Head and neck tumors

What are head and neck tumors?

Head and neck tumors are a collective term for various malignant growths in the head and neck region. These include tumors of the oral cavity, the pharynx and larynx, the external face and neck region as well as the thyroid. However, thyroid tumors are mostly considered a separate entity.

Head and neck tumors are overall a rare type of cancer. Nevertheless, approximately 15,000 people get diagnosed each year in Germany. The most commonly affected region is the larynx. 

Furthermore, there are large variations in incidence depending on the geographic region.

Men are more frequently affected than women by almost all head and neck tumors. The highest incidence for head and neck tumors is between 60 and 70 years of age. For example, the average age for diagnosing laryngeal cancer is 68 years while the average age for cancers of the oral cavity and pharynx is around 65.

Causes: How do head and neck tumors develop?

There is an increasing link between the exposure to certain carcinogenic substances and the development of head and neck tumors. This association particularly applies to tumors of the oral cavity, pharynx and larynx. A substance that has the potential to cause the development of cancer is called a carcinogen. 

Among the carcinogens associated with these types of tumors is tobacco, which is why smoking is considered a major risk factor. The same applies to the use of chewing or snuff tobacco. Smoking cannabis is likewise suspected of being carcinogenic.

Alcohol can also promote the development of cancer. This particularly applies to the regular consumption of high-percentage alcohol. A combination of two risk factors, such as smoking and heavy drinking, drastically increases the risk for head and neck cancer. According to a study conducted in 2006, 75% of all head and neck cancers were said to have been associated with increased alcohol or tobacco consumption.

Further risk factors include certain viruses, chronic injuries to the oral mucosa, occupational exposure to asbestos or lacquers, and ionizing radiation. 

Symptoms of head and neck tumors

The symptoms of head and neck tumors depend on the type of tumor.

Tumors of the oral cavity and upper pharynx often produce a palpable swelling as the first noticeable symptom. Patients usually notice this swelling incidentally when using their tongue. Other symptoms include pain, bleeding or changes in speech caused by the space-occupying lesion.

Similarly, tumors located in the lower pharynx are also noticed due to their increasing size which often causes difficulty swallowing.

One distinct feature of laryngeal cancer is that it causes early-onset hoarseness. In later stages, it can cause shortness of breath and wheezing.

Tumors of the upper pharynx and nose are often noticed through middle ear effusion, pain or obstructed nasal breathing. Effusion of the middle ear describes an accumulation of fluid behind the eardrum. While this occurs frequently in children, when observed in adults, it must be investigated promptly.

Head and neck cancers can form metastases and spread to distant organs. In most cases, the cancer metastasizes via the lymphatic drainage into the regional lymph nodes. Haematogenous metastasis in distant organs such as the lungs is rare. In some cases, the tumor itself does not cause any symptoms but leads to swelling of the lymph nodes through the metastatic spread of cancer cells.

Diagnosis: How does a specialist diagnose these tumors?

The diagnosis of head and neck tumors begins with a detailed medical history and is followed by a physical examination. This includes palpation of the tumor and the regional lymph nodes. This may already provide the first clues about the type of tumor.

Afterwards further specific ENT examinations are carried out. These include a so-called indirect laryngoscopy, which involves the inspection of the oral cavity, the pharynx and larynx, as well as an endoscopy of the nasal cavity and the ears. Furthermore, the tongue and its surface are also closely examined. 

Imaging methods are used to further examine the existing tumor. This includes alongside computed tomography (CT)and magnetic resonance imaging (MRI), among others. Lymph nodes can be visualized during an ultrasound examination.

In order to identify and localize any possible metastases in distant organs, a PET-CT scan is conducted. This involves the intravenous injection of a sugar. This sugar molecule is attached to a radioactive substance. As the sugar is metabolized in the body, the radioactive substance becomes visible. Due to the high metabolic rates in cancer cells, they can be made visible during this examination.

Therapy: How are head and neck tumors treated?

The treatment of head and neck tumors generally depends on the extent of the disease as well as the patient's individual health factors. Preexisting medical conditions and the general health status are particularly relevant. Many patients have relevant medical conditions associated with smoking and excessive alcohol consumption.

The primary goal of the treatment is a complete removal of the tumor and any affected lymph nodes. This is a highly complex procedure due to the relatively confined anatomical space. Nevertheless, surgical allowing for better preservation of healthy surrounding tissue. In the past, such procedures often required partial removal of the jaw.

In cases where lymph nodes are affected or the tumor is difficult to resect, a combination therapy of radiation therapy and surgery may be useful. In some cases, chemotherapy may be indicated.

Particularly in recent years, additional treatment options have been developed with the aim to treat the tumor as locally as possible and minimize any side effects. This development includes specific antibodies directed against receptors on cancer cells, inhibiting their growth.

To develop an individualized treatment plan specialists from various medical disciplines, including oncologists, radiologists, and pathologists, have to work together as part of a multidisciplinary team.

Prognosis and life expectancy for head and neck tumors

The prognosis of head and neck tumors depends primarily on the size of the tumor as well as the presence of metastases to the lymph nodes or distant organs. So-called 5-year survival rates are used to compare the life expectancy of different tumors. These indicate the percentage of patients who survive for five years after the cancer diagnosis.

The 5-year survival rate for tumors that have not metastasized is approximately 72%. With lymph node involvement, the rate decreases to 50%. In the presence of metastases in more than two lymph nodes, the 5-year survival decreases to approximately 38%.

What physicians and clinics are specialists in head and neck tumors?

The diagnosis and treatment of head and neck tumors requires a high level of expertise. This necessitates physicians from various medical disciplines to work closely together to develop a personalized treatment plan for each individual patient.

We have carefully reviewed all of the specialists listed below with regard to their experience in treating head and neck tumors and consider them to be highly competent in this field. Benefit from their experience and expertise and arrange an initial consultation quickly and easily.