Types Of Head And Neck Cancer Pdf

types of head and neck cancer pdf

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Head and neck squamous cell carcinoma HNSCC represents a group of tumors arising in the oral cavity, oropharynx, and larynx.

Diagnostic Tumor Markers in Head and Neck Squamous Cell Carcinoma (HNSCC) in the Clinical Setting

Head and neck cancer develops from tissues in the mouth, larynx throat , salivary glands , nose, sinuses or the skin of the face. Symptoms predominantly include a sore that does not heal or a change in the voice. In those with advanced disease, there may be unusual bleeding, facial pain, numbness or swelling, and visible lumps on the outside of the neck or oral cavity. Given the location of these cancers, trouble breathing may also be present.

The majority of head and neck cancer is caused by the use of alcohol or tobacco , including smokeless tobacco , with increasing cases linked to the human papillomavirus HPV.

Not using tobacco or alcohol can reduce the risk for head and neck cancer. While screening in the general population does not appear to be useful, screening high risk groups by examination of the throat might be useful.

Globally, head and neck cancer accounts for , new cases of cancer and , deaths annually on average. In , it was the seventh most common cancer worldwide with , new cases documented and , dying from the disease. The usual age at diagnosis is between 55 and 65 years old.

Symptoms predominantly include a sore of the face or oral cavity that does not heal, trouble swallowing, or a change in the voice. In the case of head and neck cancer, these symptoms will be notably persistent and become chronic. There may be a lump or a sore in the throat or neck that does not heal or go away. There may be difficult or painful swallowing.

Speaking may become difficult. There may also be a persistent earache. Other symptoms can include: a lump in the lip, mouth or gums, ulcers or mouth sores that do not heal, bleeding from the mouth or numbness, bad breath, discolored patches that persist in the mouth, a sore tongue, and slurring of speech if the cancer is affecting the tongue. There may also be congested sinuses, weight loss, and some numbness or paralysis of facial muscles. Squamous cell cancers are common in areas of the mouth, including the inner lip, tongue , floor of mouth , gums , and hard palate.

Cancers of the mouth are strongly associated with tobacco use, especially use of chewing tobacco or dipping tobacco , as well as heavy alcohol use. Cancers of this region, particularly the tongue, are more frequently treated with surgery than are other head and neck cancers. Paranasal sinus and nasal cavity cancer affects the nasal cavity and the paranasal sinuses.

Most of these cancers are squamous cell carcinomas. Nasopharyngeal cancer arises in the nasopharynx , the region in which the nasal cavities and the Eustachian tubes connect with the upper part of the throat. While some nasopharyngeal cancers are biologically similar to the common head and neck squamous cell carcinomas HNSCCs , "poorly differentiated" nasopharyngeal carcinoma is lymphoepithelioma , which is distinct in its epidemiology , biology, clinical behavior, and treatment, and is treated as a separate disease by many experts.

Most oropharyngeal cancers are squamous cell carcinomas that begin in the oropharynx throat , the middle part of the throat that includes the soft palate , the base of the tongue , and the tonsils. People with oropharyngeal carcinomas are at high risk of developing second primary head and neck cancer. The hypopharynx includes the pyriform sinuses, the posterior pharyngeal wall, and the postcricoid area.

Tumors of the hypopharynx frequently have an advanced stage at diagnosis, and have the most adverse prognoses of pharyngeal tumors. They tend to metastasize early due to the extensive lymphatic network around the larynx.

Laryngeal cancer begins in the larynx or "voice box. Laryngeal cancer is strongly associated with tobacco smoking. Surgery can include laser excision of small vocal cord lesions, partial laryngectomy removal of part of the larynx or total laryngectomy removal of the whole larynx.

If the whole larynx has been removed, the person is left with a permanent tracheostomy. Voice rehabilitation in such patients can be achieved through three important ways - esophageal speech, tracheoesophageal puncture, or electrolarynx. Cancer of the trachea is a rare cancer usually classed as a lung cancer.

Most tumors of the salivary glands differ from the common squamous cell carcinomas of the head and neck in cause, histopathology , clinical presentation, and therapy. Other uncommon tumors arising in the head and neck include teratomas , adenocarcinomas , adenoid cystic carcinomas , and mucoepidermoid carcinomas. Tobacco smoking is one of the main risk factors for head and neck cancer. A major carcinogenic compound in tobacco smoke is acrylonitrile. Both 8-oxo-dG and formamidopyrimidine are mutagenic.

However, cigarette smokers have a lifetime increased risk for head and neck cancers that is 5- to fold increased over the general population. Smokeless tobacco is a cause of oral cancer and oropharyngeal cancer. Other environmental carcinogens suspected of being potential causes of head and neck cancer include occupational exposures such as nickel ore refining , exposure to textile fibers, and woodworking.

Use of marijuana , especially when younger, has been linked to an increase in squamous-cell carcinoma cases in at least one study, [29] while other studies suggest use is not shown to be associated with oral squamous cell carcinoma, or associated with decreased squamous cell carcinoma.

