Head and neck cancers include cancers outside the skull and above the shoulders. These cancers usually start in the squamous cells that line the mouth, nose, and other internal surfaces in the head and neck.
Often cancer cells will form a lump or tumor. Tumors can be benign (non-cancerous) or malignant (cancerous). Benign tumors do not spread into nearby tissue, lymph, or blood systems. Malignant tumors grow into nearby tissue and can spread throughout your body.
Our interdisciplinary head and neck care team is part of the UMMC Cancer Center and Research Institute. Most of our team works only with head and neck cancer patients, giving them invaluable, extensive experience. In fact, they offer some treatments so specialized this is the only place in the state where they are available.
Specialists from several areas serve on the care team, including ear, nose, and throat surgeons, microvascular surgeons, neuroradiologists, medical oncologists, radiation oncologists, a maxillofacial prosthodontist, a dental specialist in oral medicine and radiology, dentists, nurses, speech pathologists, dieticians, social workers, and others. They meet weekly so each member can review each case, recommend treatment, and receive updates at several points during treatment. Team members consider a patient’s age and general health, along with the type, location, and stage of the cancer in making treatment recommendations. They also follow National Comprehensive Cancer Network guidelines in developing treatment plans.
This team also includes a coordinator who helps guide patients through the ins and outs of cancer treatment and coordinates their initial visit.
Contact the head and neck cancer coordinator to schedule appointments or ask questions beforehand. We’ll work to schedule all of your appointments at the same time to make your care easier and more convenient. Most services will be at the Cancer Center and Research Institute in the Jackson Medical Mall, but we also provide cancer care on the main campus at University Hospital and the University Physicians Pavilion.
Detecting cancer in its earliest stage is the key to beating the disease. To catch oral cancer early, check your mouth regularly, looking for white or red spots (lesions) on your lips, gums, tongue, or inside your mouth. Many dentists also will check for signs of cancer during regular dental check-ups. UMMC offers screenings through the School of Dentistry.
To detect other head and neck cancers early, see your primary care provider for annual screenings as part of your regular annual wellness exam.
UMMC offers individualized treatment for head and neck cancers. These may include surgery, chemotherapy, radiation therapy, targeted therapy, and clinical trials, when appropriate.
Cancer is an emotional, trying time for you and your family, and our job is to help you through it. Whether you need financial assistance or advice, counseling or a support group, or any other social or medical services, your nurse coordinator can quickly connect you to the care you’re looking for.
Often ear cancer begins as skin cancer on the outer ear and travel into the ear canal. The most common type is squamous cell carcinoma, but these cancers also can start as basal cell carcinomas. Squamous cell carcinomas tend to be more aggressive and spread quicker, so early treatment is key to stopping or controlling this cancer.
Sometimes the cancer may start in the middle ear or spread from another site in the body to the temporal bone. The temporal bone is on the side of the skull, just above the ear. It also forms part of the skull base behind the ear. It contains the middle and inner parts of the ear and the nerves that control a person’s sense of balance. These cancers can form in the temporal bone or travel to it.
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The hypopharynx is the bottom part of the pharynx, the lower part of the back of the throat. It lies beside and behind the larynx. It is the entrance to the esophagus (the tube that connects the mouth and throat to the stomach), and the trachea (the windpipe that connects the nose and mouth to the lungs). The hypopharynx makes sure food goes into the esophagus and not into the trachea.
Hypopharyngeal cancers are rare. Most of these cancers form in the cells that line the inside of the hypopharynx. The American Cancer Society estimates about 2,850 cases will be diagnosed annually in the United States, but says that number is falling as more people quit smoking.
The larynx (voice box) allows a person to speak and protects the airway, or trachea, during swallowing. The larynx has three main parts: the supraglottis, the part above the vocal cords which includes the epiglottis (it closes the larynx when during swallowing so food doesn't go into the lungs); the glottis, the middle part containing the vocal cords; and the subglottis, the lower part between the vocal cords and trachea. The treatment for laryngeal cancer is dependent upon where in the larynx the cancer began. Laryngeal cancer may also affect the vocal cords.
The American Cancer Society estimates about 12,700 cases of laryngeal cancer will be diagnosed each year, about five times more frequently in men than in women.
The nasopharynx is the upper part of the pharynx, the part right behind the nose. The nostrils lead to this box-like chamber with an opening on each side that leads to an ear. Usually cancers start in the cells that line the nasopharynx. Nasopharyngeal cancer is also called nasopharyngeal carcinoma or NPC.
