Types Of Head And Neck Cancers

The larynx is commonly called the voice box. This tube-shaped organ in the neck is important for breathing, talking, and swallowing. It is located at the top of the windpipe, or trachea. The hypopharynx is also called the gullet. It is the lower part of the throat that surrounds the larynx.

The nasal cavity is the large, air-filled space behind the nose. Paranasal sinuses are small air-filled spaces at the front of the skull, and surrounding the nasal cavity. They are found on the cheeks (the maxillary sinuses), above the eyes (the frontal sinuses), between the eyes (the ethmoidal air cells or sinuses) and behind the ethmoidal aircells (sphenoid sinuses).

Nasal and paranasal cancers are relatively rare. The most common location of paranasal sinus cancer is the maxillary sinus.

The main causes of nose and paranasal sinus cancers are: 

• Smoking (cigarettes, cigars or pipes) or using ‘smokeless’ tobacco (snuff and chewing tobacco) If a person smokes or has smoked in the past, they have a higher risk of getting nasal and paranasal sinus cancer than someone who has never smoked.
• Drinking alcohol — If a person drinks a lot of alcohol over many years, they have a higher risk of getting nasal and paranasal sinus cancer, especially combined with smoking.
• Breathing in certain chemicals or dust that may cause cancer including wood dust (hard and soft wood), leather dust (e.g. shoe making), chromium, nickel, heavy metal exposure, formaldehyde, cloth fibres (e.g. textile manufacturing) and mineral oils (used in metal work and printing.

Nasopharyngeal Cancer is a type of throat cancer that forms in the nasopharynx, which is highest part of the throat —  in or behind the nose.

The pharynx is the medical term for the throat. It has three parts:

• nasopharynx (upper throat)
• oropharynx (mid throat, including the tonsils)
• hypopharynx (lower throat).

Cancer that starts anywhere in the oropharynx is called Oropharyngeal Cancer. Your doctor may also call it by the part it has grown in, like tonsil or tongue base cancer. Most Oropharyngeal Cancers start in the cells that line the surface of the throat (called squamous cell carcinomas).

The oral cavity includes the mouth and tongue. The oropharynx includes the middle of the throat, from the tonsils to the tip of the voice box.

The main causes of Oropharyngeal Cancer are:

• Human Papillomavirus (HPV) infection (especially HPV types 16 and 18) — We now know HPV causes many oropharyngeal cancers.
• Smoking (cigarettes, cigars or pipes) or using smokeless tobacco (snuff and chewing tobacco) — If a person smokes or has smoked in the past, they have a higher risk of getting oropharyngal cancer than someone who does not smoke.
• Drinking alcohol —  If a person drinks a lot of alcohol over many years, they have a higher risk of getting oropharyngeal cancer, especially combined with smoking.

Around 7,000 people are diagnosed with mouth cancer each year in the UK, which is about 1 in every 50 cancers diagnosed (source NHS) with an increase of over 49% of cases over the past ten years (source Oral Health Foundation). 

The salivary glands make spit (saliva) and releases it into the mouth to keep the mouth and throat moist, and help with swallowing and digesting food.

Parotid Gland

The parotid glands are found just in front of the ears and behind the jaw. They move saliva into the mouth through a tube called the parotid duct. This tube opens on the inside of the cheek, near the upper molar teeth. The nerve that controls the facial muscles (called the facial nerve), runs through the parotid gland. This nerve makes you smile, frown, close your eyes and raise your eyebrows.

The parotid glands also contain lymph nodes (bean shaped glands that are part of the immune system’s defence against infections). Sometimes skin cancers, can spread to the lymph nodes inside the parotid glands. Most parotid gland tumours are not cancers and are called benign tumours.

Submandibular and Sublingual Glands

The submandibular glands lie under the jawbone, one on each side. They release saliva into the mouth through a duct (tube) that opens in the floor of the mouth, under the tip of the tongue. Three important nerves are found next to these glands –the hypoglossal nerve, lingual nerve and marginal branch of the facial nerve. These nerves give movement, feeling and taste to the tongue and move the lower lip. Tumours of the submandibular gland can be benign (not cancer) or malignant (cancer).

The sublingual glands lie under the tongue, one on each side. They release saliva into the submandibular duct and are near the lingual nerves which give feeling and taste to the front of the tongue. The sublingual glands are the smallest of the major salivary glands and rarely develop tumours, but tend to be malignant (cancer) when they do develop.

Minor Salivary Glands

There are hundreds of minor salivary glands throughout the mouth and throat. They can be found inside the mouth, just under the surface including the lips, cheeks and top of the mouth (soft palate). The minor salivary glands can also develop tumours, which can be benign or malignant.

Risk Factors

• Age - most Salivary Gland Cancers occur in people aged over 50 years
• Exposure of the head and neck to radiation therapy
• Autoimmune diseases – these can lead to a type of cancer in the salivary glands called lymphoma
• Skin cancers can spread to lymph nodes in the salivary glands

Cancer of Unknown Primary in the head and neck region occurs when the origin of the cancer is unknown, but is found to have spread to the lymph nodes in the neck.