Excessive consumption of eggs, processed meats, and red meat were associated with increased rates of cancer of the head and neck in one study, while consumption of raw and cooked vegetables seemed to be protective.

Vitamin E was not found to prevent the development of leukoplakia , the white plaques that are the precursor for carcinomas of the mucosal surfaces, in adult smokers.

Betel nut chewing is associated with an increased risk of squamous cell cancer of the head and neck. Some head and neck cancers are caused by human papillomavirus HPV. HPV can induce tumor by several mechanisms: [46]. Induction of cancer can be associated for the expression of viral oncoproteins, the most important E6 and E7, or other mechanisms many of them run by the integration such as the generation of altered transcripts, disruption of tumor suppressors, high levels of DNA amplifications, interchromosomial rearrangements, or changes in DNA methylation patterns, the latter being able to find even when the virus is identified in episomes.

Therefore, E6 and E7 act synergistically in triggering cell cycle progression and therefore uncontrolled proliferation by inactivating the p53 and Rb tumor suppressors. Viral integration tends to occur in or near oncogenes or tumor suppressor genes and it is for this reason that the integration of the virus can greatly contribute to the development of tumor characteristics.

Epstein—Barr virus EBV infection is associated with nasopharyngeal cancer. Nasopharyngeal cancer occurs endemically in some countries of the Mediterranean and Asia, where EBV antibody titers can be measured to screen high-risk populations.

Nasopharyngeal cancer has also been associated with consumption of salted fish, which may contain high levels of nitrites. The presence of acid reflux disease gastroesophageal reflux disease [GERD] or larynx reflux disease can also be a major factor. Stomach acids that flow up through the esophagus can damage its lining and raise susceptibility to throat cancer.

Patients after hematopoietic stem cell transplantation HSCT are at a higher risk for oral squamous cell carcinoma. There are several risk factors for developing throat cancer. These include smoking or chewing tobacco or other things, such as gutkha , or paan , heavy alcohol consumption, poor diet resulting in vitamin deficiencies worse if this is caused by heavy alcohol intake , weakened immune system , asbestos exposure, prolonged exposure to wood dust or paint fumes, exposure to petroleum industry chemicals, and being over the age of 55 years.

A person usually presents to the physician complaining of one or more of the above symptoms. The person will typically undergo a needle biopsy of this lesion, and a histopathologic information is available, a multidisciplinary discussion of the optimal treatment strategy will be undertaken between the radiation oncologist , surgical oncologist , and medical oncologist.

Throat cancers are classified according to their histology or cell structure, and are commonly referred to by their location in the oral cavity and neck. This is because where the cancer appears in the throat affects the prognosis - some throat cancers are more aggressive than others depending upon their location. The stage at which the cancer is diagnosed is also a critical factor in the prognosis of throat cancer.

Treatment guidelines recommend routine testing for the presence of HPV for all oropharyngeal squamous cell carcinoma tumours. Squamous-cell carcinoma is a cancer of the squamous cell — a kind of epithelial cell found in both the skin and mucous membranes. Adenocarcinoma is a cancer of epithelial tissue that has glandular characteristics. Several head and neck cancers are adenocarcinomas either of intestinal or non-intestinal cell-type. Avoidance of recognised risk factors as described above is the single most effective form of prevention.

Regular dental examinations may identify pre-cancerous lesions in the oral cavity. When diagnosed early, oral, head and neck cancers can be treated more easily and the chances of survival increase tremendously.

Improvements in diagnosis and local management, as well as targeted therapy , have led to improvements in quality of life and survival for people with head and neck cancer. After a histologic diagnosis has been established and tumor extent determined, the selection of appropriate treatment for a specific cancer depends on a complex array of variables, including tumor site, relative morbidity of various treatment options, concomitant health problems, social and logistic factors, previous primary tumors, and the person's preference.

Treatment planning generally requires a multidisciplinary approach involving specialist surgeons and medical and radiation oncologists. Surgical resection and radiation therapy are the mainstays of treatment for most head and neck cancers and remain the standard of care in most cases. For small primary cancers without regional metastases stage I or II , wide surgical excision alone or curative radiation therapy alone is used.

More extensive primary tumors, or those with regional metastases stage III or IV , planned combinations of pre- or postoperative radiation and complete surgical excision are generally used. More recently, as historical survival and control rates are recognized as less than satisfactory, there has been an emphasis on the use of various induction or concomitant chemotherapy regimens.

Surgery as a treatment is frequently used in most types of head and neck cancer. Usually the goal is to remove the cancerous cells entirely. This can be particularly tricky if the cancer is near the larynx and can result in the person being unable to speak. Surgery is also commonly used to resect remove some or all of the cervical lymph nodes to prevent further spread of the disease. CO 2 laser surgery is also another form of treatment. Transoral laser microsurgery allows surgeons to remove tumors from the voice box with no external incisions.