Nasopharyngeal cancer is uncommon in the United States, occurring in about seven of every one million people annually. This cancer is more common in Asia and North Africa, Inuits of Alaska and Canada, and recent Chinese and Hmong immigrants to the United States.
The oral cavity includes the front two-thirds of the tongue, the gums, the inner lining of the cheeks, the bottom of the mouth, the roof of the mouth, and the area behind the wisdom teeth. This part of the body is instrumental in the ability to breathe, speak, chew, and swallow.
Oral cancers usually start in the squamous cells, the ones that line the mouth. More than 80 percent of such cancers are linked to tobacco use. Initially, oral cancer may appear as white patches in the mouth called areas of leukoplakia. It’s important to work with a care team experienced in treating oral cavity cancers. This increases the likelihood that the cancer will be accurately diagnosed and effectively treated.
The oropharynx is the middle part of the pharynx. It includes the back third of the tongue, soft palate, tonsils, and the side and back walls of the throat.
Oropharyngeal cancer is also called throat cancer, since it starts in the area that moves from the mouth to the throat. The American Cancer Society, which considers oral cavity and oropharyngeal cancers together, estimates 25,800 people will be diagnosed with these cancers annually. Several types of growths may occur in the oropharynx, but many are non-cancerous. Smoking, drinking, and exposure to the human papilloma virus (HPV) each increase the risk of oropharyngeal cancer.
Paranasal sinuses are the ones nearest the nose. They’re lined with cells that make mucus and keep the inside of the nose moist. Frontal sinuses are in the forehead just above the nose. The ethmoid sinuses are located between the eyes. Sphenoid sinuses are behind the nose, near the center of the head. And, maxillary sinuses are in the cheekbones beside the nose.
These sinuses and nasal cavity help filter and warm air before goes into the lungs. When air moves through these spaces it also helps a person talk. The nose also contains the nerves responsible for the sense of smell.
Cancers in the paranasal sinuses and nasal cavity are rare, with roughly 2,000 cases diagnosed in the United States each year. However, since the sinuses and nasal cavity have so many different types of cells with so many different functions, several types of cancer can start here.
The parathyroid glands are four tiny glands in the neck embedded within the thyroid gland. The parathyroid glands make parathyroid hormone (PTH), which helps the body use calcium and keeps the amount of calcium in the blood at normal levels. Tumors in the parathyroid are usually benign (not cancer). These are called adenomas.
With either a benign tumor or cancer, the gland may make too much PTH. This causes hypercalcemia (too much calcium in the blood), which is a serious and life-threatening condition. There may be no signs or symptoms of a parathyroid tumor until there is too much calcium in the blood. Signs and symptoms include weakness and feeling tired. Larger parathyroid tumors may cause a lump in the neck near the thyroid.
Salivary glands make saliva, which contains enzymes to keep food moist and help digest it and antibodies to protect against mouth and throat infections. Most salivary gland cancer begins in the parotid glands, the small salivary glands in the roof of your mouth. More than half the tumors which begin in salivary glands are not cancerous, which means they will not spread to other organs in the body.
Salivary gland cancers are rare, accounting for less than 1 percent of the cancers in the United States. More than half the tumors found in them are benign.
These tumors may sit just below the skull, in the area behind the eyes and nasal cavity. Sometimes they form in the area where the spinal cord, blood vessels, and nerves enter the brain. Not all tumors in this area are malignant, but having a tumor in this space can still cause some major health problems.
Cancers found at the base of the skull are extremely rare. These cancers include many which may start elsewhere in the head and grow toward the base of the skull where nerves and major blood vessels enter the brain. Or they may skim along the skull base and toward the optic nerves (behind the eyes) or temporal bone (on the side of the skull). This may also include brain cancers that grow downward.
The thyroid is a gland at the base of the throat that helps control heart rate, body temperature, metabolism, and the amount of calcium in the blood. It is shaped like a butterfly and sits near the trachea. A thin piece of tissue, called the isthmus, connects its right and left lobes. The thyroid is small, only about one inch across at its widest point.
Different types of cancer can develop in different types of thyroid cells. The two main types of thyroid cells are follicular cells and C cells. Follicular cells use iodine from the blood to make a hormone that helps regulate metabolism. The pituitary gland makes thyroid-stimulating hormone or TSH, which tells the thyroid how much hormone to release. C cells make calcitonin, a hormone that regulates how the body uses calcium.
There are also other cells in your thyroid, and cancer can start in any of them. Most thyroid cancers are treatable. It is considered one of the least deadly cancers, with a 97 percent survival rate after five years.