Head and Neck Cancers

What Are Oral and Throat Cancers?

Oral cancers typically occur in individuals over the age of 40 and are twice as likely to develop in men compared to women. The most common sites for oral cancers are the tongue, the floor of the mouth, soft palate areas near the base of the tongue, lips, and gums. If oral cancer is not diagnosed and treated early, it can spread, causing persistent pain, loss of function, facial and oral deformities, and even death.

What Are the Causes of Oral and Tongue Cancers?

The exact cause of oral cancers is not fully known, but smoking, tobacco products, alcohol, HPV virus, and certain carcinogenic substances in foods have been found to increase the risk of oral cancer. Genetic predisposition is also an important risk factor for oral and tongue cancers.

What Are the Symptoms of Oral Cancers?

Oral cancers may appear as white or red areas inside or around the mouth or on the tongue. If caused by HPV, lesions may appear as condylomas or warts. Symptoms include recurrent bleeding in the mouth or throat, hoarseness, a sensation of a foreign body in the throat, difficulty chewing and swallowing, difficulty moving the tongue or jaw, numbness or loss of sensation in the tongue or other parts of the mouth, and a mass or lesion feeling in the mouth or on the tongue.

Does the HPV Virus Pose a Risk for Oral and Tongue Cancer?

HPV, which can be transmitted through oral sex, has recently been recognized as a significant cause of rare oral and tongue cancers. This virus, also linked to throat cancer, is increasingly common in our country. It’s important to note that women with genital warts and a history of oral sex who have condylomas, warts, or similar lesions in the mouth area should consult a doctor.

What Is Laryngeal Cancer?

Laryngeal cancer is one of the most common types of cancer in otolaryngology.

Tumors generally remain confined to the larynx for a long time before spreading to surrounding organs and the neck. Early diagnosis provides a good chance for complete treatment.

However, in advanced cases, treatment can lead to permanent loss of function, significantly affecting the patient’s quality of life and social interactions. Complete removal of the larynx can result in the loss of vocal cords, inability to speak, and disconnection from communication with others, which are the most severe outcomes of the disease. In such cases, a permanent opening (tracheostomy) is created in the neck for breathing.

Who Is at Risk for Laryngeal Cancer?

While the exact causes of laryngeal cancer are not fully understood, it has been closely linked to smoking. The combined use of alcohol and smoking increases this risk.

Laryngeal cancer is generally more common in men between the ages of 50-60, although it is increasingly being seen in younger individuals and women as well.

What Are the Symptoms of Laryngeal Cancer?

Unfortunately, like many other types of cancer, laryngeal cancer does not have any specific symptoms. The symptoms depend on the tumor’s location and size within the organ. If the tumor is on or has spread to the vocal cords, hoarseness and changes in voice quality are usually the first symptoms. Therefore, prolonged hoarseness should not be ignored, and an ENT specialist should be consulted. Other symptoms may include a feeling of something stuck in the throat, throat pain, and pain radiating to the ears. It’s important to note that these symptoms can also be caused by other throat conditions, such as pharyngitis. Therefore, you should consult your doctor if any symptoms persist. Larger tumors can cause symptoms such as shortness of breath, difficulty swallowing, pain while swallowing, and blood-tinged phlegm. General weakness, weight loss, and swelling on the side of the neck may occur as the cancer progresses.

How Does the Disease Progress?

Laryngeal cancers generally remain within the organ for a long time, with a tendency to spread within the larynx. Later, they may spread to surrounding organs and lymph nodes in the neck. Distant spread to organs such as the lungs, bones, or liver is rare and usually seen in advanced tumors. Compared to many other types of cancer that spread throughout the body, laryngeal cancer has a relatively milder course.

Classic Treatment of Laryngeal Cancer

There is a treatment option for every patient diagnosed with laryngeal cancer. The choice of treatment depends on the location of the cancer in the larynx, its stage, the patient’s age, and overall health.

There are three main types of treatment:

1. Surgery (removal of the cancerous tissue)
2. Radiation therapy (using radiation beams to kill cancer cells)
3. Chemotherapy (using drugs to kill cancer cells)

Surgery: This is a frequently used and highly effective treatment for laryngeal cancer. One of the following surgeries may be used to remove the cancer and parts of the larynx:

• Cordectomy: Removal of one vocal cord.
• Partial laryngectomy: Removal of a portion of the larynx.
• Total laryngectomy: Removal of the entire larynx.

In all these surgeries, an opening may be created in the front of the neck, leading to the windpipe to allow breathing. In total laryngectomy, where the entire larynx is removed, this opening is permanent. In other surgeries, the opening is closed after the surgical area heals. If cancer cells have spread to the lymph nodes in the neck or there is a high risk of spread, neck dissection (removal of lymph nodes in the neck) may also be necessary.

Laser Surgery: In some early-diagnosed laryngeal cancers, cancer tissue can be removed by cutting it with a laser beam.

Radiation Therapy (Radiotherapy): Radiation therapy uses high-energy radiation beams to kill cancer cells and shrink tumors. In laryngeal cancers, radiation beams are typically directed at the neck from an external device. Treatment usually involves administering a daily dose of radiation over a period of six weeks. Medications may also be given during radiotherapy to enhance the effects of radiation on cancer cells.

Chemotherapy: Chemotherapy involves the use of drugs to kill cancer cells. Some chemotherapy drugs are in pill form, while others are administered via injections, usually in a hospital setting. The choice of treatment depends on the location, spread, and size of the tumor within the larynx. Other factors influencing treatment decisions include the patient’s age, overall health, lung function, and personal preferences. In our country, laryngeal cancer is primarily treated with surgical methods. Radiation therapy is used for small tumors on the vocal cords or as an adjunctive treatment after surgery, in four-to-six-week courses. For large, widespread tumors, radiotherapy alone is generally less effective. Chemotherapy is used in large, extensive tumors to shrink the tumor and prepare for traditional treatments. Early diagnosis is crucial in treating this disease. For smaller tumors, if the patient’s overall health permits, partial surgery (conservative surgery) allows for the removal of only the cancerous portion within safe margins, preserving the vocal cords and other parts of the larynx. In most of these surgeries, there is no need for a permanent opening in the throat. Today, many surgical techniques allow for treatment without completely removing the larynx. These surgeries are performed in specialized centers for laryngeal cancer in our country. However, for large, extensive tumors, complete removal of the larynx may be necessary. In these cases, the vocal cords are sacrificed to treat the cancer. A permanent opening in the neck for breathing is also required. However, several methods are available to help patients speak understandably, even without vocal cords. These include training to use esophageal voice and speech prosthetics. If the tumor has spread to or is at risk of spreading to lymph nodes in the neck, neck treatment is included in the surgery plan.

Life Expectancy for Patients

With today’s treatment methods, complete treatment and long-term survival are possible for patients. However, early diagnosis is crucial for this. Generally, with complete treatment of a small tumor on the vocal cords, a five-year survival rate of 90-95% can be achieved. For more advanced tumors, this rate drops to 35-50%. These findings highlight the importance of early cancer treatment.

What is Salivary Gland Cancer?

The salivary glands are located around the mouth and throat. The main glands are the parotid (just below the ear), submandibular (under the jawbone), and sublingual (under the front of the tongue) glands.

All these glands release saliva into the mouth through specific ducts: the parotid through a duct near the upper teeth, the submandibular through ducts under the tongue, and the sublingual glands through small ducts in the floor of the mouth.

In addition to the main large glands, there are hundreds of smaller glands located within the inner surface of the lips and cheeks. The saliva produced by these glands keeps the mouth moist, initiates digestion, and protects teeth from decay.