What is a neck tumour?

A neck tumour is the name given to a variety of cancers of the head and neck area. In addition to a pharyngeal carcinoma, a laryngeal or laryngeal carcinoma as well as other forms of oral cavity carcinoma also belong to the neck tumour. All these forms of throat tumours have in common that they remain asymptomatic for a long time and are therefore usually diagnosed quite late. Malignant neck tumours, which are caused by the degeneration of normal cells into malignant tumours, are the most common type of cancer worldwide, affecting more than 15,000 patients in Germany alone every year. At the time of diagnosis, the neck tumour is often already in an advanced stage in most patients.

What causes a neck tumour?

The most common causes for the development of neck tumours include alcohol abuse and nicotine consumption. Some studies have also been able to detect human papilloma viruses (HPV) in the samples of tumour tissue from a neck tumour, which is why doctors assume that papilloma viruses can also be held responsible for the development of neck tumours. Since HP viruses are sexually transmitted infectious agents, they can enter the mouth and throat through oral sex, for example. According to studies, engaging in oral sex can increase the risk of throat tumours by a factor of 4.4.

How can a throat tumour be prevented?

To reduce the risk of developing throat tumours, smoking should only be done in moderation and alcohol consumption should be limited. Eliminating these risk factors helps cancer patients in particular to prevent the tumour from forming again (recurrences). Vaccination can help against infection with human papilloma viruses (HPV).

In which areas do neck tumours form?

Neck tumours form mainly in the following places:

• in the larynx area, called the larynx, including the vocal cords (glottis),
• in the oral cavity, including the tongue, the floor of the mouth, the hard palate, the mucous membrane of the cheeks and the ridges of the jaw,
• the oropharynx, which includes the posterior and lateral pharyngeal walls, the base of the tongue, the tonsils and the soft palate,

Neck tumours are less often found in the nasopharynx, the nasal cavity and the paranasal sinuses, as well as the lowest part of the throat (hypopharynx) and the salivary glands.

What are the symptoms of neck tumours?

Neck tumours are asymptomatic for a long time. If there is a carcinoma of the oral cavity, the mucous membrane of the mouth may turn whitish. This is called leukoplakia, which is a precancerous condition. The white to reddish-white coating in the mucous membranes of the mouth cannot be rubbed off. Only in the advanced stage can throat tumours cause the following symptoms:

• Hoarseness,
• Coughing,
• Difficulty swallowing

Voice changes can also be an indication of a possible tumour. If hoarseness and/or chronic swallowing difficulties persist for weeks, a doctor should be consulted in any case, as this may be a throat tumour. If there is a functional disorder of the eustachian tube due to an inflamed mucous membrane (tubal middle ear catarrh), ear pain, hearing loss and/or blocked nasal breathing may also occur.

How is a neck tumour diagnosed?

A neck tumour is diagnosed by imaging. In most cases, the mouth, throat and larynx are examined endoscopically, i.e. through a probe. By means of endoscopy, the larynx and also the vocal cords can be examined for changes.

If the examination leads to the suspicion of a possible tumour, a magnetic resonance imaging (MRI) or a computer tomography (CT) can also be ordered. To determine the stage of the tumour, a tissue sample must be taken for a biopsy. If it is found that the disease is already far advanced, the lungs, the so-called thorax, as well as the abdomen should be examined in order to exclude metastases or to detect them at an early stage.

What stages can a neck tumour be divided into?

A neck tumour is classified into different stages depending on the size and location of the primary tumour (T), the presence and number of neck lymph node metastases (N) and any distant metastases (M). The staging is based on imaging techniques such as an MRI, CT or positron emission tomography ( PET).

How is a neck tumour treated?

Because neck tumours are close to vital structures in the head and neck area, they are always treated in an interdisciplinary way. This means that many experts may be involved in the treatment of neck tumours, such as:

• Oncologists (specialist in cancer),
• Ear, nose and throat specialists,
• Head and neck surgeons,
• Psychooncologists (responsible for the psychological care of cancer patients),
• Dentists

The first treatment approach for a neck tumour is primarily the surgical removal of the so-called primary tumour. However, multimodal therapy approaches are often used. In addition to surgery, chemotherapy is also ordered, for example. In this way, even advanced neck tumours that are limited to the head and neck area can be completely cured in 30 to 40 percent of all cases.

If the neck tumour has already metastasised, a cure is no longer possible. In this case, the neck tumour is treated palliatively. This means that the growth of metastases should be slowed down and the patient's quality of life increased. Modern immunotherapies or chemotherapy can be used for this purpose.

What is the prognosis for a neck tumour?

The chances of a cure for a neck tumour depend on the stage and location of the tumour. The more advanced the tumour, the worse the patient's chances of recovery. If the neck tumour has already metastasised, a cure is no longer possible. If the neck tumour is diagnosed and treated at an early stage, the prognosis is favourable.