With the recent unfortunate loss of film critic Roger Ebert and media reports of actor Michael Douglas’ battle with cancer, the rare but potentially devastating group of head and neck cancers has received much needed attention.
Cancers of the head and neck are categorized by the area in which they originate: the oral cavity or tongue; the throat (pharynx); voicebox (larynx) and the sinuses or nasal cavity. Cancer can also begin in the salivary or thyroid glands—although these cancers are technically different, they often are included because the damage can occur in the head and neck.
Head and neck cancers usually begin in cells that line mucosal surfaces inside our mouth, nose and throat, referred to as squamous cell cancers.
They commonly present with a sore that is not healing, lump in the neck—due to persistently enlarged lymph nodes, a painful throat that does not go away and difficulty in swallowing or change in voice quality. It is important to note that these symptoms may also be caused by less serious conditions such as acid reflux (GERD).
Alcohol and tobacco use are the most important and preventable risk factors for head and neck cancers. Infection with human papillomavirus (HPV), especially HPV-16, is a recently identified risk factor for cancers that involve the tonsils or base of tongue (oropharynx). In the United States, the incidence of oropharyngeal cancers caused by HPV is increasing. It is hoped but not yet known whether adoption of HPV vaccines for young boys and girls will eventually translate to decreased incidence.
Treatment plans depend on a number of factors, including location of tumor, stage of cancer (based on imaging results) and a person’s general health condition. Treatment can include a combination of surgery, radiation therapy and chemotherapy. Treatment will often affect the patient’s ability to chew, swallow or talk. It is therefore very important that treatment be delivered in a multi-disciplinary setting which includes reconstructive surgery, dental care, speech and swallow therapy, physical therapy, social work and nutrition. Due to vital organs involved in that region, head and neck cancers along with toxicity from their rigorous treatment can have a profound impact on affected patients and their loved ones. Research is ongoing to improve treatment options and also to address long-term side-effects of treatment.
Getting treated for any cancer involves making many choices. Always learn as much as you can about your options and ask lots of questions. Questions to ask your doctor are
- What are downsides to this treatment.
- Will this treatment cure my cancer? Help me live longer? Reduce symptoms?
- Are there other options?
- Doctor, what would you do if you or a family member were in this situation?
If you have symptoms, it’s important to see your doctor as soon as possible. When detected early enough, many cancers are treatable. If you would like more information about head and neck cancer, please visit URMC Head and Neck Cancer or URMC Cancer.
Mohamedtaki A. Tejani, M.D., is senior instructor in the Hematology/Oncology division at the University of Rochester Medical Center. He attended Dartmouth Medical School and trained at Yale-New Haven Medical Center and Fox Chase Cancer Center. Dr. Tejani’s clinical experience and areas of interest include gastrointestinal cancers, head and neck cancers and communication. Dr. Tejani firmly believes that patient care is a privilege. Listening and responding to a patient’s unique story is critical in helping that family on their cancer journey.