Head and Neck
Most head and neck cancers begin in the squamous cells that line the structures found in the head and neck. Because of this, head and neck cancers are often referred to as squamous cell carcinomas. Some head and neck cancers begin in other types of cells. For example, cancers that begin in glandular cells are called adenocarcinomas.
Cancers of the head and neck are further identified by the area in which they begin:
- Oral Cavity - The oral cavity includes the lips, the front two-thirds of the tongue, the gums (gingiva), the lining inside the cheeks and lips (buccal mucosa), the bottom (floor) of the mouth under the tongue, the bony top of the mouth (hard palate), and the small area behind the wisdom teeth.
- Salivary Glands - The salivary glands are in several places: under the tongue, in front of the ears, and under the jawbone, as well as in other parts of the upper digestive tract.
- Paranasal Sinuses & Nasal Cavity - The paranasal sinuses are small hollow spaces in the bones of the head surrounding the nose. The nasal cavity is the hollow space inside the nose.
- Pharynx - The pharynx is a hollow tube about 5 inches long that starts behind the nose and leads to the esophagus (the tube that goes to the stomach) and the trachea (the tube that goes to the lungs).
Once our physician identifies your cancer, treatment will involve possible biopsy or excision as well as staging. The extent of disease will dictate treatment which may potentially involve surgery, radiation therapy and chemotherapy. For aggressive tumors, multiple modalities of treatment will be employed and the expertise of physicians in other specialties may additionally be required.
Tonsillitis is an inflammation of the tonsils, the fleshy areas at the back of the throat, caused by a virus or bacteria. This condition is common in children and spreads through contact with throat or nasal fluids. The tonsils become swollen, red and painful and may be coated with a yellow or white substance.
Most cases of tonsillitis are caused by a virus, although it can sometimes be caused by the same bacteria that causes strep throat. Tonsillitis symptoms are similar to those of strep throat or a common cold and may include:
- Sore throat
- Red, swollen tonsils
- Difficulty swallowing
- Swollen lymph nodes
Your doctor will usually be able to identify tonsillitis by finding red and swollen tonsils with spots or sores on them. A rapid strep test may also be performed to determine the cause. Tonsillitis can usually be treated at home through rest and drinking plenty of liquids. Antibiotics may be prescribed for bacterial infections. Surgery to remove the tonsils may be recommended if a child has had several serious throat infections in a short period of time.
Swallowing Problems (Dysphagia)
There are many possible causes for a person to suffer difficulty or pain when swallowing food or liquid. The most common causes include:
- Conditions that narrow the esophagus – Sore, swollen or infected throat; esophageal strictures caused by lodged pills or other objects; laryngopharyngeal reflux disease (throat clearing, mucus, voice changes, trouble swallowing, post nasal drip); diverticulums; tumors or cancers.
- Conditions that compress the esophagus from the outside – Goiter (enlarged thyroid gland); tumors, cancers or other abnormalities of the throat, larynx, spine and neck.
- Dry mouth – Sjogren syndrome, nerve or brain damage, medication side-effects.
- Muscle weakness – Autoimmune or nerve disorders; nerve or brain damage such as ALS or stroke.
Patients with dysphagia will be asked about the exact sensations they feel when swallowing; how quickly the problem appeared and how long it has been occurring; whether they are taking any medications that could cause these side-effects; what other symptoms they are experiencing, if any; and whether there is a family history of such problems. If a physical exam is not enough to make a diagnosis, other tests may be ordered such as trans-nasal esophagoscopy, 24 hour ambulatory pH monitoring, modified barium swallow, functional evaluation of swallowing and sensory testing (FEESST), CAT scan or MRI. Treatment and recovery depend on the underlying condition.
Thyroid nodules are abnormal growths on the thyroid gland that appear as lumps in the throat. The cause of a thyroid nodule is not known, but they occur most often in older adults, and are usually not cancerous. However, thyroid nodules require medical attention to help prevent any complications.
There are several different types of nodules that can form in the thyroid gland. While many do not cause any symptoms, others can affect hormone production and may lead to weight loss, nervousness or a rapid heartbeat. Some of the different types of nodules include:
- Colloid nodule
- Follicular adenoma
- Thyroid cyst
- Inflammatory nodule
- Thyroid cancer
- Multinodular goiter
Aside from thyroid cancer, these nodules are benign, but can still lead to complications like difficulty breathing, pain and discomfort and require medical attention. Larger nodules may restrict breathing or swallowing, while those that cause hyperthyroidism can lead to heart problems or osteoporosis.
Treatment for thyroid nodules depends on the type of nodule and your overall health. Some benign nodules may not need treatment and can simply be monitoring by patient and doctor, while others may require hormone therapy, radioactive iodine or alcohol ablation. Surgery may be needed for cancerous nodules and involve removal of the nodule through a total or near-total thyroidectomy. A thyroidectomy requires lifelong hormone treatment to counteract the lack of natural hormone production.
It is important to see a doctor to decide which kind of treatment, if any, is recommended for your thyroid nodule. Call us today to schedule an appointment with one of our experienced doctors.