Overview of Squamous Cell Head and Neck Cancers

*Please note: This slide show is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always consult your doctor about any questions you may have regarding a medical condition.

What are squamous cell head and neck cancers?

Squamous cell head and neck cancers develop in the lining of the mouth, throat, voice box, salivary glands, and sinuses.

Who tends to get squamous cell head and neck cancers?

These cancers are more common in men and people over 50, although that is changing as cancer from a virus called HPV affects younger people.

Squamous cell head and neck cancers are relatively rare. Specialists in head and neck cancer can provide excellent care.

Where do squamous cell head and neck cancers begin and spread?

The most common squamous cell head and neck cancers start in the lining of the mouth, throat, and voice box. Less often, they develop in the salivary glands, muscles, nerves, and other tissues.

Where do squamous cell head and neck cancers begin and spread?

These cancers typically spread to lymph nodes in the neck and sometimes are found there first. This is called an "unknown primary". Your doctor can do an examination, biopsies, and imaging tests to find the source, but in some cases, it is not found.

Areas affected by squamous cell head and neck cancer: Mouth and throat

Mouth cancer can occur almost anywhere, including the gums, tongue, roof of the mouth, and behind the teeth.

Areas affected by squamous cell head and neck cancer: Mouth and throat

Throat cancer can affect any part of the throat, including the upper (nasopharynx), middle (oropharynx), and lower (hypopharynx) throat and voice box (larynx).

The oropharynx includes the tonsils, base of the tongue, and soft palate, which is behind the roof of your mouth.

Areas affected by squamous cell head and neck cancers: Voice box, sinuses, nasal cavity and salivary glands

Cancer in the larynx includes the vocal cords and epiglottis, which keeps food and liquids out of the windpipe.

Cancer can also develop in the sinuses (hollow cavities around the nose), major salivary glands—parotid, submandibular, and sublingual—and minor saliva glands throughout the mouth and throat.

Risk factors for squamous cell head and neck cancers

The main risk factors for squamous cell head and neck cancers are:

• Tobacco use, including smokeless tobacco and chewing paan (betel quid)
• Alcohol use, especially combined with tobacco use
• Infection with a virus called HPV

More risk factors for squamous cell head and neck cancers

Other risk factors include:

• Exposure to radiation, wood dust, asbestos, and certain synthetic fibers or toxins for cancers of the sinus
• Epstein-Barr virus
• Living in Southeast Asia

More rarely, certain genetic diseases can raise the risk of squamous cell head and neck cancers.

General symptoms of head and neck cancers

Ask your doctor about these symptoms that do not go away:

• Ear pain
• Sore throat
• Mouth sores
• Bad breath
• A neck lump for more than 3 or 4 weeks

General symptoms of head and neck cancers

Ask your doctor about these symptoms that do not go away:

• Difficulty swallowing
• Voice changes or difficulty speaking
• A stuffy nose
• Sinus infections
• Headaches, especially with nosebleeds
• Facial pain or numbness

Diagnosing squamous cell head and neck cancers

Head and neck cancers are diagnosed with a physical examination, imaging tests, and examination of a tissue sample (biopsy).

Early detection is important. There is no specific screening test, but regular dental care is important. Dentists usually check for mouth cancers during their examination.

Stages of squamous cell head and neck cancer

Staging helps doctors determine the best treatment and gives information about your outlook.

Staging combines the tumor size (T), lymph node involvement (N), and whether cancer has spread (M, metastasis). Stages from 0 to IV are based on this TNM system.

Treatment for squamous cell head and neck cancers

Treatment for head and neck cancer may include surgery, radiation therapy, chemotherapy, targeted therapy, and immunotherapy. These may be combined, especially for intermediate or advanced disease.

Factors in planning treatment for squamous cell head and neck cancer

To plan your treatment, your cancer treatment team will consider:

• Your age and general health
• The tumor type, stage and location
• The cause of your cancer, including whether it is caused by HPV
• How treatment will affect your quality of life

Your team should include a dentist, nutrition expert, speech and swallowing therapist, and other care providers.

Surgery and radiation for squamous cell head and neck cancer

Surgery or radiation therapy are often the first treatment for these cancers.

Surgery may affect speaking, eating and swallowing, or change your appearance. You may have speech and eating therapy or reconstructive surgery after the cancer is removed.

Other treatments for squamous cell head and neck cancer

Additional, or adjuvant, treatments include chemotherapy, immunotherapy, and targeted therapy. They are called neoadjuvant if given before surgery.

Your doctor will talk with you about options for the best outcome. Also, ask about clinical trials, as they provide access to treatments not yet available to the public.

Care after squamous cell head and neck cancer treatment

After you complete your treatment, it's important to watch for recurrence, prevent more cancers, and manage symptoms of cancer treatment. This includes:

• Regular checkups with your team
• Imaging and blood tests
• Any needed rehabilitation, including speech and swallowing therapy
• Helping people quit smoking and tobacco use

Working closely with your healthcare team can help you plan for the best outlook after treatment.

References

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