Head, neck and mouth cancer

Tags: Cancer

From questions on oral and throat cancer, to queries on cancer in the head, neck and lymph nodes – our live chat offered a busy and diverse discussion on the signs symptoms and treatments of head, neck and mouth cancer.

And on hand to answer your questions was our expert Bhavin Visavadia, a Consultant Maxillofacial Surgeon Head and Neck Surgeon.

Here’s what he had to say:

AG24 asked:I have had a lump on the back on my ear for years, it has started to get painful recently and often triggers headaches, my GP is unsympathetic and unhelpful. I have health care with AXA, however, I don't know what my options are? My headaches are getting worse and I often get fatigue. Nobody is offering me a MRI/CT scan. What are my options? I don't want to pay for a private health check as I can't afford it.

Mr Bhavin Visavadia:Hello I'm sorry to hear you have a painful lump on your ear. This could be inflamed and arising from the skin i.e. a cyst if it is growing and uncomfortable it would need to be examined.

AG24 asked:My GP has not referred me to anyone or said anything about it. They brush it under the carpet.

fiona asked:Hi Mr Visavadia I have a question on the glands in the right side of my neck. They seem to be constantly swollen and sore and it’s been going on for a few months now. It was happening at the start of the year, then stopped for a few months, now back since late August. Sometimes it feels muscular and my shoulder aches too, but mostly it is very clear that it is glands.

Mr Bhavin Visavadia:Hi Fiona the neck glands are usually lymph nodes which is where the body's immune system fights infection etc. At examination these glands are assessed and any other neck glands and mouth structures e.g. teeth, tonsils. Have you felt run down?

fiona asked:I got a bad cold in August which is when the glands started feeling sore again. It's funny that you mention teeth as my gums and wisdom teeth have been hurting on and off.

Mr Bhavin Visavadia:Again within my Specialist Interest, usually a clinical examination, blood tests and if the glands are persistently swollen- an ultrasound scan can be arranged pretty swiftly.

Reuben asked:Hi Mr Visavadia, I've been smoking for 10 years and understand the connection to Lung Cancer. Could this increase the risk of Cancer elsewhere on the body too?

Mr Bhavin Visavadia:Tobacco use is a major risk for head and neck cancer

Jim asked:Hello, what symptoms should you look for in oral mouth cancer?

Mr Bhavin Visavadia:Symptoms such as ulcers which are persistent, white or red/ white patches, lumps and painful areas of the mouth are usual symptoms

We usually recommend that a dentist or GP refer urgently anyone with persistent mouth symptoms which are not the common toothaches or gum bleeding. Sometimes as per Fiona's query a neck lump may be the only presentation.

A question from a Twitter follower:What causes mouth cancer, is there anything that can be done to prevent it?

Mr Bhavin Visavadia:Good question. The most common cause is smoking The use of alcohol is also significant and the risks double when both activities are undertaken We are seeing increasing numbers of cancers arising in patients who neither smoke or drink and we believe that there is an association with the Human Papilloma Virus HPV

Jim asked:If a persistent ulcer was identified as being cancerous would the treatment be the same as a lump and to just remove it? What side effects could this potentially have on your mouth/jaw?

Mr Bhavin Visavadia:Jim we would arrange a small sample to be analysed first (biopsy) and then if it were positive move onto further detailed tests such as MRI and CT scans. Once I have all the information I have a discussion about the best available treatment with my Multi Disciplinary Team and decide upon surgery and/or Radiotherapy

AXA PPP healthcare:Could you please explain what the Human Papilloma Virus is?

Mr Bhavin Visavadia:HPV is a virus which is known to be associated with Cervical Cancer in women. In the UK we are vaccinating all teenage girls to protect them. We have evidence that this virus can be responsible for cancer of the back of the mouth the Orophaynx

Removing a tumour in the mouth can affect a patient’s speech and swallowing. Today we have reconstructive techniques which allow me to build a new jaw or replace part of the mouth or tongue which has been affected by cancer surgery

A question from a Twitter follower:What are the symptoms associated with mouth cancer? Is there anything to look out for?

Mr Bhavin Visavadia:Hi usual symptoms are a persistent ulcer- a sore which is present for more than 2 weeks. Any unusual patches in the mouth -white or combined white/red patches. Any lumps or bumps should also be investigated.

AG24 asked:What are symptoms for neck cancer? And head?

Mr Bhavin Visavadia:Neck cancer is usually due to lymph gland involvement. They filter the tissues of the head and mouth and it is in the glands that any cancer cells are fought

In the head region the sinuses less commonly can be involved and I have to say that most of the time we will be reassuring patients who present with blocked noses or throat soreness. The skin of the face exposed to sun damage can present with raised nodules or dry patches and ulcers (a break in the skin) which seem to be persistent. The head region also has large salivary glands below the ear which can commonly develop benign and occasionally more sinister lumps

Symptoms of oral cancer include: red, or red and white, patches on the lining of your mouth or tongue one or more mouth ulcers that do not heal after three weeks a swelling in your mouth that lasts for more than three weeks pain when swallowing (dysphagia) a tooth, or teeth, that become loose for no obvious reason a persistent pain in the neck a hoarse voice unexplained weight loss unusual changes in your sense of taste earache the lymph nodes (glands) in your neck become swollen This is a more comprehensive list of symptoms.

Davey asked:Which cancer would you say is most common; head, neck or oral?

Mr Bhavin Visavadia:Oral cancer is the most common We see about 5500 cases per year in the UK i.e. more common than cervical cancer. Worrying Pigmented skin conditions should always be reviewed.

Nicky asked:I'm in my early 40s and over the last couple of months have experienced an persistent ache in the right side of my lower jaw. My dentist said it was just where the jaw changes position as we get older. Are dentists up to speed on spotting anything more serious, or should people like me go and see a GP?

Mr Bhavin Visavadia:Dentists are all trained to spot the signs of cancer. Jaw pains particularly around the joint are usually due to muscle spasm and sometimes wear and tear within the joint.

Nicky asked:Too much talking, then?!

Mr Bhavin Visavadia:Possibly! But could be a clenching habit during the day and teeth grinding habit at night in your sleep. If there is deep seated pain within the joint (in front of your ears they move when you open and close your mouth) and you cannot open your mouth wide then it could be cartilage damage also.

Nicky:No - it's more in the lower jaw - feels the teeth are being push inwards. Reassured to know the dentist is well placed to spot anything that could be sinister though. Thanks

Harby1959 asked:Hi, I just had a gist removed from my spine in my neck this May. Is there chances of it regrowing! As I had radiotherapy and chemotherapy too!

Mr Bhavin Visavadia:Do you have any more information on this? is it a sarcoma?

Harby1959 asked:I also have gists in my liver and lower spine S1 L3 L4! I've had it now 15 years! Also on Sutent permantly! Yes it is a sarcoma.

Mr Bhavin Visavadia:Harby, this type of tumour is usually managed within a specialist centre and with dedicated Oncologists supporting patients. There is always a chance of tumour recurrence which is why your specialist will give you regular checkups.

Harby1959:I know it's rare, but as soon as it goes from place in my body it arrives in another!

Mr Bhavin Visavadia:I'm sorry to hear that. Sutent, I gather, is a drug to prevent such disease progression

Harby1959:It's my last hope!! It's not a cure like Gleevec was which stopped working after 8 years in April! Sutent is just there to control but not cure.

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