Advanced Head and Neck Squamous Cell Carcinoma

Head and neck squamous cell carcinoma (HNSCC) is a type of cancer that starts in the squamous cells that line the mucosal surfaces inside the head and neck. It is most commonly found in the oral cavity area, including the lips, tongue, floor of the mouth, buccal mucosa, and/or gum, and in the larynx. It can also occur in the nasal cavities, sinuses, and pharynx. HNSCC is the sixth most common cancer worldwide and accounts for approximately 3-5% of all cancers.

Advanced HNSCC is defined as cancer that cannot be completely removed by surgery, or that has spread beyond the area where it originated. Advanced HNSCC is usually treated with chemotherapy and radiation, with or without other treatments such as immunotherapy. Treatment depends on the size and location of the tumor, and the overall health of the patient.

Risk Factors of Advanced HNSCC

There are several risk factors associated with advanced HNSCC, including:

Tobacco use - smoking or chewing tobacco
Alcohol use - drinking alcohol heavily or for prolonged periods of time
Human papillomavirus (HPV) infection
Exposure to certain substances (wood, metal, rubber, nickel, plaster, silica, and soot)
Poor oral hygiene
Previous radiation therapy for head and neck cancer
Immune suppression due to organ transplant or a chronic infection
Exposure to diesel exhaust
Low levels of vitamins A, B, and C from a poor diet
Advanced age

Signs and Symptoms of Advanced HNSCC

The signs and symptoms of advanced HNSCC can vary depending upon the size and location of the tumor. Common signs and symptoms include:

A lump in the neck
Persistent sore throat
Trouble swallowing
Hoarseness or changes in voice
Pain in the throat or ear
Persistent cough
Nose bleeds
Frequent sinus infections

Diagnosing Advanced HNSCC

Diagnosis of advanced HNSCC may include a physical exam, medical history, imaging scans, and biopsies. Imaging scans may include a CT scan, MRI, PET scan, ultrasound, and/or x-rays. A biopsy is done to confirm the diagnosis and to determine the tumor’s stage.

Treating Advanced HNSCC

The treatment of advanced head and neck squamous cell carcinoma depends on the size and location of the tumor, and the overall health of the patient. Treatment may include surgery, chemotherapy, radiation, immunotherapy, and/or targeted therapies. The goal of treatment is to control the cancer and relieve symptoms, but it is important to note that advanced HNSCC can be difficult to treat and the prognosis is often poor.