[Health Tip] Today is 'World Head and Neck Cancer Day'... Prevention Essential to Protect 'Quality of Life'

Every year on July 27th is 'World Head and Neck Cancer Day.' Head and neck cancer, which mainly occurs in the head and neck areas, is closely related not only to eating, breathing, and speaking but also to aesthetic functions, making active functional preservation and reconstruction important.

Symptoms and Treatments by Site of Occurrence in Head and Neck Cancer
[Photo by Seoul National University Hospital]

Head and neck cancer includes oral cancer (mouth), nasal cavity and paranasal sinus cancer (nose), pharyngeal cancer, laryngeal cancer, thyroid cancer, salivary gland cancer, etc., excluding cancers occurring in the brain and eyes within the head and neck region. According to recent national cancer registry statistics, head and neck cancers excluding thyroid cancer account for 2.2% of all cancer cases, and including thyroid cancer, they make up about 15%.

The most important risk factor for head and neck cancer is smoking. Smokers have a 1.7 to 2 times higher risk of developing laryngeal cancer compared to non-smokers. Smoking strongly influences the occurrence of other head and neck cancers as well, and when combined with alcohol consumption, it induces mutations in mucosal cells, further increasing the risk of head and neck cancer. Additionally, human papillomavirus (HPV) is associated with oropharyngeal cancer, and Epstein-Barr virus (EBV) is linked to nasopharyngeal cancer.

If head and neck cancer is detected and treated at stages 1 to 2, the survival rate can be increased up to 80-90%, making early diagnosis crucial. Diagnosis is primarily conducted through physical examination and imaging tests. Cervical computed tomography (CT) and ultrasound examinations allow precise evaluation of cervical lymph node metastasis. If the cancer has already progressed, positron emission tomography (PET)-CT is additionally performed before treatment to determine whether there is distant metastasis to the liver, lungs, bones, etc. A biopsy may be performed immediately in the outpatient clinic if a lesion is found.

Symptoms of head and neck cancer vary depending on the site and progression of the cancer. The most common thyroid cancer may cause some pain, hoarseness, or difficulty swallowing, but often shows no specific symptoms. Nasal cavity and paranasal sinus cancers commonly cause nasal congestion and persistent nosebleeds from one side. Oral cancer presents with non-healing ulcers inside the mouth similar to stomatitis, discoloration, pain, and lumps under the ear or upper neck. Laryngeal cancer causes hoarseness, and as the tumor progresses, it may lead to breathing difficulties.

Risk Factors and Diagnostic Methods of Head and Neck Cancer
[Photo by Seoul National University Hospital]

Treatment methods also vary by location. Since head and neck cancers occur in areas related to eating, speaking, and breathing functions, which greatly affect quality of life, treatment plans are decided through multidisciplinary discussions involving various medical departments, considering the primary site, stage, expected functional loss from surgery, and expected response to non-surgical treatments (such as chemoradiotherapy).

Generally, early-stage cancers are treated with surgery or radiation therapy alone, while advanced stages undergo surgery combined with chemoradiotherapy. Thyroid cancer is known to be an indolent cancer, but if it invades the airway, esophagus, or nerves and muscles controlling the vocal cords, it is classified as aggressive cancer. In such cases, surgery removes the tumor along with the invaded trachea or esophagus, followed by reconstructive surgery. Nasal cavity and paranasal sinus cancers are primarily treated surgically, but recently, endoscopic surgery is preferred to preserve nasal function. If removal of the palate or facial bones is necessary, reconstructive surgery is performed simultaneously by transplanting autologous tissue from the arms, legs, or shoulders to restore original function and appearance. Early-stage laryngeal cancer is treated with surgery or radiation therapy alone. For advanced cancer, chemoradiotherapy may be chosen to preserve the larynx, and surgery is performed if recurrence occurs. Surgical treatment may preserve the larynx, but in most cases, the entire larynx is removed, and an artificial larynx is implanted to enable voice production.

Professor Jeong Eun-jae of the Department of Otorhinolaryngology at Seoul National University Hospital advised, "As with all cancers, prevention is best for head and neck cancer, and the cure rate is very high if diagnosed early. To prevent it, abstaining from alcohol and smoking is necessary. If suspicious symptoms of head and neck cancer such as persistent neck lumps or pain, voice changes, oral ulcers or bleeding, unilateral nasal congestion or bleeding continue, we recommend visiting a hospital for examination."