Head and Neck Cancers

Q1. Is frequent nosebleed a sign of nasopharyngeal cancer?
Since the tumour of nasopharyngeal cancer is located behind the nasal cavity, blood rarely comes out of the nostrils. It is usually spat out. Nose bleed is one of the many symptoms of nasopharyngeal cancer, other symptoms include nasal congestion, tinnitus, hearing loss or ear discomfort, damage to cranial nerve, double vision, facial paralysis, etc.  The most common type is swollen lymph nodes in the neck, which are found in about 50% of nasopharyngeal cancer patients on presentation.

Q2. It is said that cancer can also develop in the tongue. What are the symptoms of tongue cancer?
Tongue cancer has few symptoms at early stage, the most common one is tongue ulcers that last over 3 to 4 weeks. The ulcers may become larger and bleed from time to time without pain.  Please seek medical attention if the tongue ulcers fail to heal. Due to tumour growth, cancer may spread through lymphatics to the neck lymph nodes in advanced stage. When the tumour grows deep into the tongue or is large in size, it may cause slurred speech and may affect the lingual nerve and cause pain in the tongue, even ears.     

Q3. I feel a lump in my neck. Is it lymphoma?
There are 4 major causes of swollen lymph nodes in the neck. Inflammation in the head and neck, oral cavity, scalp, etc. is the most common cause, and can lead to lymph node inflammation and swelling. The second type is inflammation due to specific conditions, e.g. when the tuberculosis bacteria invades the lymph nodes. The third cause is metastasis, which occurs when tumours in the head and neck region, or even abdomen, spread to lymph nodes in the neck and cause swollen lymph nodes. The last type has to do with tumours that grow from the cells in the lymph nodes and develop into lymphoma. If you can feel swollen lymph nodes in the neck, please seek medical attention to ascertain the cause.

Q4. What are the symptoms of laryngeal cancer other than hoarseness? How is laryngeal cancer treated?
The most common symptoms of early laryngeal cancer are hoarseness and occasional blood-tinged sputum. Airway obstruction may occur at late stage due to enlarged tumours, causing breathing difficulties and frank blood in sputum when coughing. When the condition deteriorates further, patients may have difficulties with eating or swollen lymph nodes due to metastasis.      

Q5. Where is the thyroid gland? What are the treatments for thyroid cancer?
This is the model of our throat and neck. The thyroid gland is located on both sides of the lower front of the neck, in the midline. When a carcinoma develops in the thyroid gland or other tumours are suspected, tissue samples should be obtained by ultrasound-guided fine needle aspiration biopsy for diagnosis. When thyroid cancer is confirmed, the treatment choices depend on tumour size. Generally speaking, for tumours not larger than 1cm, removal of half of the thyroid gland is recommended. In case of larger tumours or advanced thyroid cancer, the entire thyroid gland should be removed. Also, radioactive iodine treatment is required after surgery.

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