Head and neck cancer is a term which is used to describe a heterogeneous group of malignant tumours around the mouth, nose and paranasal sinus, and throat. Most of these cancers are Squamous cell carcinoma histopathologically.
There are Five types of Head and neck cancers:
1. Oral and oropharyngeal cancer
2. Nasal cavity and paranasal sinus cancer
3. Nasopharyngeal cancer
4. Laryngeal and Hypopharyngeal cancer
5. Salivary glands cancer
Other types of cancer that can be located in the head and neck region are Thyroid cancer, brain tumours, upper oesophageal cancer, eye cancer, parathyroid cancer, and Sarcomas. Still, due to their different biology and pathological nature, these are discussed separately.
More than 650,000 cases and approx 330,000 deaths occur annually worldwide because of Head and neck cancer. Approx 57.5% of global head and neck cancers occur in Asia, especially in India. Head and neck cancers in India accounted for nearly 30% of all the cancers, and out of these most common is Oral cancer.
The Primary Risk factor associated with these head and neck cancers include:
1. Tobacco Use and Second-hand Smoke
The primary cause of head and neck cancer in India is the use of smokeless tobacco that is chewable tobacco, and the habits vary socioculturally across the country. Smoking is also rampant in the younger population, especially in villages and due to this reason sale of tobacco to the minor is prohibited. You will always see the warning signs and pictures over a pack. Tobacco contains approx 6000 harmful chemicals which are carcinogenic in nature and, Nicotine which is a habit-forming substance and not itself carcinogenic but potentiates the effect of other carcinogens. These substances cause changes in the DNA of the cells, which leads to Mutation. These cells keep on accumulating these mutations until they become autonomous and no more under the control of the body and its immunity. In turn, these cells keep on growing, first invading superficially and then invade the basement membrane and become frank cancer.
2. Alcohol Consumption
Concurrent use of both alcohol and Tobacco further increases the risk.
3. Human Papillomavirus infection (For Oropharyngeal cancer)
4. Epstein-Barr Virus infection (For Nasopharyngeal cancer), common in African Population
5. Sun exposure and chemical exposures for Skin Cancers
Other factors that may increase the risk can be poor Orodental hygiene, Environmental or occupational inhalants, Poor nutrition, Radiation exposure, Male sex, Weak immune system and any previous history of Head and neck cancer.
Most of the patients in India present at an advanced stage due to ignorance and lack of awareness, lack of medical facilities and financial issues. If caught at an early stage, the disease can be cured, but as you can see the risk factors listed above, all are avoidable, and together we can decrease the risk of developing this disease.
We at Manipal Hospital, Dwarka Delhi have specialised clinics for Tobacco and Alcohol cessation counselling as well as a trained Psychologist along with specialist Oncologist’s advise for the benefit of our patients and the General public.
Consultant - Surgical Oncology, Oncology Sciences
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