The most frequent etiology of head neoplasms is noncancerous. Brain tumors are found more frequently among older adults than younger children, and the elderly group has the highest risk of cancer. Other age groups have a lower probability of cancer.
The prevalence of CNS-HNs appears to be between 4.3 and 8.1 per million per year in different geographical regions of the world, and with increasing age the prevalence increases. Most of the data for North America was collected in Toronto where neurosurgical oncology residency programs are established and where there was a higher incidence of patients with head or CNS tumors. We believe there is a regional variation not because of demographic but because patients of different risk factors are managed differently. Neurosurgical oncology training programs need a better understanding of the epidemiology of CNS-HNs and greater participation of primary care in the diagnosis and management of these neoplasms.
For recurrent or metastatic head neoplasms, the treatment protocol is basically the same as that for newly diagnosed tumors. Postoperative local irradiation or chemotherapy with temozolomide can significantly reduce the tumor growth. Intratumoral chemotherapy can also be employed to stop tumor growth in cases of the residual tumors or in case of recurred or metastatic tumors with a relatively better response to chemotherapy. Radiation therapy in the combination with chemotherapy should be considered for advanced or recurrent squamous cell carcinoma or mucoepidermoid carcinoma in an attempt to improve the local control rate and the probability of local remission.
Most head neoplasms are related to tobacco use, with a small number of head neoplasms being associated with alcohol. These data provide a basis to evaluate the risk of cancer of the head in smokers with alcohol consumption. A randomized clinical trial is therefore warranted to assess the optimal approach to prevention of head neoplasms in the U.S. population.
The most common treatment for head neoplasms is surgical resection of the tumor. Other treatments include embolization of tumors, radiation therapy (for prophylactic or adjuvant treatment of brain tumors, such cancer being the most common type of cancer), chemotherapy and anti-angiogenic drugs. Chemotherapy is often more effective than radiation treatment, as radiation doesn't penetrate to the tumors within the brain.
Symptoms of head neoplasms can be divided into those due to mass effect and compression by brain tissue and those caused by systemic effects. Signs and symptoms of brain cancer including headache, dizziness, visual disturbances, seizures and weakness can all be secondary to various causes. The diagnosis of brain cancer can be complicated by other neurological conditions. A history of seizures, head trauma or recent head surgery are highly suggestive, and other neurological conditions should be considered. The examination may identify symptoms attributable to compression of the cranial nerves.
Head and neck cancer presents with higher mortality rates than other cancers, and the five-year survival decreases gradually every year. The survival rate also differs based on the nature and location of the tumor and its stage. The location, size, and type of the head and neck cancer are key factors in determining survival. Injuries, mostly from bicycle accidents, threaten the survival of many patients from these tumors, and consequently are a frequent cause of death among them.
This meta-analysis indicates that IMRT provides a survival benefit regardless of the degree of risk associated with treatment. As the treatment intensities were comparable and no significant dose variations were found in this meta-analysis, an increase in PBI may be due to the IMRT effect on overall survival (i.e. more patients survive with IMRT than with placebo). The analysis included a wide variance in treatment intensity, making the results not generalizable, but the heterogeneity implies that the PBI effect might be more pronounced for a higher BED.
IMRT achieves high local control rates in selected patients. IMRT is frequently used in conjunction with other modes of radiation therapy, including TPA, chemotherapy, surgery, and endovascular treatments when indicated.
The authors concluded a statistically significant improvement in QOL was evident and a greater number of respondents felt they could enjoy life and engage in everyday activities when compared with conventional radiation therapy using IMRT.
In the authors' experience, IMSRT is a safe technique for managing head and neck cancer and may prove beneficial in appropriately selected patients, providing the necessary dose of radiation is delivered.
While head neoplasms are not life-threatening, these tumors can recur even when they are removed early. In order to prevent recurrence, it is important to seek treatment early and aggressively. The best way to get rid of the tumor is with surgery or head radiation. This has been in use since before the 20th century. Today, medical devices such as neurofibromatosis gene therapy can help target a mutated tumor that will otherwise keep growing. The future will have more advanced medical technology to help treat head neoplasms. When head neoplasms do form, seek the help of a physician right away.