Dr. Manish Julaha

Causes and symptoms of Head and Neck Cancer

My name is Dr. Manish Julaha and I practice Head & Neck Oncosurgery. Today I'll tell you some facts about Head and Neck cancer how to predict them early. So in India approxiately 1.2 million cancer patients are detected every year, and out of this one thirds of the number occur in head and neck, mainly oral cavity and throat. And this is a very big number if you compare with rest of the countries because head and neck cancer they account for less than 10% in western countries and less than 4% in U.S. So what is the cause of such high number of head and neck cancers in India. It is mainly the use of tobacco and another sad fact about head and neck cancer in India is that majority of the patients, you can say more than 65% are present in stage 3 or stage 4. And we say cancer is curable if it is detected early and when patients presents to us in such late stages it effects all the paramaeters like overall survival, treatment outcome, side effects, functional outcome, quality of life everything is affected. And when patients come in early stage, the treatment is less invasive with less side effects and the functional outcome is very good and the chances of recurrence is very less.

So what can we do to detect head and neck cancer at the earliest. We can do this if we've the knowledge of the signs and symptoms which hint towards the head and neck cancer and by doing self examination. So what are the early signs and symptoms. They're mainly any ulcer in the oral cavity which dosen't heal in three weaks or any lump in the lung or oral cavity, any red or white patches in the oral cavity, or there maybe unexplained earache or nasal blockage, mainly on one side, specially with blood stained mucous discharge, ill fitting of denture because of any swelling in the gums. So, these are the early signs and symptoms. If we find any such thing we should take expert opinion. And by doing self examination we can detect head and neck cancer at the earliest. I would say all those people who're at a high risk of getting head and neck cancer they should do the self examination at least once a month. So who're the people who're at high risk of getting head and neck cancer. Most importantly those who use tobacco in any form, then elderly people above the age of 45 and people who have exposure to ionizing radiation in past, and people who have had head and neck cancer in the past they're at high risk of getting a second cancer so they should also be very careful.

Now, how to do this self examination. It is very simple, to do this you've to stand in front of the mirror and you've to feel both the lips, upper lips and lower lips, using your thumb and index finger feel both the lips and by pulling them outward you've to see the inner lining of the upper lip and lower lip and also you have to look at the upper gums and lower gums. And using your thumb and index finger pull your cheek and look at the inner lining of your cheek on both sides and look for any ulcer or lump or any red or white patches. Now just open your mouth and say "aaa" and while saying "aaa" just look at the throat and also at the roof of the mouth. Then by touching your tongue on the back of upper teeth have a look at the under surface of the tongue and the floor of mouth. Then pull your tongue outward and look at it's upper surface, by moving the sideways look at the sides also. Again look for any ulcer or lumps or any red or white patches and you have to examine your neck also. Just by standing straight palpate below the jaw bone and above the collar bones, and by moving the head backwards look for any asymmetry of the neck, if there is any fullness on one side as compared to the other side, there maybe some lump. If you find any such thing just take expert opinion.

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A nose bleed can take place due to a number of reasons, which usually all boil down to acute dryness of the nasal passages. The nosebleed and dryness can stem from sinus, allergic reactions, constant blowing of the nose, infections, and also during very harsh winter months when there is no lubrication in the nose. Nose bleed can also occur due to conditions, such as high blood pressure and when a foreign object gets stuck inside the nose.

Here are a few tips on treating nosebleeds:

1. First step: The very first action when you experience a nose bleed should be to sit down. Once you are sitting, you should firmly pinch the spot that is soft. This lies just above the nostril. Do this for at least ten to fifteen minutes. The trick is to stay upright rather than lying down as this will bring down the blood pressure in the nasal blood vessels to stop further bleeding.
2. Breathe: Breathe with your mouth as you lean forward to help in draining the blood into your nose, rather than out of it or towards the throat.
3. Ice compress: Find a bag of frozen corn or peas in your freezer or an ice pack, and press this firmly against the nose to help in stemming the bleeding. As you are doing so, do not forget to cover the bridge of your nose with a towel so that it prevents you from catching a cold.
4. Medication and side effects: If you are on any kind of anticoagulants that end up thinning the blood, then you may immediately want to see your doctor about a possible side effects and a change in the medication. This could also be an effect of haemophilia where the bleeding does not stop.
5. Children: If a child who is under the age of two years suffers from such nosebleeds, then you will need to rush him or her to the doctor immediately as it could point at a more serious problem.
6. Anaemia (learn more about Anaemia and how it affects the health): Nose bleeds could also suggest the presence of anaemia, so you may want to see your doctor about lab tests to determine and possibly rule out this cause. You can also start medication accordingly for this kind of an ailment.
7. Nasal Packing: The doctor can carry out this procedure with the help of gauze that can seal the spot where the bleeding is happening.
8. Cautery: This is a minor procedure that involves burning the blood vessel that is causing the persistent bleeding with a stick of silver nitrate. The stick will be inserted after local anaesthesia is administered to the patient.

