn't heal or go away, problems swallowing, changes in the voice, blood-tinged saliva or phlegm or persistent ear pain.

Treating Head and Neck Cancer

The National Cancer Institute estimates about $3.2 billion is spent on treatment for head and neck cancer each year in the U.S. When possible, the main course of treatment is surgery. Doctors remove the cancer and a small section of surrounding healthy tissue. Sometimes nearby lymph nodes are removed as well. Depending upon the location and/or stage or spread of the cancer, surgery may be followed up with radiation therapy and/or chemotherapy.

Surgery for head and neck cancer is often a very radical procedure. Doctors may need to cut through muscles and work around major nerves and blood vessels. A tracheotomy (artificial opening into the neck) may be made to place a feeding tube into the stomach and allow the patient to get air into the lungs. Depending upon the location and extent of the cancer, the surgery may leave disfiguring changes in the face, jaw or neck. The surgery may also affect the ability to speak, chew or swallow.

Transoral Laser Surgery

A newer treatment for some patients with head and neck cancer is transoral laser surgery. Instead of making an incision from outside the body, a special endoscope (lighted viewing tube) is placed into the mouth to access the cancer from inside the body. Then a carbon dioxide laser is aimed at the cancer. The laser energy cuts into the tumor, sealing blood vessels as it works to limit bleeding. Doctors cut the tumor into small pieces that are removed a little at a time, until the entire tumor is gone. Since there is little bleeding, the surgeon maintains a clear field of vision during the procedure, enabling complete removal of the abnormal tissue while avoiding critical nerves and blood vessels. The laser also produces less swelling and scarring and there is a lower risk of infection. Surgeons may not have to remove or disrupt as much healthy tissue. And since it's done from inside the body there is a better aesthetic outcome. Research also shows, compared to traditional surgery, transoral laser surgery is associated with shorter hospital stays and lower rates of complications or death.

Miriam Lango, M.D., a Head and Neck Surgeon at Fox Chase Cancer Center, says not all patients are candidates for transoral laser surgery. Patients with very large tumors, or tumors that are difficult to access through the mouth may need traditional surgery. Lango warns her transoral surgery patients that if she is unable to proceed with the laser, they will need to undergo traditional surgery. Lango also says that while transoral laser surgery may be associated with better functional and aesthetic outcomes, there is no proof it improves survival from the cancer.

For information on head and neck cancers:

American Academy of Otolaryngology - Head and Neck Surgery

American Cancer Society

National Cancer Institute