What are the symptoms of head and neck cancers and is there a way I can be screened?

Q: What are the symptoms of head and neck cancers and is there a way I can be screened?

Head and neck cancer (specifically, cancers of the upper aerodigestive tract) comprise of tumors that arise from the oral cavity, oropharynx, nasal cavity/sinuses, nasopharynx, and the larynx (voice box). Squamous cell carcinoma (SCCA) is the most common type of cancer found in the head and neck, while HPV related squamous cell carcinoma, which is sexually transmitted and associated most commonly with oropharyngeal cancers, has been on the rise over the past decade.

Symptoms vary depending on where the cancer starts. Cancers of the oral tongue are visible and can be very painful as a non-healing ulcer or mass. Base of tongue cancers (located on the back of the tongue) usually cannot be fully visualized by looking inside the mouth, and can go unnoticed until symptoms start to occur, such as subtle changes in the voice (“hot potato voice”), difficulty or pain when swallowing, difficulty breathing, or a chronic sore throat for a prolonged period of time. Sometimes, a head and neck cancer may not present many symptoms and can be silent for a long time.

Prolonged exposure to tobacco and alcohol consumption have been found to be causative agents for head and neck cancers, which traditionally present in 60-70 year age groups; however, genetic predisposition or a combination of any of the above factors may also contribute to the development of head and neck cancers. HPV-related cancer patients present at earlier ages, ie. 40-50s. And though it is rare, young patients in their late 20s and 30s can also be affected without any tobacco risk or HPV factors.

There is no blood test available for screening head and neck cancers. If you have any of the risk factors or persistent symptoms for greater than three weeks, you should seek a consultation with an otolaryngology-head and neck surgery trained physician who can perform a comprehensive history and physical examination of the head and neck, including evaluation of the back of the nose, throat and larynx using a fiberoptic laryngoscope.

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