Worldwide, cancers of the ear, nose and throat are not very common. In India, however, cancer of the mouth and back of throat (oropharynx) are the commonest cancers in adult men. Although, strictly speaking, throat includes back of nose (nasopharynx), back of throat (oropharynx), upper food passage (hypopharynx) and voice box (larynx). Cancer of the nasopharynx is the rarest form.
Causes of developing cancer in the throat region
The use of tobacco (smoked or chewed), consumption of alcohol and chewing of betel quid or paan, zarda and khaini are the main causes of development of cancer of the mouth, throat and voice box. People who do not have any of these habits may still develop these cancers; in some cases this is related to infection with the human papilloma virus (which is also a cause of cancer of the uterine cervix in women)/ while in other cases it may be the result of genetic susceptibility. Some cases of mouth cancer can arise in persistent ulcers because of catching of the cheek on a sharp tooth. Cancer of the ear is very rare, but usually follows many years of ear infection with constant discharge of pus.
Symptoms of cancer in the mouth (Oral cavity):
Nearly 50 per cent of mouth cancers arise from white or red patches (leukoplakia or erythroplakia) of damaged lining that may remain present for many months before they become cancerous. Warning symptoms are sensation of burning (especially in the presence of spicy food), progressive increase in the size of the patch, or bleeding from the patch on touching. Cancers of the tongue usually present as ulcers on the surface or edge,' which gradually increase in size, and may bleed. They are rarely painful to begin with.
A condition with a high chance of becoming cancer is oral submucous fibrosis (OSMF), in which areas of the tongue or cheek become painful in the presence of spicy food, and there is progressive difficulty in opening the mouth. This is always seen in people who take excessive paan, zarda and khaini.
Symptoms of cancer in the Throat (Oropharynx):
Common early symptoms are appearance of a lump in the neck which progressively increases in size (it will never become smaller), or a persistent pain in the ear in the absence of any ear infection. This is due to nerve involvement, and will be constant. Later symptoms include difficulty in swallowing food and/or liquids, and change in the quality of voice.
Symptoms of cancer in the Voice box (Larynx):
A persistent change in the voice or loss of voice for more than two weeks is always suspicious.
Symptoms of cancer in the Ear:
Onset of pain in an ear which has been discharging pus for many years may signal the appearance of cancer.
Symptoms of cancer in the Nose:
Blood-stained nasal discharge, persistent one-sided nasal obstruction, and, sometimes, deep-seated nasal or sinus pain.
Treatment of cancers of Ear Nose and Throat
In order to treat cancers of the ear, nose and throat it is essential to know three things:
1. The nature of the cancer (which includes the type, and whether it is high, mid or low-grade)
2. The extent of the cancer (which usually requires endoscopy of the nose or throat, and microscopy of the ear)
3. Whether there is any spread to the lymph glands of the neck (which usually requires a CT or MRI scan, and a needle test or FNAC
To know the nature and grade of the cancer, it is necessary to take a sample of the cancer tissue and have it examined in a pathology laboratory. Unfortunately, there are many myths regarding this biopsy procedure. People have the fear that taking a biopsy will convert a swelling into a cancer. This is absolutely false. There is also fear that biopsy will make the cancer spread faster. This will only happen if there is a delay in starting correct treatment after the biopsy report has been received, it must be emphasized that it is impossible to treat cancer appropriately without biopsy, as the nature and grade will not be known.
Once the above information has been gathered, the cancer can be correctly treated. For small cancers, either surgery (including laser surgery) or radiothera¬py may be enough for cure. More than 80 per cent of cancer of the throat can be cured if diagnosed at early stage. Larger cancers, cancers with involvement of neck lymph glands, and those of ear or nose usually require combination treatment with surgery and radiotherapy. In some cases, the radiotherapy may be preceded or combined with treatment with anti-cancer drugs (chemotherapy). With correct timely treatment more than 60 per cent of such cancers may be cured.
It must be emphasized that extensive studies performed by the respected US National Institutes of Health have found no role of homoeopathy in curing cancers of the ear, nose and throat.
Prevention of cancers of Ear Nose and Throat
Stop smoking, do not drink excessive amounts of alcohol, avoid passive smoking and do not take paan, zarda or khaini. Always see an ENT specialist if any of the symptoms mentioned above should occur.
Consult an ENT specialist if you suffer from
•White or red patches in the mouth which burn with spicy food
•Change of voice for more than two weeks
•Persistent pain in one ear in the absence of any ear infection
•Appearance of a lump in the neck
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