Ear cancer most often develops in the outer skin of the ear, though there are a few cases of cancer found in the inner ear.
Melanomas and carcinomas are the two categories of cancer that can affect the ear. Squamous cell carcinomas that arise in the outer region of the ear are more common, but basal cell carcinomas as well as malignant melanomas arising in the inner or middle ear also occur.
Middle, outer, and inner ear are the three different regions of the ear. The middle part of the ear is a tiny cavity with three little bones; this region allows vibrations to pass from the eardrum up to the inner ear. The inner ear comprises fluid and the cochlea (tiny spiral tube). The minute nerves present in the cochlea convert vibrations into impulses, which then travel up to the brain. The cavities in the inner ear are filled with fluid that helps in maintaining balance.
Symptoms of Outer Ear Cancer
Ear cancers mostly develop in the outer skin. About 5% of skin cancers develop in the ear. An inflamed spot or sore that persists for more than 4 weeks is the primary symptom for outer ear cancer.
Sores that bleed or become ulcers could be some early signs of cancer. Moles that show changes like growth, itchy feeling, and bleeding need to be examined. The upper edge of the outer ear may show uneven or ragged structures with bleeding and crusting. These however may be harmless and may prolong for years.
Symptoms of Middle and Inner Ear Cancer
Inner ear cancers are very uncommon; according to researchers, less than one million people in the UK develop cancer in the middle ear. Ear cancer symptoms rely upon the location of the tumor in the ear. Discharge from the inner ear that is blood-stained is a typical symptom for middle ear cancer.
Some other symptoms include
- Inability to move the face on the affected side of ear
- Earache—pain inside the ear
- Hearing loss
- Swelling in lymph nodes of the neck
- Dizziness and light headedness.
Compared to adults, children are more prone to infections in the ear. It is necessary to have a specialist examine the nasopharynx in people who develop infections in the ear for the first time. The physician must check for upper lung infection along with the ear infection. Tumors in the ear may be benign or malignant as in squamous cell cancer. Growth of these tumors is slow, so plenty of time is available for diagnosis and treatment.
Symptoms Based on Type of Ear Cancer
- Basal cell cancer: this type of cancer mostly develops over the face and then spreads to the ear. Ulcers appear as bead-edged and raised and do not heal for a very long time. The ulcer, which may appear to be hard with a crust, bleeds when touched. In other cases, ear cancer looks nodular and hard. Basal cell cancer which is aggressive can distort the whole outer ear. Cancers in the basal cell are different from others in that they do not metastasize, but are found to be locally spread and lead to damage to tissues.
- Squamous cell cancers: The structure of the cancer that appears in the squamous cell has the appearance of a cauliflower or as an ulcer. These ulcers are attached at the bottom to tissues. The cancer cells spread to the nearby lymph nodes, through blood, and may even extend to the temporal bone.
- Malignant melanomas: These normally originate from an existing mole that changes from brown to black color and rapidly grows in size with an uneven border. It may also occur as a blistered ulcer. This cancer may expand to nearby tissues in the form of skip and satellite lesions surrounding the primary cancer. They also spread through the lymphatic system and the blood.
- Adenoidcystic carcinomas: This cancer develops in the external ear canal. It is a rare cancer characterized by slow growth. Adenoid cystic carcinomas appear inappropriately located in the ear and originate from the sweat glands, tissues of salivary glands, and also from the gland secreting earwax. Hearing loss, weakness in facial muscles, tinnitus, and acute pain are some of the symptoms. The tissues grow abnormally, and ulcer and swelling may occur. Sometimes, blood or thick yellowish pus may ooze from the affected ear. This cancer may metastasize locally to the salivary glands, bone, lymph nodes, or soft tissues, or even to the distant liver and lung.
- Ceruminous adenocarcinoma: This is another type of ear cancer that develops in the glands that secrete ear-wax. It normally spreads in the nearby areas. The most typical symptoms include earache and hearing problems like otalgia. The facial nerves are influenced in this type of cancer, leading to paralysis of the facial nerves.
Reviewed by Afsaneh Khetrapal BSc (Hons)