Cancer of the upper aerodigestive tract. Basic principles and concepts

Historically, head and neck cancer has been more prevalent in men than women; however, more young women are smoking today than ever before and the incidence of such cancer in this group is increasing dramatically. In addition, use of smokeless tobacco is on the rise, especially among school-age children. The clinician should assume that any asymmetric cervical node in an adult patient contains metastatic cancer until proved otherwise. A proper head and neck evaluation should be performed before biopsy is considered. The type of treatment chosen depends on the disease stage, individual case, patient's desires, facilities available in the medical community, and advantages and disadvantages of each form of treatment--surgical dissection, irradiation, and chemotherapy. Follow-up care is of utmost importance because of the great likelihood that recurrent disease or metastases will develop and the high risk that a second metachronous primary carcinoma will occur. Stress should be placed on getting the patient to stop smoking.