Head and neck cancer

Classification according to ICD-10
C00	Malignant neoplasm of the lip
C01	Malignant neoplasm of the base of the tongue
C02	Malignant neoplasm of other and unspecified parts of the tongue
C03	Malignant neoplasm of the gums
C04	Malignant neoplasm of the floor of the mouth
C05	Malignant neoplasm of the palate
C06	Malignant neoplasm in other and unspecified parts of the mouth
C07	Malignant neoplasm of the parotid gland
C08	Malignant neoplasm of other and unspecified large salivary glands
C09	Malignant neoplasm of the tonsil
C10	Malignant neoplasm of the oropharynx
C11	Malignant neoplasm of the nasopharynx
C12	Malignant neoplasm of the piriform recess
C13	Malignant neoplasm of the hypopharynx
C14	Malignant neoplasm in other and imprecisely designated locations of the lip, oral cavity and pharynx
C30	Malignant neoplasm of the nasal cavity and middle ear
C31	Malignant growth of the sinuses
C32	Malignant neoplasm of the larynx
C33	Malignant neoplasm of the trachea
ICD-10 online (WHO version 2019)

Under head and neck cancer is a group of malignant ( malignant ) tumors that originate in the head and neck region. The malignancies in the head and neck area have individual peculiarities depending on where they originated. In Germany around 17,000 people develop cancer of the head and neck each year. Often an infection by human papillomavirus (HPV) is the cause. Men become ill on average at 64 years of age, women at 66 years. The majority (over 90%) are squamous cell carcinomas . Most malignant tumors in the head and neck area are only discovered at an advanced stage, which leads to a considerable worsening of the prognosis . Depending on the location, the therapy is carried out by ENT specialists or oral, maxillofacial and facial surgeons (MKG).

The head and neck cancers include the following cancers

• Oral carcinoma
• Nasopharyngeal cancer (nasopharynx cancer)
• Oropharyngeal cancer (oral pharynx cancer)
• Carcinoma of the hypopharynx (pharynx cancer)
• Laryngeal cancer (throat cancer)
• Tracheal cancer (windpipe cancer )

See also : "C00-C14 lip, oral cavity and pharynx" in the article List of neoplasms according to ICD-10

Epidemiology

Cancers of the head and neck area are now the sixth most common malignancy worldwide. This form of cancer is increasingly seen in old people and young women.

etiology

The main cause of most cancers of the head and neck area is nicotine abuse in the form of tobacco smoking . Tobacco smoking increases the risk of developing some form of head and neck cancer considerably. The probability is also increased by the excessive consumption of high-percentage alcohol , which serves as a solvent for the carcinogens found in cigarette smoke.

In some forms of head and neck cancer, there are also other risk factors :

• Bad oral hygiene and sharp tooth edges, for example in oral cancer
• About 25% of oral squamous cell carcinomas are associated with human papillomavirus (HPV). These behave more benign than the tumors without HPV exposure.
• A thyroid and salivary gland neoplasm can be triggered by increased radiation exposure .
• If a corresponding genetic predisposition is present in the patient, one can infection with the Epstein-Barr virus to nasopharyngeal cancer cause.
• As far as we know, exposure to occupational carcinogens is of minor importance for malignant head and neck tumors. A connection due to an increased incidence is currently only seen in carcinomas of the inner nose caused by certain solvents or by the ingestion of hardwood dust.

The consumption of betel nuts also apparently leads to an increase in head and neck cancer diseases in some countries in Southeast Asia .

prophylaxis

The greatest protection against cancer of the head and neck area is to give up tobacco consumption. A balanced diet rich in vitamins and avoiding overly hot dishes, as well as regular dental care (including dental restoration if necessary ), have a prophylactic effect. However, the administration of beta-carotene to smokers for cancer prevention had exactly the opposite effect : the risk of developing cancer increased significantly. Similar results were found in the 1990s for lung cancer in smokers who were also given beta-carotene.

diagnosis

In most cases, head and neck cancers are diagnosed by many patients themselves based on their symptoms. In the case of permanent swelling of the lymph nodes in the neck, swallowing difficulties with an unclear cause and prolonged hoarseness (from three weeks), an ear, nose and throat specialist should be consulted immediately . In the event of persistent swelling or wounds in the mouth that do not heal (longer than 14 days), an oral and maxillofacial surgeon should be consulted for clarification.

The first examinations are carried out by clinical inspection, palpation or, in the case of deeper localization, with a laryngoscope (laryngoscopy). If a corresponding initial suspicion is confirmed, diagnostic imaging methods are usually used.

