Cancer of the head and neck is the fifth most common cancer in the United States. The head and neck includes the mouth, tongue, nose, nasopharynx, sinuses, pharynx, tonsils, and larynx. The most common cancer site in the head and neck is the larynx or voice box. This accounts for about a quarter of all head and neck cancers. The greatest risk factor for head and neck cancer is smoking; however, cancer of the larynx increasingly is being reported in patients who were lifetime nonsmokers.
As previously discussed, reflux can affect the larynx (see Question 52). Long-standing acid damage to the larynx causes inflammation of the cells lining the larynx. Repeated damage and healing causes these cells to die off and reproduce themselves at a faster rate than normal. Because of this faster turnover of cells, there is a greater risk of damage to the DNA (the genetic code within the cells), which allows cells to become more and more abnormal as they reproduce and ultimately results in cancer. Signs and symptoms of laryngeal cancer are a long-standing sore throat or voice changes such as hoarseness. A doctor specializing in diseases of the ears, nose, and throat, an ENT doctor, usually makes the diagnosis.
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