Patients and their doctors should consider treatment options carefully. They should discuss each type of treatment and how it might change the way the patient looks, talks, eats, or breathes and how each treatment can affect their quality of life.
The patient may look different after surgery, and the face and neck may be swollen. The swelling usually improves with time. However, if lymph nodes are removed, the flow of lymph in the area where they were removed may be slower and lymph could collect in the tissues a condition called lymphedema , causing additional swelling that may last for a long time. Head and neck lymphedema may be visible or internal.
In most cases, it can be reversed, improved, or reduced if treated promptly. Patients with untreated lymphedema may be more at risk of complications such as cellulitis , or an infection of the tissues. Untreated cellulitis, if severe, can be dangerous and could lead to further swallowing or breathing difficulties. After a laryngectomy surgery to remove the voice box or other surgery in the neck, parts of the neck and throat may feel numb because nerves have been cut.
If lymph nodes in the neck were removed, the shoulder and neck may become weak and stiff. Patients who receive radiation to the head and neck may experience side effects during and for a short while after treatment, including redness, irritation, and sores in the mouth; a dry mouth or thickened saliva; difficulty in swallowing; changes in taste; or nausea.
Radiation may also cause loss of taste, which may decrease appetite and affect nutrition, and earaches caused by the hardening of ear wax. Patients may also notice some swelling or drooping of the skin under the chin and changes in the texture of the skin.
The jaw may feel stiff, and patients may not be able to open their mouth as wide as before treatment. Although side effects will improve slowly over time in many patients, others will experience long-term side effects of surgery or radiation therapy, including difficulty swallowing, speech impairment, and skin changes Patients should report any side effects to their doctor or nurse and discuss how to deal with them.
The goal of treatment for head and neck cancers is to control the disease. But doctors are also concerned about preserving the function of the affected areas as much as they can and helping the patient return to normal activities as soon as possible after treatment. Rehabilitation is a very important part of this process. The goals of rehabilitation depend on the extent of the disease and the treatment that a patient has received.
A stoma is an opening into the windpipe through which a patient breathes after a laryngectomy, which is surgery to remove the voice box. Sometimes, especially with cancer of the oral cavity, a patient may need reconstructive and plastic surgery to rebuild bones or tissues. However, reconstructive surgery may not always be possible because of damage to the remaining tissue from the original surgery or from radiation therapy. Patients will receive special training on how to use the device.
Patients who have trouble speaking after treatment may need speech therapy. Often, a speech-language pathologist will visit the patient in the hospital to plan therapy and teach speech exercises or alternative methods of speaking. Speech therapy usually continues after the patient returns home.
Eating may be difficult after treatment for head and neck cancer. Some patients receive nutrients directly into a vein after surgery or need a feeding tube until they can eat on their own. A feeding tube is a flexible plastic tube that is passed into the stomach through the nose or an incision in the abdomen.
A nurse or speech-language pathologist can help patients learn how to swallow again after surgery. Regular follow-up care is very important after treatment for head and neck cancer to make sure that the cancer has not returned and that a second primary new cancer has not developed. Head and neck cancers not related to HPV infection are especially likely to recur after treatment.
Depending on the type of cancer, medical check-ups could include exams of the stoma, if one has been created, and of the mouth, neck, and throat. Regular dental exams may also be necessary. From time to time, the doctor may perform a complete physical exam, blood tests, x-rays, and computed tomography CT , positron emission tomography PET , or magnetic resonance imaging MRI scans. The doctor may monitor thyroid and pituitary gland function, especially if the head or neck was treated with radiation.
Also, the doctor is likely to counsel patients to stop smoking. Research has shown that continued smoking by a patient with head and neck cancer may reduce the effectiveness of treatment and increase the chance of a second primary cancer. People who have been treated for head and neck cancers have an increased chance of developing a new cancer, usually in the head, neck, esophagus, or lungs 34 — The chance of a second primary new cancer varies depending on the site of the original cancer, but it is higher for people who use tobacco and drink alcohol Especially because patients who smoke have a higher risk of a second primary cancer, doctors encourage patients who use tobacco to quit.
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They also store dead cells and bacteria to be flushed from your body. As well as causing lumps on either side of your neck, lymph nodes are located in your armpits, under the jaw, in the groin, and above your collarbone. Either fluid-filled or solid, thyroid nodules are usually harmless, but they can indicate an autoimmune disorder or cancer. In addition to a lump on your neck, a thyroid nodule could cause a cough or difficulty swallowing. Your voice may be hoarse, and you may have pain in your neck and throat.
A viral condition that most often affects people of high school and college age, mononucleosis can cause neck lumps due to swollen lymph nodes as well as symptoms similar to thyroid nodules. In addition, you may have headaches and overall fatigue. Body aches and night sweats are also frequent symptoms. If you are hoarse or notice voice changes for more than two weeks, see a physician. These may be painless, which can be misleading. Cancer is often painless. Bleeding may occur, but often not until late in the disease.
If an ulcer or swelling is accompanied by lumps in the neck, you should be concerned. In addition, any sore or swelling in the mouth that does not go away after two weeks should be evaluated by a physician. Bringing up blood —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 a physician. Swallowing problems —Cancer of the throat or esophagus may make swallowing solid foods, and sometimes liquids, difficult.
If you have trouble almost every time you try to swallow something, you should see a physician. A barium swallow X-ray or a direct examination of the swallowing tube with a scope, called an esophagoscopy, can help determine the cause. Changes in the skin —The most common head and neck cancer is basal cell skin cancer. Fortunately, this is rarely serious if treated early. Basal cell cancers appear most often on sun-exposed areas like the forehead, face, and ears, but can occur almost anywhere on the skin.
Basal cell cancer often begins as a small, pale patch that slowly grows, 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 head and neck. Most squamous cell cancers occur on the lower lip and ear.
They may look like basal cell cancers and are usually not dangerous if caught early and treated properly. Medical Illustrations. Risk Factors and Prevention. Symptoms and Signs. Types of Treatment. About Clinical Trials. Latest Research. Coping with Treatment. Follow-Up Care.
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