Head, Neck & Skin Cancer

Head and neck cancers are those that grow in and around the throat, larynx, nose, sinuses and mouth. The majority of these cancers are squamous cell carcinomas that form in the cells lining the mucosal surfaces of the head and neck. They often spread to the lymph nodes, but are highly curable if discovered early.

Head and neck cancers are classified according to the area in the body where they form. They include:

• Larynx. Also known as the voicebox, this is a tube-shaped organ in the neck containing the vocal cords. It helps us speak, swallow, and breathe.
• Oral cavity. This includes the lips, tongue, gums, and mouth.
• Salivary glands. These glands produce saliva to keep food moist and help break it down.
• Pharynx. This hollow tube begins behind the nose and leads to the esophagus and trachea.
• Nasal cavity. These are the hollow spaces in the bones around the nose, where air passes on the way to the throat.

Other cancers can form in this part of the body (brain tumors, esophageal cancer, thyroid cancer, etc.) but these behave very differently and are not classified as heck and neck cancers.

Causes of Head & Neck Cancer

The biggest risk factors for head and neck cancers are tobacco (both cigarettes and chewing tobacco) and alcohol, especially when used together. 85 percent of head and neck cancers are linked to tobacco. Other risk factors include exposure to industrial toxins (e.g., wood dust, paint fumes), dietary factors, human papillomavirus, Epstein-Barr virus, gastroesophageal reflux disease (GERD), asbestos exposure and radiation.

Certain ethnic groups (particularly Chinese) are more vulnerable, as are those from Southeast Asia who chew betel nut, and South Americans who drink mate, a beverage similar to tea.

Symptoms of Head & Neck Cancer

Symptoms of head and neck cancers are similar to those associated with other conditions and may seem harmless at first. Common signs include a lump or sore that doesn’t heal, persistent sore throat, difficulty swallowing and hoarseness.

Other symptoms you may experience: bleeding from the mouth, swelling of the jaw, frequent congestion, sinus infections that don’t respond to treatment, headaches, earaches, facial numbness or paralysis, enlarged lymph nodes and an unexplained loss of weight.

Treatment for Head & Neck Cancer

Treatment depends upon several factors. The size and location of the tumor, its stage, and your age and health must all be taken into consideration. Our team at Willamette ENT & Facial Plastic Surgery will make a decision based on these unique factors. Options might include surgery, radiation therapy, chemotherapy, targeted therapy or a combination of the above.

Skin Cancer Surgery

Surgery is the most common treatment for skin cancer. Whether you’re suffering from basal cell cancer, squamous cell cancer or melanoma, chances are your doctor will recommend a surgical procedure to remove the tumors and, often, cancerous lymph nodes as well.

Surgery Types

There are a variety of skin cancer surgery procedures to consider based on your type of cancer and how much it has spread. The most common skin cancers are referred to as “nonmelanoma skin cancers” and are slow growing and easily treatable.

Basal cell carcinomas (which comprise about 90 percent of all skin cancer diagnoses) fall under this category, as do squamous cell carcinomas. Neither of these varieties usually metastasizes, but they are considered malignant due to their ability to destroy surrounding tissue.

The most common surgical procedure for treatment of nonmelanoma skin cancers is Mohs surgery. Also known as chemosurgery, the cure rate is very high – 98 percent or greater for both basal cell and squamous cell carcinomas.

Mohs surgery is a four-step process that entails surgically removing sections of tissue, examining each specimen, mapping the cancerous areas and – when all cancerous cells have been removed – performing reconstructive surgery.

Melanoma is the deadliest form of skin cancer.  Surgery is required to remove the primary melanoma as well as any cancerous lymph nodes. Surgical procedures to treat melanoma include local excision, wide local excision, lymph node dissection and sentinel lymph node biopsy.

Cure rates vary widely and are largely dependent upon how early melanoma is detected and how far it has metastasized in the body.

