Local recurrences of head and neck cancers (all histologies)

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Head and neck cancers are malignancies that develop in the face and neck region. 

The most common onset locations are:

• Oral cavity (floor of the mouth, lips, tongue, palate, gingival mucous membranes)
• Nasal cavities and paranasal sinuses
• Pharynx (tonsils, nasopharynx, oropharynx, hypopharynx)
• Larynx
• Salivary glands (parotid, submandibular, sublingual glands, minor salivary glands)
• Thyroid
• Lymph nodes in the neck
• Eye orbit
• Ear and temporal bone
• Skin
• Skull base

90% of head and neck cancers are squamous cell carcinomas (or spinocellular or epidermoid carcinomas), 5% corresponds to salivary glands tumours, and the rest to melanomas, lymphomas or sarcomas.

Men are affected significantly more than women. The incidence rate of these malignancies increases with age, although most cases have been observed in patients between the ages of 50 and 70.

Causes of local recurrences of head and neck cancers

Although each head and neck neoplasm has its own specific risk factors, some are recurrent in most tumours of the face and neck region.
Some common risk factors for head and neck cancers include:

• Smoking
• Alcohol
• Not suitable dental devices
• Ill-fitting dentures
• Poor oral hygiene
• Chronic candida infection
• Infection with human papillomavirus (HPV)
• Infection with the Epstein-Barr virus
• Exposure to sunlight
• Exposure to radiation, for instance, in previous radiation therapies
• Exposure to substances such as asbestos, cadmium and nickel powders

Symptoms of local recurrences of head and neck cancers

The symptoms of head and neck cancers are different depending on the location and extent of the neoplasm, but generally the following symptoms can be found:

• Mouth ulcers
• Dysphonia
• Difficulty breathing
• Dysphagia
• Swelling of the neck in the lateral or anterior regions
• Headaches
• Otalgia
• Nose bleeds

Diagnosis of local recurrences of head and neck cancers

In case a recurrence of head and neck cancer is suspected, a visiting a specialist to determine a correct patient's medical history is a priority. 

After a careful exploration of the oral cavity, the doctor can request the following tests:

• Endoscopy
• Biopsy
• Ultrasound scan
• Computed tomography (CT)
• Nuclear magnetic resonance (NMR)
• Fluorodeoxyglucose Positron Emission Tomography (FDG-PET)

In thyroid tumours, blood tests play an important role in defining the diagnosis.

Treatment of local recurrences of head and neck cancers

Choosing a treatment for local recurrences of head and neck cancers varies according to the nature, location and size of the tumour, and the patient's general medical condition. 

These recurrences are usually symptomatic of a particularly resistant tumour form. Hadrontherapy is a potentially effective therapeutic option which permits treating even radio-resistant neoplasms without damaging the surrounding healthy structures.