The “head and neck” part of the body is made up of soft tissues, bones, and a variety of glands and organs. Head and neck cancer can be found in any of these areas. Skin cancers that develop on the scalp, face, or neck may also be considered head and neck cancers.

Most head and neck cancers begin in the cells that line the mucosal surfaces in the head and neck area, such as the mouth, nose and throat. Mucosal surfaces are moist tissues lining hollow organs and cavities of the body that are open to the environment. Head and neck cancers are often referred to as "squamous cell carcinomas" because they appear scale-like under a microscope. Some head and neck cancers also develop first in different types of cells. For example, cancers that develop in the cells contained in glands are called "adenocarcinomas."

Head and neck cancer is identified by the area in which it develops first, and can develop in any of the following:

• The oral cavity that includes the lips, most of the tongue, the gums, the lining of the cheeks and lips, the floor of the mouth under the tongue, the hard palate, and the area behind the wisdom teeth
• The major salivary glands that produce saliva, the fluid that keeps mucosal surfaces in the mouth and throat moist, are located in the floor of the mouth, and near the jawbone
• The paranasal sinuses, small hollow spaces in the bones of the head surrounding the nose (the nasal cavity is the hollow space inside the nose)
• The pharynx, a hollow tube about 5 inches long that starts behind the nose and leads to the esophagus and the trachea
• The larynx, also called the voice box, a short passageway in the neck just below the pharynx (the larynx contains the vocal cords and the epiglottis, which moves to cover the larynx to prevent food from entering the air passages)
• Sometimes, cancer cells are also found in the lymph nodes of the upper neck even when there is no evidence of cancer in other parts of the head and neck (this cancer is called "metastatic squamous neck cancer with unknown primary")

Cancers of the brain, eye, thyroid gland, scalp, skin, muscles, and bones of the head and neck are not usually categorized as cancers of the head and neck.

Symptoms of head and neck cancer include:

• A lingering sore throat
• Difficulty swallowing
• Hoarseness
• Difficulty breathing
• A lump in the neck that appears with or without pain
• A sore on the head or neck that will not heal

To make a diagnosis of head and neck cancer, the doctor evaluates the patient’s medical history, performs a physical examination, and typically orders a series of diagnostic tests. The different tests depend on the symptoms the patient experiences and reports to the doctor.

A list of the different tests used to diagnose head and neck cancer is included below:

• Endoscopy. Uses a narrow, lighted tube called an endoscope to examine areas inside the body. The type of endoscope the doctor uses depends on the area being examined. For example, a laryngoscope is inserted through the mouth to view the larynx; an esophagoscope is inserted through the mouth to examine the esophagus; and a nasopharyngoscope is inserted through the nose to see the nasal cavity and nasopharynx.
• Laboratory tests. Examine bodily fluids such as the saliva.
• X-rays. Create images of areas inside the head and neck.
• CT (or CAT) scan. A series of detailed pictures of areas inside the head and neck created by a computer linked to an x-ray machine.
• Magnetic resonance imaging (MRI). Uses a powerful magnet connected to a computer to create detailed pictures of areas inside the head and neck.
• PET scan. Uses a type of sugar that is absorbed by cancer cells, which then appear as dark areas (compared to normal cells) on a scan.
• Biopsy. The surgical removal of tissue. A pathologist will examine the tissue removed under a microscope to determine if it contains cancer cells and make a final diagnosis. Ultimately, a biopsy is the only sure way to tell whether a person has cancer.

• Surgery—the surgeon may remove the suspicious place where the cancer is located, as well as some of the surrounding tissue. Lymph nodes in the neck may also be removed (lymph node dissection) if there is an indication that the cancer has spread to those.
• Chemotherapy—uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
• Radiation therapy—uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
  

Head and Neck Cancer Resources

http://www.cancer.gov/cancertopics/types/head-and-neck/
http://www.nlm.nih.gov/medlineplus/headandneckcancer.html
http://www.centerwatch.com/patient/studies/cat161.html

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