Head and Neck Cancer

  1. Introduction
  2. I was recently diagnosed with head and neck cancer
  3. What are the Treatment Options
  4. I was already treated – now what should I do?
  5. Clinical Trials
  6. Links to our favorite web sites

Introduction:
Cancer of the Head and Neck includes several different tumors occurring in the aero-digestive tract that extends from the lips to the vocal cords.  The treatment for head and neck cancer varies according to the size of the cancer, the number of lymph nodes that are involved, the extent to which the cancer has spread to other parts of the body, the particular location, and cell type of the tumor. 

Types of Head and Neck Cancer

  • Ethmoid Sinus Tumors
  • Maxillary Sinus Tumors
  • Salivary Gland Tumors
  • Cancer of the Lip
  • Cancer of the Oral Cavity
  • Cancer of the Oropharynx
  • Cancer of the Hypopharynx
  • Cancer of the Glottic Larynx
  • Cancer of the Supraglottic Larynx
  • Cancer of the Nasopharynx
  • Other: lymphoma, sarcoma, melanoma, occult primary

How common is head and neck cancer in the United States?
Head and neck cancer accounts for about 3% of new cancer cases in the United States each year.  There were approximately 47,560 new cases estimated to occur in 2008 in the US. 

How common is head and neck cancer in the worldwide?
Worldwide there are approximately 500,000 new cases each year. Head and neck cancer is the fifth most common cancer worldwide and is the most common neoplasm in central Asia.

Is head and neck cancer equally common among men and women?
Men are affected significantly more than women with a ratio ranging from 2:1 to 4:1.

What are the Risk Factors for Head and Neck Cancer?
Alcohol and tobacco abuse are the most common risk factors in the US.  Moreover, patients who develop head and neck cancer as a result of alcohol and tobacco are also at a significant risk for developing other cancers, even after the original cancer is successfully treated.  The second cancer may occur again in the head and neck, or in another site, like the lung, or esophagus.
Human papilloma virus (HPV) infection is another risk factor for head and neck cancer. 

What is Human papilloma virus (HPV)?
Human papillomavirus (HPV) infection is the most commonly diagnosed sexually transmitted disease in the United States. It is associated with condyloma acuminatum (genital warts), squamous intraepithelial lesions (pre-cancerous lesions on the cervix) and even cancers such as: cervical, vaginal, vulval, penile, and anal cancer. 
Recent studies suggest that HPV is an important cause of head and neck cancer in patients who do not use tobacco or alcohol. 

Are other viruses associated with head and neck cancer?
Yes, there is a very strong association between HNC and the Epstein-Barr virus (EBV).  In particular, EBV is associated with nasopharyngeal carcinoma (NPC).   Nasopharyngeal cancer is a relatively rare malignancy in the United States, but is one of the most common cancers in southern China.
Also, human immunodeficiency virus (HIV) is associated with a variety of malignancies. In particular lymphomas of the head and neck occur with increased frequency, and oral cavity cancers have been described in selected patients

I’ve heard the Betel Nut Chewing is also associated with Head and Neck Cancer?
Betel nut chewing, which is widespread in certain regions of Asia, is an independent risk factor for the development of squamous cell HNC.  It is particularly important when combined with tobacco and alcohol. Betel nut chewing may also be related to the development of liver and esophageal cancer.

Treatment options:

  1. Surgery
  2. Radiation
  3. Combination of surgery, radiation therapy, and chemotherapy (or targeted agent)
  4. Combination of radiation therapy and chemotherapy (or targeted agent) only

Treatment using chemotherapy and radiation therapy in combination, can often be very effective and help many patients avoid surgery (this is also called an organ-preservation protocol).

If the tumor is not completely eliminated by chemotherapy and radiation therapy, the patient may still require surgery.

Treatment for head and neck cancer is complex and requires aggressive support.

 

Dental care is also of utmost importance for patients receiving radiation therapy. 

If radiation therapy is anticipated, SEE YOUR DENTIST AS SOON AS POSSIBLE.
If any procedures are required, it may result in the delay of the start of your radiation therapy. For more information about how to prepare for Radiation Therapy please follow this link to Maxillofacial Surgery.

 

Many patients require insertion of a feeding tube called a PEG tube.

  • This tube is normally inserted into your stomach with the assistance of endoscopy by a gastroenterologist in the department of gastroenterology.
  • Sometimes this is performed by our radiologist.

Head and Neck Tumor Board:
We also have a head and neck cancer tumor board.

The following specialists are present for discussion of complex cases:

  • head and neck surgeons
  • radiation oncologists
  • medical oncologists
  • radiologists
  • pathologists
  • and other specialists

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