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Head and neck cancer

The complexity of the anatomical structures of the head and neck and the importance of their functions, so relevant for the relationship with the environment, make the treatment of cancer of the upper aerodigestive tract delicate. It includes tumors of the lip, oral cavity, nasopharynx, oropharynx, hypopharynx, cervical esophagus, nose, paranasal sinuses, larynx, trachea, ear, salivary glands, thyroid and parathyroid glands and the skin of the head and neck.

In recent years, technological innovations in the field of surgery and radiotherapy and advances in systemic therapies have achieved greater precision of treatment with higher survival rates, fewer side effects and better quality of life.EtiologyHead and neck cancer has some risk factors and predisposing factors known for some time and others discovered more recently

  1. Tobacco. More than 80% of patients are smokers. It is currently the most important risk factor and depends on the amount of tobacco smoked and the number of years of smoking. In addition to the existing carcinogenic agents, tobacco produces a local irritant effect that causes chronic inflammation precursor to malignization of the cells of the aerodigestive mucosa. Thermal damage from smoke and chronic burning is relevant in the mucosa of the oral cavity, oropharynx and larynx. Its chewing consumption also acts as an important risk factor.
  2. Alcohol. It is an important risk factor in the hypopharynx, cervical esophagus and oral cavity. The consumption of alcohol and tobacco has a synergistic effect multiplying between 10 and 20 times the possibility of developing head and neck cancer. Alcohol consumption is also related to altered hygienic-dietary habits that lead to nutritional deficits and hypovitaminosis. Only after 20 years without consuming alcohol does the risk of developing head and neck cancer appear to be similar to the risk among those who have consumed alcohol.
  3. Viral factors. The human papillomavirus (HPV), mainly serotypes 16 and 18, is related to the genesis of oropharyngeal carcinoma. Likewise, Epstein-Barr virus is a risk factor in rhinopharyngeal cancer and in cases of cervical metastasis of unknown primary.
  4. Immunosuppression. Certain diseases that lead to decreased immune status may predispose to the development of head and neck cancer.
  5. Ionizing radiation. Patients who have received prior radiation therapy have been shown to be more predisposed to eventually develop cancer of the thyroid gland or major salivary glands.
  6. Other related factors. Wood dust has a demonstrated association with ethmoid adenocarcinoma. Polycyclic hydrocarbons from the heavy steel industry, asbestos and mustard gas are proven risk factors.