About 30 percent of head and neck cancers are caused by smoking. To prevent this type of cancer or its recurrence, it is necessary to avoid smoking, alcohol consumption and excessive sun exposure, and to adopt a healthy lifestyle.

Malignant tumors-cancers located in the head and neck region include cancers of the larynx, throat, pharynx, mouth, nose, sinuses, salivary glands, tongue, thyroid gland, facial bones and skin structures. Mustafa KONAKLIOGLU,MD, ENT and Head and Neck Surgery Specialist at Bayindir Hospital Sogutozu, reported that the most common cancer type in head and neck cancers are laryngeal cancers with a rate of 45-50 percent, and head and neck cancer types make up 9 percent of all body cancers and 4 percent of deaths caused by cancer. He adds that is much more common in people aged over 50 and 4-5 times more seen in men than women.

Environment and food pollution also trigger
Approximately 30 percent of head and neck cancers are closely related to prolonged exposure to specific factors such as tobacco smoking and alcohol drinking. Oral and throat cancers are almost never seen in adults who do not smoke or drink. Prolonged exposure to sunlight is associated with lip cancer and is the major cause of skin cancer," says Mustafa KONAKLIOGLU, MD also gives the following information: "Smoking, tobacco chewing, alcohol, genetic factors, malnutrition, environmental factors, hygienic factors, industrial products, radiation and some microbes are known to play a significant role in the development of these cancers. Increased environmental pollution, food shortage, chemicals used for food preservation, genetically modified foods, industrial wastes destroying natural water resources and nature, atmospheric pollution have negative effects on human health and life, causing significant health problems and increase in cancers. Constant exposure to sunlight also increases the risk of lip and skin cancers. Some microbes we call viruses have associations with formation of nasopharyngeal cancer.”

Do not ignore these symptoms
ENT and Head and Neck Surgery Specialist Mustafa KONAKLIOGLU, MD emphasizes that symptoms such as neck swelling, voice changes, blood in saliva or phlegm should be considered for early diagnosis. Mustafa KONAKLIOGLU, MD, lists important symptoms as follows:

Neck swelling: Head and neck cancers usually spread to the lymph nodes in the neck before spreading anywhere in the body. Swelling in the neck that lasts more than two weeks should be shown promptly to a doctor. Of course, not all swellings mean cancer, however all kind of swellings may be the first noticeable sign of cancer of the mouth, larynx, goiter, or of certain lymphomas and blood cancer. Such swellings are often painless and tend to grow steadily.

Voice changes: Most laryngeal cancers cause a change in the voice. Hoarseness or voice changes lasting more than two weeks should alert you to see your doctor. An Otorhinolaryngologist and Head and Neck Surgeon can examine your vocal cords by easy and painless methods. Although not all voice problems are due to cancer, but you shouldn't risk your chances for early diagnose. If hoarseness persists longer than two weeks, a visit to your physician is recommended.

Non-healing sores: Most tongue and lip cancers might cause non-healing sores and swelling. The sores and swellings are painless unless they become inflamed. Although bleeding may occur, it is not often seen until advanced-stage of the disease. If a sore or swelling is accompanied by lumps in the neck, you should be concerned. Your doctor or dentist will evaluate whether a biopsy (tissue sampling test) is required and refer you to a head and neck surgeon for this procedure.

Bringing up blood: 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 doctor.

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 consult a doctor. 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 skin: The most common head and neck cancer is basal cell skin cancer and it 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 skin cancers show color changes.

Malignant melanoma typically produces a blue-black or black discoloration of the skin. However, any mole or spot that changes size or color, or begins to bleed, should be seen as soon as possible by a dermatologist or ENT physician.

Persistent earache: Constant pain in or around the ear when you swallow can be a sign of infection or tumor in the throat. This is particularly serious if you also have difficulty swallowing, a hoarse voice, or a lump in the neck. These findings should be evaluated promptly by an ENT specialist.

Smoking 10-15 times increrases cancer risk
Each cigarette is a mixture containing a large number of carcinogenic compounds. Nearly 50 carcinogenic substances have been identified in cigarette smoke, including hydrocarbons, nitrozamines, aromatic amines, aldehydes, volatile carcinogens, inorganic compounds and radioactive substances. These substances disrupt the cells and structures inside by binding to them and cause uncontrolled cellular proliferation.Those who smoke more than 10 years have a 10-15 times higher risk of developing cancer than non-smoker.

More than 200,000 people die each year from smoking-related diseases in the United States. With the impact of public smoking bans, the number of people who quit smoking increases, but the trend towards the use of smokeless tobacco and chewable tobacco is accelerating. Although this reduces the risk of lung cancer, it increases oral cancers.

Diagnosis and treatment stages
Diagnosis: To the question: " How to get accurate and precise information about the spread, formation and characteristics of cancer?" Mustafa KONAKLIOGLU,MD ,ENT and Head and Neck Surgery Specialist at Bayindir Hospital Sogutozu, replies: "In case of suspicion of cancer, the otorhinolaryngologist should request some advanced radiological (computed tomography, magnetic resonance imaging, PET-computed tomography etc.) and laboratory examinations to investigate the extension and penetration of the tumor into neighboring tissues and more distant areas. In addition to the information obtained as a result of these examinations, a biopsy should be taken from the tumor in order to definitively reveal the nature of the tumor. These sequential steps will provide the most accurate and precise information."

Treatment: There is a strong relation between the early diagnosis of head and neck cancers and the success of treatment. The stage and type of the cancer, age, gender, body resistance, and socioeconomic status of the patient are important factors in the treatment planning. The treatment is planned according to the type and stage of the cancer, patient age, gender, body resistance, socio-economic situation etc. Specialist  Mustafa KONAKLIOGLU, MD, says "Basic methods used successfully in the treatment of head and neck cancers are surgery, radiotherapy (radiation therapy), chemotherapy (drug therapy) and various combinations of these methods. As it can be understood from here, the active participation of specialists from many different branches are required in treatment - therefore the Councils of Head and Neck Cancers have been established.”

In these councils, the most ideal and personalized treatment plans are made for patients with a multidisciplinary approach with the participation of specialists in otorhinolaryngology, radiation oncology, medical oncology, radiodiagnostics, nuclear medicine and pathology. Up to 90 percent of survival rate can be achieved with only surgical or radiotherapy treatment especially in patients who apply to a specialist at an early stage of head and neck cancer. However, combined treatment requirements emerge in cases of advanced head and neck cancer and success rates are lower.

For a more comfortable treatment 
ENT and Head and Neck Surgery Specialist Mustafa KONAKLIOGLU  says, " In the treatment process of head and neck cancers, the communication and relationship of patients with their physicians and health centers are very important.” He emphasizes the importance of being in close contact with otorhinolaryngology specialists in order to eliminate complaints such as respiratory difficulties, hoarseness, swallowing / feeding difficulties, neck pains that may occur especially in the early stages of the treatment process. In addition, psycho-oncological support might be crucial in cases of psychological breakdown caused by cancer diagnosis and treatment.

High importance of post-treatment
Follow-up of head and neck cancer patients in the period after the completion of their treatment is as important as their treatment. Since there is a risk of cancer recurrence, the patient should visit ENT specialist for follow-up examinations every month for the first year, every two months for the second year, every three months for the third year, every four months for the fourth year and annually thereafter for the  lifelong. Thus, consistent follow-up is important for early detection and treatment in the event of recurrence of disease.