It also allows access to tumors that are not reachable with robotic surgery. Radiation therapy is the most common form of treatment. There are different forms of radiation therapy, including 3D conformal radiation therapy, intensity-modulated radiation therapy, particle beam therapy and brachytherapy, which are commonly used in the treatments of cancers of the head and neck.

Most people with head and neck cancer who are treated in the United States and Europe are treated with intensity-modulated radiation therapy using high energy photons. At higher doses, head and neck radiation is associated with thyroid dysfunction and pituitary axis dysfunction. Chemotherapy in throat cancer is not generally used to cure the cancer as such. Instead, it is used to provide an inhospitable environment for metastases so that they will not establish in other parts of the body.

Typical chemotherapy agents are a combination of paclitaxel and carboplatin. Cetuximab is also used in the treatment of throat cancer. Docetaxel -based chemotherapy has shown a very good response in locally advanced head and neck cancer.

Docetaxel is the only taxane approved by US FDA for head and neck cancer, in combination with cisplatin and fluorouracil for the induction treatment of inoperable, locally advanced squamous cell carcinoma of the head and neck. While not specifically a chemotherapy, amifostine is often administered intravenously by a chemotherapy clinic prior to IMRT radiotherapy sessions. Amifostine protects the gums and salivary glands from the effects of radiation.

Mouth, head and neck cancer

Head and neck cancer accounts for nearly A mean of The variables analyzed included: age, gender, occupation, skin color, tobacco and alcohol consumption, primary site of the tumor, clinical staging, degree of histological differentiation and outcome. The data was analyzed by descriptive and exploratory statistics. Primary site of tumor was usually in the oral cavity


information leaflet about head and neck cancer had increased awareness of risk compared to Certain tumour types behave differently from conventional squamous carcinomas from url: chezchevaux.org​pdf/.


Overview of Head and Neck Tumors

Head and neck cancer is a general term for a range of cancers that start in the tissue or lymph nodes in the head and neck area. This region includes the mouth, tongue, palate, gums, salivary glands, tonsils, throat pharynx , voice box larynx , nose and sinuses. Most head and neck cancers start in the cells that line the moist surfaces of the mouth, nose or throat squamous cells. These are called squamous cell carcinomas SCC. Some head and neck cancers start in glandular cells.

Mouth, head and neck cancer describes different cancers that happen in the organs and tissues of the mouth, head or neck. Cancer starts when cells grow in an abnormal way. As they grow, the cancer cells can form a tumour, which can affect how the organ or tissue normally works.

Head and neck cancers

Head and neck cancer develops in almost 65, people in the United States each year. Larynx including the supraglottis, glottis, and subglottis.

Knowledge Center

Head and Neck Cancer. In a Chinese phase III trial reported in The Lancet Oncology, Liu et al found that endoscopic nasopharyngectomy was associated with improved overall survival vs intensity-modulated radiotherapy IMRT in patients with resectable locally recurrent nasopharyngeal carcinoma who had received prior In a Canadian population-based study reported in the Journal of Clinical Oncology, Noel et al found that patient-reported symptom burden was significantly associated with the likelihood of emergency department use and unplanned hospitalization among patients with head and neck cancer. In a comprehensive molecular characterization of the most common type of head and neck cancer, researchers from the United States and Poland have clarified the contribution of key cancer-associated genes, proteins, and signaling pathways in these cancers, while proposing possible new treatment In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.

Head and neck cancer develops from tissues in the mouth, larynx throat , salivary glands , nose, sinuses or the skin of the face. Symptoms predominantly include a sore that does not heal or a change in the voice. In those with advanced disease, there may be unusual bleeding, facial pain, numbness or swelling, and visible lumps on the outside of the neck or oral cavity. Given the location of these cancers, trouble breathing may also be present. The majority of head and neck cancer is caused by the use of alcohol or tobacco , including smokeless tobacco , with increasing cases linked to the human papillomavirus HPV. Not using tobacco or alcohol can reduce the risk for head and neck cancer.

Information PDFs | Types of Head and Neck Cancer | Head and Neck Cancer Australia

Types of head and neck cancer

Head and neck cancers HNCs are specifically defined as cancers of the upper aerodigestive tract, which includes the oral cavity, the mucosal lip, the oropharynx, the hypopharynx, the nasopharynx, the larynx, and the salivary glands. Alcohol consumption. Heavier consumption of alcohol is associated with increased HNC risk. There is also a possibility of genetic susceptibility to HNC among certain heavy drinkers of alcohol that may predispose them to such cancers. HPV infection. Individuals with HPV-positive HNCs tend to be younger, healthier fewer comorbid diseases than in long-term tobacco and alcohol users , and have different behavior- related risk factors, including more sexual partners and earlier ages of onset of sexual activity.

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Although head and neck carcinoma ranks fifth among cancer types, patient survival rates have not changed significantly over the past years. Objective: To.

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