Principles in the Management of Head and Neck Cancer

Abstract

Head and neck cancers (H&N) are a significant problem in our country constituting approximately one-third cancer cases in contrast to 4–5% in the developed world [1]. Men are more commonly affected than women and the incidence increases with age. Ninety-eight percent of the patients are over 40 years old. Squamous cell cancer constitutes the most common pathology and includes cancers of the oral cavity, oropharynx, larynx and hypopharynx, nasopharynx, nasal cavity, and paranasal sinuses. Non-squamous types include thyroid cancer, salivary gland cancer, and sarcomas. The two most common etiological factors of head and neck cancer are tobacco and alcohol. Because of the exposure to these carcinogens to the entire epithelium of the aerodigestive tract, patients with H&N cancers have more chance for developing second primaries. Other factors implicated include viruses, occupational agents, pollutants, diet, and genetic influences. Infection with carcinogenic types of human papillomavirus (HPV, especially type 16) is a risk factor, particularly for oropharynx cancers [2].