What is cancer of the head and neck?

Cancer of the head and neck (head and neck cancer) is an abnormal growth of the cells that form tumors in your nose, mouth, throat, salivary glands (glands that make saliva, or spit), neck, or throat. If the cancer spreads to other parts of the body, it is still head and neck cancer, and is called metastatic head and neck cancer.

There are different types and stages of head and neck cancer based on what kind of cancer cells are found, where the tumor started and where it has spread. Knowing the type and stage of head and neck cancer you have helps your healthcare provider decide on the best treatment plan for you. It is important to diagnose and treat head and neck cancer as soon as possible. The main goals of treatment are to kill the tumor cells, prevent a localized cancer from spreading, and prevent metastatic cancer from spreading more than it already has.

The most common types of head and neck cancers include:

• Voice box cancer (laryngeal cancer)
• Throat cancer (hypopharyngeal cancer, nasopharyngeal cancer, or oropharyngeal cancer)
• Nose cancer (nasal cavity cancer and paranasal sinus cancer)
• Salivary gland cancer

The main risk factor for head and neck cancer is tobacco use, either by smoking or using smokeless tobacco. You may also be at an increased risk if you are exposed to chemicals in the workplace or environment, have frequent swelling of the nose and throat from sinus problems, have the Human Papillomavirus (HPV), or have inherited certain genes from your parents.

What can I expect in the hospital?

Several things may be done while you are in the hospital to monitor, test, and treat your condition. They include:

Monitoring

• You will be checked often by the hospital staff.
• Your blood oxygen level may be monitored by a sensor that is attached to your finger or earlobe.
• Your fluid intake may be monitored closely by keeping track of everything you eat and drink and any IV fluids you receive.
• Your fluid output may be monitored closely by keeping track of the amount of urine and bowel movements you produce.

Testing

Testing may include:

• Arterial blood gas (ABG): A blood test to measure the levels of oxygen and carbon dioxide in your blood
• Blood tests to check for infections or blood loss
• Tests to look for abnormalities in your nose, mouth, or throat, which may include:
  • Barium swallow, modified: An X-ray taken show of your mouth and throat after you swallow barium. Barium is a liquid that helps your mouth and throat show up on the X-ray
  • Computed tomography (CT) scan: A series of X-rays taken from different angles and arranged by a computer to show thin cross sections of the nose, mouth and throat
  • Endoscopy: A test in which uses a thin, flexible, lighted tube through your nose or mouth and down into your throat to look for abnormal cells. Sometimes one or more pieces of tissue are removed to help make a diagnosis. This is called a biopsy. Depending on where the scope is placed, the procedure may be called laryngoscopy, pharyngoscopy, nasopharyngoscopy, or panendoscopy.
  • Magnetic resonance imaging (MRI): A powerful magnetic field and radio waves are used to take pictures from different angles to show thin cross sections of the mouth, nose, and throat
  • X-rays: Pictures of the inside of the mouth, nose, and throat to check for abnormal areas
• Tests to check if the cancer has spread to other parts of your body, including:
  • Blood tests to check for certain hormones, proteins, or chemicals that may be high if you have cancer
  • Bone X-rays: Pictures of your bones to check for cancer
  • Bone scan: A series of detailed pictures that are taken after your healthcare provider injects a small amount of radioactive material into your blood. The scan shows any areas of bone where the radioactive material is being absorbed.
  • Chest X-ray: Pictures of the inside of your chest to check for cancer
  • Computed tomography (CT) scan
  • Magnetic resonance imaging (MRI)
  • Positron emission tomography (PET) scan: A series of detailed pictures that are taken after your healthcare provider injects a small amount of radioactive material into your blood. The scan shows areas where the radioactive material is being absorbed.

Treatment

The treatment for cancer of the head and neck depends on your symptoms, how well you respond to treatment, your overall health, and any complications you may have. Your chance of cure depends on how far the cancer has advanced. You may need to make lifestyle changes to stay as healthy as possible.

• You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.
• You may receive oxygen through a small tube placed under your nose or through a mask placed over your face. In very severe cases, you may need a tube put into your lungs to help you breathe.
• You may have a tube put through your nose down into your stomach, called a nasogastric or NG tube. The tube may be used to give fluids or medicine, or with suction to help relieve pressure from air or fluids in your stomach and intestine.
• You may need surgery to treat cancer of the head and neck. Surgery may include removing the cancer cells and the tissue nearby the cancer cells. Sometimes this may involve removing muscle and bone and surgery to rebuild the area where muscle and bone has been removed.
• Treatments may include:
  • Chemotherapy (anticancer drugs), which uses medicine to kill cancer cells.
  • Radiation therapy, which uses high-energy X-rays to kill cancer cells.
• Your provider may also prescribe medicine to:
  • Treat pain
  • Treat or prevent an infection
  • Treat or prevent anemia, which means you have too few red blood cells to carry enough oxygen to your body. Anemia may be caused by your cancer, your treatment, or other problems.
  • Treat or prevent side effects, such as nausea or constipation, from other treatments
  • Reduce swelling in the airways
  • Help your immune system fight cancer
• You may need therapy to help you adjust to swallowing or speaking after surgery.

What can I do to help?

• You will need to tell your healthcare team if you have new or worsening:
  • Swelling of your lips, tongue, or throat that make it hard to breathe or swallow
  • Coughing up mucus that is thick or blood-stained
  • Nausea or vomiting
  • Dehydration, which means losing too much fluid from your body. This can often happen if you have frequent vomiting or diarrhea.
  • Dizziness or lightheadedness
  • Depression
  • Redness, swelling, pain, warmth, or drainage from your surgical wound
  • Fever, chills, or muscle aches.
• Ask questions about any medicine, treatment, or information that you do not understand.

How long will I be in the hospital?

How long you stay in the hospital depends on many factors. The average amount of time to stay in the hospital with cancer of the head and neck is 5 to 8 days.