Head and neck cancer: past, present and future

Abstract

Head and neck cancer consists of a diverse group of cancers that ranges from cutaneous, lip, salivary glands, sinuses, oral cavity, pharynx and larynx. Each group dictates different management. In this review, the primary focus is on head and neck squamous cell carcinoma (HNSCC) arising from the mucosal lining of the oral cavity and pharynx, excluding nasopharyngeal cancer. Presently, HNSCC is the sixth most prevalent neoplasm in the world, with approximately 900,000 cases diagnosed worldwide. Prognosis has improved little in the past 30 years. In those who have survived, pain, disfigurement and physical disability from treatment have had an enormous psychosocial impact on their lives. Management of these patients remains a challenge, especially in developing countries where this disease is most common. Of all human cancers, HNSCC is the most distressing since the head and neck is the site of the most complex functional anatomy in the human body. Its areas of responsibility include breathing, the CNS, vision, hearing, balance, olfaction, taste, swallowing, voice, endocrine and cosmesis. Cancers that occur in this area impact on these important human functions. Consequently, in treating cancers of the head and neck, the effects of the treatment on the functional outcome of the patient need the most serious consideration. In assessing the success of HNSCC treatment, consideration of both the survival and functional deficits that the patient may suffer as a consequence of their treatment are of paramount importance. For this reason, the modern-day management of head and neck patients should be carried out in a multidisciplinary head and neck clinic.

Work disability associated with cancer survivorship and other chronic conditions

“…For example, chronic pain in breast cancer survivors is related to more invasive surgery, multiple treatments such as surgery combined with radiation, and post-operative pain (Poleshuck EL 2006). Treatment for head and neck cancers, the sixth most prevalent cancer globally, commonly leads to disfigurement, chronic pain and poor functional outcomes (Chin 2006). The results of our study show that cancer survivors suffer from work limitations at a higher rate than individuals with other chronic diseases.…”

4-hexylresorcinol exerts antitumor effects via suppression of calcium oscillation and its antitumor effects are inhibited by calcium channel blockers

“…In microorganisms, chemical analogs of 4-HR occur in dormant cysts (5,6) and resting cyst-like cells (7,8). Exogenous administration of these auto-regulatory factors and their analogs-alkyl resorcinol induces dormancy in bacteria (9); these compounds are similarly active in eukaryotic cells such as ras-transformed fibroblasts (10).…”

Cisplatin Treatment Induces a Transient Increase in Tumorigenic Potential Associated with High Interleukin-6 Expression in Head and Neck Squamous Cell Carcinoma

“…Approximately 90% of head and neck cancers are squamous cell carcinomas (HNSCC; ref. 2). Head and neck cancers are associated with a high rate of mortality and considerable morbidity, due to their anatomic location.…”

“…Major risk factors for the development of HNSCC are tobacco use, alcohol consumption, and infection with human papillomavirus (1). Current treatment usually involves a combination of surgical resection with radiotherapy and chemotherapy (2). All of these treatment modalities have undergone improvements over the last several decades and have led to improvements in outcomes for some types of HNSCC (for example, advanced laryngeal and pharyngeal carcinoma; ref.…”

“…Cisplatin has been commonly used in the treatment of HNSCC as well as many other cancers (2,6). Its modes of action are still incompletely understood, but seem to involve the induction of DNA damage due to the formation of platinum-DNA adducts that distort the structure of the DNA helix (6,7).…”