You must see a doctor for severe and prolonged bleeding.

Dizziness or vertigo is a feeling of being off centre, which makes a patient feel like there is lack of balance. This is especially apparent when one is at a height or while wearing footwear with high heels. It may be caused due to a variety of causes, and ear problems are one of the primary causes of this kind of dizziness.

Let us take a look at the various ear problems and how they can cause dizziness or vertigo:

1. Infection: The bacteria or virus that causes cold and loose motions can also cause an ear infection. This can give rise to temporary vertigo which may last up to six weeks or more. Dizziness or vertigo happens in such cases because the viral effect spreads to the inner ear which causes a ringing and off balance sensation. The general physician or ENT specialist will usually prescribe a round of medicines only if the condition becomes too severe to handle.
2. Benign Paroxysmal Positional Vertigo: This kind of dizziness is also known as BPPV and may be caused due to the motion of a calcium particle known as otolith, in the ear. This can cause a fluttering movement that gives the sensation of falling down or losing balance. This usually takes place in the part of the ear that catches the sensation of gravity. The movement of the otolith can make the patient feel as if his or her head is turning or swaying, while in reality the patient may be stationery. This problem can be fixed with the help of a two minute therapy known as Epley Manoeuvre, which can be conducted easily in the ENT specialist's clinic.
3. Meniere's Disease: There is actually a specific condition that is characterised primarily by dizzy spells and vertigo. The other symptoms of this ear bone condition include ringing of the ears, loss of hearing, and the feeling of fullness or pressure build up in the ears. This can be fixed with therapy and drugs as well as hearing loss aids.
4. Dandy's Syndrome: This is an ear condition where the patient constantly feels like he or she is bouncing up and down. This condition hits patients who are on antibiotic medication for any kind of infection, and it subsides once the medication is done with. It occurs in such cases because certain kinds of antibiotics may be toxic for the ear. One may also see natural improvement in the condition over the passage of time.
5. Tumours: Other reasons like tumours and strokes can also cause vertigo on a temporary or permanent basis.

Dizziness due to ear problems can be due to a number of mild to severe reasons. It is best to get these causes checked.

Loss or impairment of hearing can happen due to a variety of causes and may be temporary or permanent in nature, depending on the type and severity of the condition. One of the most common causes of hearing impairment is age. The degeneration of one's vital organs and senses becomes a reality for many people as the advancement of age happens, and the delicate insides of the ears are no different. Noise pollution, injury to the ear drum or any other part of the ear, as well as the movement of particles inside are only a few of the many reasons for loss of hearing. One of the many ways of dealing with long term hearing impairment is by using a hearing aid.

Read on to know how you can regain your hearing with hearing aids:

1. Long Forgotten Sound: A hearing aid will help you reacquaint yourself with long forgotten and subtle sounds that you may not have been able to hear for a long time. Many times, this kind of impairment also makes us forget to notice the fact that we do not hear so many normal sounds in our everyday lives - sounds that we probably did not notice even earlier. This may include the whirring of a fan, the whoosh of the air, the pitter patter of pets' feet and so much more. A hearing aid will help in bringing about an adjustment to these sounds that you will actually end up discovering again.
2. Technicalities: The hearing aid basically works by letting your hearing and ears readjust to the various volumes, intensity and vibrations that one feels when different sounds reach the ears. This helps in hearing better.
3. Amplification: A hearing aid is basically an electroacoustic device that fits in neatly behind your ear where it is tucked away from plain sight. This device helps in amplifying sounds so that you can catch them and hear them more clearly.
4. Modulation: The ENT specialist will usually prescribe a certain kind of hearing aid based on your individual condition in terms of volume, size, power and circulation. These factors help in modulating the sounds in a certain way so that they reach the nerve pathways from the inner ear and travel to the brain in a proper and effective way. This is usually done in a customised way to cater to the specific type and cause of your hearing loss.

Using a hearing aid is a matter of retraining your hearing rather than restoring it completely. These aids will be helpful in regaining a better sense of hearing within the condition you are going through, rather than reversing the condition completely.