They are also important for later therapy planning . With the help of what is known as tumor staging , the extent of the tumor is determined and it is determined whether lymph nodes or distant metastases or even a second carcinoma are present elsewhere.

The imaging methods used are sonography (ultrasound diagnostics), magnetic resonance tomography (MRT), computed tomography (CT) and positron emission tomography (PET). The chest and, if contrast agent is administered, the esophagus can be examined using a classic X-ray . An ultrasound of the abdominal cavity or a skeletal scintigraphy can also be carried out - depending on the result of the initial diagnosis.

After the imaging process, a biopsy is usually carried out in order to be able to prove the malignancy of the tumor beyond any doubt.

If the result is positive, a corresponding therapy plan is then drawn up with the patient.

therapy

Therapy can vary depending on the location, type and stage of the tumor. As with many other forms of cancer, the three usual forms of therapy, surgery , chemotherapy and radiation therapy - usually also combined - can be used. However, for tumors of the oral cavity and upper throat, surgery is the primary method of treatment. This is supplemented by radiation and / or chemotherapy, depending on the tumor stage.

For the individual treatment methods, reference is made to the corresponding individual articles on the various head and neck cancers.

literature

• CR Leemans, BJ Braakhuis, RH Brakenhoff: The molecular biology of head and neck cancer. In: Nature Reviews Cancer . Volume 11, Number 1, January 2011, pp. 9-22, ISSN  1474-1768 . doi: 10.1038 / nrc2982 . PMID 21160525 . (Review).
• H. Rudert: Malignant tumors of the lips, the oral cavity and the oropharynx. In: H. Naumann et al.: Otorhinolaryngology in clinic and practice. Volume 2, Thieme Verlag, Stuttgart 1992.
• National Cancer Institute, Head and Neck Cancer: Questions and Answers in English
• National Institute of Health, Head and Neck Cancer in English

Web links

• Radiological recordings of ENT carcinomas
• Head and Neck Cancer CTCases.net

Individual evidence

1. ↑ https://www.krebshilfe.de/informieren/presse/neues-aus-der-forschung/winzige-viren-wirksame-waffe/ , accessed on August 2, 2019
2. ↑ ^{a b c d e f} Heidelberg University Hospital: Malignant tumors of the head and neck area in general , accessed on August 10, 2007 ( Memento of the original from June 4, 2008 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked . Please check the original and archive link according to the instructions and then remove this notice. 
3. ^ ^{A b} M. R. Spitz: Epidemiology and risk factors for head and neck cancer. In: Seminars in Oncology . Volume 21, Number 3, June 1994, pp. 281-288, ISSN  0093-7754 . PMID 8209260 . (Review).
4. ↑ K. Andre, S. Screw, M. Mercier, P. Bontemps: Role of alcohol and tobacco in the aetiology of head and neck cancer: a case-control study in the Doubs region of France. In: European Journal of Cancer B, Oral Oncology . Volume 31B, Number 5, September 1995, pp. 301-309, ISSN  0964-1955 . PMID 8704646 .
5. ↑ JH Jeng, MC Chang, LJ Hahn: Role of areca nut in betel quid-associated chemical carcinogenesis: current awareness and future perspectives. In: Oral Oncology . Volume 37, Number 6, September 2001, pp. 477-492, ISSN  1368-8375 . PMID 11435174 . (Review).
6. ↑ I. Bairati include: A randomized trial of antioxidant vitamins to prevent second primary cancers in head and neck cancer patients. In: Journal of the National Cancer Institute . Volume 97, Number 7, April 2005, pp. 481-488, ISSN  1460-2105 . doi: 10.1093 / jnci / dji095 . PMID 15812073 .
7. ↑ D. Albanes et al .: Alpha-Tocopherol and beta-carotene supplements and lung cancer incidence in the alpha-tocopherol, beta-carotene cancer prevention study: effects of base-line characteristics and study compliance. In: Journal of the National Cancer Institute. Volume 88, Number 21, November 1996, pp. 1560-1570, ISSN  0027-8874 . PMID 8901854 .
8. ↑ tumor-online.de (Charité Berlin), Therapy standards for head and neck cancer ( Memento of the original from December 17, 2007 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. 
9. ^ MS Kies, CL Bennett, EE Vokes: Locally advanced head and neck cancer. In: Current Treatment Options in Oncology . Volume 2, Number 1, February 2001, pp. 7-13, ISSN  1527-2729 . PMID 12057136 . (Review).
10. ^ M. Al-Sarraf: Treatment of locally advanced head and neck cancer: historical and critical review. In: Cancer Control . Volume 9, Number 5, 2002 Sep-Oct, pp. 387-399, ISSN  1073-2748 . PMID 12410178 . (Review).

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !