Head and neck squamous cell carcinoma (HNSCC) is an aggressive malignant neoplasm that develops from squamous epithelia that line the mucous membranes of the mouth, larynx, nasopharynx and other structures of the upper respiratory tract. This disease is characterized by high invasiveness and metastasis, which makes its diagnosis and treatment difficult. HNSCC is most often found in men and is largely associated with the impact of various carcinogenic factors, such as smoking, alcohol, human papillomavirus (HPV) infection and others. Since cancer can manifest itself with mild symptoms in the early stages, many cases are detected at later stages, which negatively affects the prognosis.
History of the disease and interesting historical facts
Squamous cell carcinoma of the head and neck has been known to mankind since ancient times. The first mentions of cancer in literature can be found in the works of the ancient Greek physician Hippocrates. However, significant progress in the study of SCC began only in the 20th century, when scientists began to systematically study carcinogenic factors and their impact on the development of this pathology. In the 1950s, close links were identified between smoking and the occurrence of head and neck cancer, which led to the first global movement against smoking. At the turn of the century, with the development of molecular biology technologies, active work began on the genetic aspects of this disease, which opened up new horizons for diagnostics and therapy, including targeted and immunotherapy.
Epidemiology
According to statistics, squamous cell carcinoma of the head and neck is the fourth most common cancer in the world. According to the World Health Organization, more than 650,000 new cases are registered annually, and more than 330,000 patients die from this disease. At the same time, in the last two decades, there has been an increase in the incidence, which is largely due to the increase in the number of HPV infections, as well as changes in lifestyle and habits. For example, studies show that in some countries, the incidence among young people against the background of a decline in smoking has increased due to the spread of sexually transmitted infections.
Genetic predisposition to this disease
Genetic predisposition to squamous cell carcinoma of the head and neck is associated with mutations in various genes that play a key role in the regulation of the cell cycle and apoptosis. In particular, the study showed that the most important genes involved are TP53, CDKN2A, and FGFR2. Mutations in these genes can lead to disruption of the normal regulation of cell division and, as a consequence, to the development of malignant tumors. It is also important to note that certain polymorphisms in genes responsible for the metabolism of carcinogens can increase the risk of developing HNSCC. Inherited mutations in BRCA1 and BRCA2 are also considered as possible predisposition factors.
Risk factors for the development of this disease
There are many risk factors that contribute to the development of squamous cell carcinoma of the head and neck. The main ones include:
- Smoking tobacco and drinking alcohol
- Age: The risk increases in people over 50 years of age.
- Human papillomavirus (HPV) infection
- Chronic inflammatory diseases of the mucous membranes (eg, leukoplakia)
- Effects of chemical carcinogens (asbestos, formaldehyde)
- Lack of vitamins A and C and other antioxidants
In addition, certain occupations that involve risk of chemical exposure (e.g. asbestos workers) also increase the likelihood of early onset of the disease. The pathological process may also be aggravated by concomitant diseases such as immunodeficiency conditions.
Diagnosis of this disease
Diagnosis of squamous cell carcinoma of the head and neck involves several key steps:
- Main symptoms include vague sore throat, loss of voice, difficulty swallowing, sudden weight change, and the presence of growths in the neck or mouth.
- Lab tests: Blood tests are performed that may show inflammation and anemia.
- Radiological examinations: ultrasound, CT and MRI allow you to visualize tumors and their size.
- Other diagnostic methods: biopsy of the neoplasm is the gold standard for confirming the diagnosis.
- Differential diagnosis: it is necessary to exclude other diseases, such as benign tumors or inflammatory processes.
Timely diagnosis is essential for choosing the right treatment strategy and increasing the chances of success.
Treatment
Treatment of squamous cell carcinoma of the head and neck is carried out taking into account the stage of the disease, the location of the tumor and the general condition of the patient:
- General treatment: involves a multidisciplinary approach involving oncologists, surgeons and radiologists.
- Pharmacological treatment: use of chemotherapeutic drugs (eg, cisplatin) in combination with radiotherapy.
- Surgical treatment: resection of the tumor and lymph nodes, which plays a key role in the treatment process.
- Other treatments: Immunotherapy (eg, using cell cycle control inhibitors) is increasingly used in clinical practice.
Thus, treatment of HNSCC requires an individual approach and multimodal methods.
List of medications used to treat this disease
Some of the most commonly used pharmacological agents include:
- Cisplatin
- Fluorouracil
- Doxorubicin
- Paclitaxel
- Sorefenib
- Mercatopurine
These drugs are most often used in combination therapy, allowing for increased effectiveness of cancer treatment.
Disease monitoring
Monitoring the patient's condition after treatment for squamous cell carcinoma of the head and neck provides essential information about the progress of the disease:
- Control stages: regular check-ups with a doctor every three to five months during the first year, and then less frequently if the condition is stable.
- Prognosis: depends on the stage of the disease at the time of diagnosis and the response to treatment.
- Complications: possible relapses, metastases to other organs, as well as functional disorders due to removal of lymph nodes or tissues.
Long-term monitoring is particularly important for early detection of relapses and severe side effects.
Age-related features of the disease
Squamous cell carcinoma of the head and neck has its own age-related characteristics:
- In young people: Anomalies are associated with HPV, despite a favorable prognosis, requiring a special approach to treatment.
- In middle age: Most common morbidity associated with smoking and alcohol.
- In the elderly: Disease progression may be more aggressive due to comorbidity and decreased ability to respond to treatment.
Understanding the age-related characteristics of the disease helps in choosing a treatment method and prognosis.
Questions and Answers
- What are the most common symptoms of squamous cell cancer of the head and neck? The main symptoms of the disease include sore throat, difficulty swallowing and swelling in the neck area.
- How is this disease diagnosed? Diagnosis is based on clinical examination, biopsy and radiological results.
- What is the prognosis for patients with squamous cell carcinoma? Prognosis depends on the stage of the cancer at diagnosis and its response to treatment; the earlier the diagnosis, the better the outcome.
- What are the main treatment methods for this disease? Treatment may include surgery, chemotherapy, radiation therapy, and immunotherapy.
- Who is at risk for developing squamous cell cancer of the head and neck? The main risk factors are smoking, alcohol consumption and HPV infection.
Advice from Dr. Oleg Korzhikov
According to Dr. Oleg Korzhikov, one of the leading oncologists, it is important to understand that early diagnosis plays a key role in the successful treatment of squamous cell cancer of the head and neck. He recommends:
- Have regular medical check-ups, especially if you have risk factors.
- Quitting smoking and limiting alcohol consumption are the main methods of primary prevention.
- Eat a healthy diet rich in vitamins and minerals to strengthen your immune system.
- Consult a doctor if you experience any suspicious symptoms, such as a change in voice or the appearance of tumors.
The doctor also emphasizes the importance of psychological support for patients and their loved ones during the treatment process, which significantly improves the quality of life.
