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Tobacco is the most preventable cause of these deaths. In the
United States, up to 200,000 people die each year from smoking-related
illnesses. The good news is that this figure has decreased due
to the increasing number of Americans who have quit smoking.
The bad news is that some of these smokers switched to smokeless
or spit tobacco, assuming it is a safe alternative. This is untrue-they
are merely changing the site of the cancer risk from their lungs
to their mouth. While lung cancer cases are down, cancers in
the head & neck appear to be increasing. Cancer of the head
and neck is curable if caught early. Fortunately, most head and
neck cancers produce early symptoms. You should know the possible
warning signs so you can alert your doctor to your symptoms as
soon as possible. Remember-successful treatment of head and neck
cancer can depend on early detection. Knowing and recognizing
the signs of head and neck cancer can save your life.
Cancers that begin in the head or neck usually spread to lymph
nodes in the neck before they spread elsewhere. A lump in the
neck that lasts more than two weeks should be seen by a physician
as soon as possible. Of course, not all lumps are cancer. But
a lump (or lumps) in the neck can be the first sign of cancer
of the mouth, throat, voice box (larynx), thyroid gland, or of
certain lymphomas or blood cancers. Such lumps are generally
painless and continue to enlarge steadily.
Most cancers in the larynx cause some change in voice. Any hoarseness
or other voice change lasting more than two weeks should alert
you to see your physician. An otolaryngologist is a head and
neck specialist who can examine your vocal cords easily and painlessly.
While most voice changes are not caused by cancer, you shouldn't
take chances. If you are hoarse more than two weeks, make sure
you don't have cancer of the larynx. See your doctor.
Most cancers of the mouth or tongue cause a sore or swelling
that doesn't go away. These sores and swellings may be painless
unless they become infected. Bleeding may occur, but often not
until late in the disease. If an ulcer or swelling is accompanied
by lumps in the neck, be very concerned. Your dentist or doctor
can determine if a biopsy (tissue sample test) is needed and
can refer you to a head and neck surgeon to perform this procedure.
This is often caused by something other than cancer. However,
tumors in the nose, mouth, throat or lungs can cause bleeding.
If blood appears in your saliva or phlegm for more than a few
days, you should see your physician.
Cancer of the throat or esophagus (swallowing tube) may make
swallowing solid foods difficult. Sometimes liquids can also
be troublesome. The food may "stick" at a certain point
and then either go through to the stomach or come back up. If
you have trouble almost every time you try to swallow something,
you should be examined by a physician. Usually a barium swallow
x-ray or an esophagoscopy (direct examination of the swallowing
tube with a telescope) will be performed to find the cause.
The most common head and neck cancer is basal cell cancer of
the skin. Fortunately, this is rarely a major problem if treated
early. Basal cell cancers appear most often on sun-exposed areas
like the forehead, face, and ears, although they can occur almost
anywhere on the skin. Basal cell cancer often begins as a small,
pale patch that enlarges slowly, producing a central "dimple" and
eventually an ulcer. Parts of the ulcer may heal, but the major
portion remains ulcerated. Some basal cell cancers show color
changes. Other kinds of cancer, including squamous cell cancer
and malignant melanoma, also occur on the skin of the head and
neck. Most squamous cell cancers occur on the lower lip and ear.
They may look like basal cell cancers and, if caught early and
properly treated, usually are not much more dangerous. If there
is a sore on the lip, lower face, or ear that does not heal,
consult a physician. Malignant melanoma classically produces
dense blue-black or black discolorations of the skin. However,
any mole that changes size, color, or begins to bleed may be
trouble. A black or blue-black spot on the face or neck, particularly
if it changes size or shape, should be seen as soon as possible
by a dermatologist or other physician.
Constant pain in or around the ear when you swallow can be a
sign of infection or tumor growth in the throat. This is particularly
serious if it is associated with difficulty in swallowing, hoarseness
or a lump in the neck. These symptoms are best evaluated by an
otolaryngologist.
As many as 90 percent of head and neck cancers arise after prolonged
exposure to specific factors. Use of tobacco (cigarettes, cigars,
chewing tobacco or snuff) and alcoholic beverages are closely
linked with cancers of the mouth, throat, voice box and tongue.
(In adults who neither smoke nor drink, cancer of the mouth and
throat are nearly nonexistent.) Prolonged exposure to sunlight
is linked with cancer of the lip and is also an established major
cause of skin cancer.
All of the symptoms and signs described here can occur with
no cancer present. In fact, many times complaints of this type
will be due to some other condition. But you can't tell without
an examination. So, if they do occur, see your doctor-and be
sure.
When found early, most cancers in the head and neck
can be cured with relatively little difficulty. Cure rates for
these cancers could be greatly improved if people would seek
medical advice as soon as possible. So play it safe. If you think
you have one of the warning signs of head and neck cancer, see
your doctor right away.
See your doctor early! And practice health habits which
will make these diseases unlikely to occur.
© 2004 AAO-HNS/AAO-HNSF
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