Head and neck cancer: The 12 facts doctors wish you knew

Thursday, September 6, 2012

head and neck cancer graphic

More than 40,000 Americans are diagnosed with head and neck cancer annually.

According to the National Cancer Institute, more than 40,000 Americans are diagnosed with head and neck cancer annually.

The Comprehensive Head and Neck Cancer Program at Baylor All Saints Medical Center in Fort Worth treats patients with all stages of head and neck cancers. The program’s primary focus is the development and implementation of strategies to detect and treat cancers of the head and neck.

Yadro Ducic, MD., who has 16 years of experience in otolaryngology, plastic surgery and plastic reconstructive surgery, discusses head-and-neck cancers, including cancer of the tonsils, which has been linked to human papilloma virus (HPV).

  1. What are the more common types of head-and-neck cancers? Squamous cell cancers are the most common type seen arising from the lining tissues of the mouth and throat. (The squamous cells line the moist surfaces inside the head and neck.) Thyroid cancers are very common especially in women. Skin cancers are prevalent in Texas due to excessive sun exposure.
  2. What are the typical symptoms of head-and-neck cancer? Are these difficult cancers to detect? Most can be detected with a thorough head and neck exam by a head and neck surgeon. Common symptoms are a painless persistent neck lump, new difficulty swallowing, change in voice or painful ulcer. Any persistent symptom more than two weeks in duration should be evaluated.
  3. Is the incidence of head-and-neck cancers decreasing or are you seeing more cases? Incidence of oral cancers is decreasing as tobacco use continues to decline. Tonsil cancer incidence is increasing due to the effect of increasing prevalence of papilloma carrier states.
  4. What role does use of alcohol and nicotine products play in this type of cancer? Ninety percent (90%) of patients with squamous cell cancers have one or both of these two risk factors. Each of those two factors increases the incidence of squamous cell cancer by a factor or 400-600 percent.
  5. Is there a connection to the human papillomavirus (HPV) in certain types of head-and-neck cancers? Which cancers? Yes. It appears most prevalent in oropharynx and tonsil cancers. These patients appear to have a more favorable prognosis than patients with smoking or alcohol derived squamous cell cancers.
  6. How is head-and-neck cancer treated? It depends on the size and location. Mainstays of treatment are surgery and radiation. Chemotherapy may be a useful adjunct in certain selected cases.
  7. What are the one or two facts you wish more people knew about head-and-neck cancers? If you have a persistent symptom in the head and neck region see a head and neck surgeon for evaluation. Don’t smoke or use smokeless tobacco products or drink.  Immunize your children for HPV to hopefully decrease their chances of developing squamous cell cancers down the road.
  8. Are there promising clinical trials for a vaccine or trials to improve treatments?  Are any of these trials occurring in North Texas? Vaccine trials are at a nascent stage for squamous cell cancer and have not been very promising to date.
  9. If a parent or sibling had a head-and-neck cancer, is another family member genetically predisposed to that cancer? Except for certain thyroid cancers there is no family predisposition. However, smoking and alcohol use do run in families and thus risk may be increased in certain families of developing these cancers.
  10. What is the recovering rate from head-and-neck cancers? It varies based on treatment and stage of disease. Recovery may range from being fairly easy with a full return to function to a life changing situation with significant changes in ability to speak and swallow. Early diagnosis and treatment generally leads to improved outcomes.
  11. Are there typical disabilities for people who recover from head-and-neck cancer? A major one is alterations in swallowing function that may be life long. Working with a dedicated and experienced speech therapist is critical in optimizing recovery.
  12. Where can I learn more about head-neck cancers?  The American Academy of Otolaryngology Head and Neck Surgery is a good resource.

This blog post was contributed Susan Hall, marketing and public relations manager, Baylor Health Care System.

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