Prevention

The best way to prevent skin cancer is to avoid prolonged exposure to the sun, particularly between the hours of 10 a.m. and 4 p.m., when ultraviolet light is at its peak. Use plenty of sunscreen with an SPF of 15 or higher, and wear hats, long-sleeved shirts and pants. Be on the lookout for any changes to your skin, particularly suspicious-looking moles. If you’re older than 40, have a professional examine your skin once a year.

Mohs Surgery

Mohs surgery was developed by Dr. Frederic Mohs as a treatment for skin cancer in the late 1930s. Over the years, Mohs surgery has been embraced by surgeons as the single most effective technique for removing skin cancers.

In fact, studies show Mohs surgery has a 98 percent or higher success rate for treating basal cell and squamous cell carcinomas, the two most common types of skin cancers.

The goal of Mohs surgery is to remove as much of the skin cancer as possible while doing the least amount of damage to the surrounding healthy tissue. Unlike traditional surgery, which involves removing the visible cancer as well as the surrounding healthy tissue, Mohs surgeons inspect each layer of skin for cancer. This not only ensures that all traces of the skin cancer are removed but no healthy skin is removed unnecessarily.

Mohs surgery is performed on an outpatient basis. The procedure typically takes approximately four hours. Since it is hard to predict how deep the cancer cells go, we recommend our patients plan to be at the clinic the whole day, just to be safe.

After the procedure, we recommend scheduling regular follow-up visits with our dermatologist. As many as half of the individuals diagnosed with the most common types of skin cancers will develop another skin cancer within five years. Frequent exams will ensure anything that develops will be caught early.

Skin Lesions

A skin lesion is a part of the skin that has an abnormal growth or appearance compared to the skin around it. There are two categories of skin lesions, primary and secondary.

Primary skin lesions are present at birth or are acquired over your lifetime. A birthmark would be an example of a primary skin lesion. Secondary skin lesions evolve from primary lesions or develop as a consequence of your activities. Melanoma resulting from sun exposure would be an example of a secondary skin lesion.

At Willamette ENT & Facial Plastic Surgery, we diagnose and treat all types of facial skin lesions with an emphasis on facial skin cancer.

Causes of Skin Lesions

Facial skin cancer is the result of mutations in the skin cells that cause them to grow out of control. The biggest risk factor for skin cancer is ultraviolet radiation from sunlight and tanning beds. Those with fair skin, a history of sunburns and excessive sun exposure, moles, or a family history of skin cancer are more prone to developing it.

Symptoms of Skin Lesions

Facial skin cancer is divided into three different types:

• Basal cell carcinomas affect the face, ears, and scalp, and are characterized by a pearly, waxy bump; a flat, flesh-colored lesion; or a brown scar-like lesion.
• Squamous cell carcinomas are most typically found on the face, lips, and ears. Signs include a firm, reddish nodule, and a flat lesion with a scaly or crusted surface.
• Melanomas can occur anywhere, but are commonly found on the head or neck. Symptoms of facial melanoma include a mole that changes in size or color, or bleeds; a brownish spot with dark speckles; a lesion with an irregular border and parts that appears red, blue, blue-black, or white; and dark lesions on the mucous membranes lining the nose and mouth.

There are a few other types of facial skin cancers that are less common. These present with red or purple patches on the skin or mucous membranes; firm, shiny nodules in the hair follicles or just beneath the skin; or hard, painless nodules on the eyelids or other parts of the face.

Treatment for Skin Lesions

Treatment for facial skin cancer depends on the type, size and location of the cancer, as well as your overall health. Small lesions limited to the surface of the skin can often be removed with a simple skin biopsy.

Other superficial skin cancers detected early can often be removed by freezing with liquid nitrogen or vaporizing with laser therapy. Excisional surgery or Mohs surgery for larger growths, can also be effective in cutting out cancer without causing damage to the surrounding skin.

When surgery isn’t an option, radiation therapy may be recommended. Chemotherapy involves the use of creams or lotions that contain cancer-killing drugs applied directly to the skin. This treatment is especially effective in cancers that are confined to the top layer of skin. For cancers that have spread to other parts of the body, systemic chemotherapy is often effective.

Call Willamette ENT & Facial Plastic Surgery at (503) 581-1567 for more information or to schedule an appointment.