April is head and neck cancer awareness month and is symbolized by a burgundy and white ribbon. This group of cancers can be divided into several groups:
*Laryngeal (Voice box)/lower throat cancer
*Oral cavity/mouth cancer
*Nasopharyngeal /upper throat cancer
*Nasal Cavity/ sinus cancer
*Salivary Gland cancer
In 2022, 54,000 new cases will be diagnosed and approximately 11,000 deaths. This cancer affects men two times more often than females. The number of new cases and death rates has recently seen an uptick (less than 1%) due to the increased number of cancer cases associated with Human Papilloma Virus, HPV, mostly seen in the Non-Hispanic white population.
As with other cancers, early detection leads to an increased cure rate. Some of the most common symptoms that one may experience are: persistent cough, changes in voice quality, difficulty swallowing or breathing, white and/or red oral patches, ear pain, nonhealing or bleeding throat sore or lump, neck mass, and unexplained weight loss. These symptoms are very nonspecific and may be associated with non-cancerous diagnoses.
The most common causes of a head and neck cancer include tobacco use especially if mixed with alcohol consumption. Also on the rise is infection with the human papillomavirus infection (often seen in people who have this diagnosis and were never smokers). Gastric reflux and a diet low in fruits and vegetables are also contributory to causing this disease.
A monthly self-oral exam can help in early detection. This would include looking for white or red patches. Be sure to examine your mouth with all dentures removed, and check in front and behind the gums as well as the roof and floor of the mouth. Look at all surfaces of your tongue. Also, check your neck for any enlarged glands or masses.
Treatment for these cancers is very effective. HPV-related cancers have a better outcome than those associated with tobacco. In the early stages, surgical resection with or without neck dissection is often curative. Radiation Therapy may be given following surgery depending on findings on the final pathology report. More advanced cancers are treated with combined radiation and chemotherapy rather than surgery to try to preserve swallowing or speech. Combination treatment can be quite challenging causing severe sore throat and an inability to swallow. A feeding tube is placed in order to keep nutrition up. Those patients who are well-nourished often do better and have less severe side effects. Special care for dentition is also required with a fluoride tray and removal of any rotten or loose teeth prior to starting radiation.
Eliminating tobacco use, both smoking and chewing as well as an improved diet will help decrease the incidence of head and neck cancers as well as continue to decrease the mortality from these types of cancers.