Thyroid cancer
Usually close to or at the midline, thyroid gland lumps are distinctive in that they move up with swallowing. Some
thyroid cancers, such as papillary and medullary thyroid cancer, are genetically determined. Today's advanced
screening methods mean that thyroid cancers are detected earlier, with a generally good prognosis. The cornerstone
of treatment is surgery with radioiodine therapy.
Nose cancer
There is a genetic predilection for nose cancer in the Cantonese, although other Chinese communities are not
exempt. Unfortunately, it presents late because it shows no symptoms until it is large enough to obstruct
breathing, invade the ear or appear as a neck lymph node due to spread.
The Epstein and Barr (EB) virus has been found to be present in patients with nose cancer, so the EB viral marker
is used for early detection and as part of post-treatment follow-up. The mainstay of treatment for nose cancer is
radiation therapy, with chemotherapy recommended at the later stages and surgery employed in some severe cases.
Overall, the prognosis is directly "related to the stage at diagnosis, with early diagnosis affecting the outcome
significantly.
Squamous cell carcinoma
The mouth, tongue, throat, voice box and the entry to the food pipe (the pyriform sinus) have a squamous cell
lining. This lining can change because of smoking, alcohol consumption, betel nut chewing and frequent trauma from
tooth edges.
The change can result in squamous cell carcinoma, which tends to present with ulcers that don't heal, bleeding or
pain. Swallowing issues and a change in voice indicate late presentation and evaluation must be sought. Such
cancers are treated with a combination of surgery, radiation and chemotherapy, depending on the site and stage of
the disease.
Salivary gland cancers
The three salivary gland sites are the parotid, located at the angle of the jaw; the submandibular, under the side
of the jaw; and the minor salivary glands, located in the mouth. These slower-growing cancers present no early
signs but are long-standing swellings. There are hardly any symptoms until they affect the nerves, resulting in
pain or weakness of facial muscles. Treatment involves surgery followed by radiation therapy, and the prognosis is
satisfactory.
The head and neck region affects all our major functions of expression, breathing, senses, and our eating, speaking
and other functions. Since there is no better answer than early screening and detection, neck masses, mouth ulcers,
bleeding, swallowing discomfort and voice change should not be ignored.
