Head and Neck Cancer
What is Head and Neck Cancer?
The term “head and neck cancer” describes a number of different cancers that develop in or around the throat, larynx, sinuses, and mouth. When healthy cells in these areas change and grow out of control, they form a mass known as a tumor. Many of these tumors start in flat squamous cells that form the surface layer of tissue inside the head and neck.
What are the types of Head and Neck Cancer?
Head and neck cancers are classified according to their anatomic location and also by the specific cell type that the cancer starts in. The most common type of head and neck cancer is called squamous cell carcinoma. Other forms of head and neck cancer include lymphoma, adenocarcinoma, mucoepidermoid carcinoma and mucosal melanoma.
How are Head and Neck Cancers treated?
Treatment of head and neck cancer depends on the tumor type, stage, treatment side effects, patient preference and overall health. The main treatment options include surgery, radiation, chemotherapy and immunotherapy. Often a combination of these treatment options is used. In some cases, radiation and chemotherapy are given instead of surgery depending on the location and type of the cancer.
How are Head and Neck patients followed after treatment?
In keeping with current guidelines, head and neck cancer patients are seen at regular intervals for at least five years after completing treatment. This is done mainly to detect cancer recurrence. Because treatment can affect important structures which impact speech, swallowing and breathing, it will be important to follow up with your doctor to address issues which can occur over time.
I am worried that I have Head and Neck Cancer, what do I do?
If you develop signs or symptoms that make you concerned about head and neck cancer, contact our team at Endeavor Health Advanced Neurosciences Center to make an appointment with our head and neck cancer specialists. When seeking evaluation for head and neck cancer, it is important to choose physicians who are specifically trained and focused on cancer.
Our team is made up of physicians who are experts in the diagnosis and treatment of all head and neck cancers. This expertise has been gained from rigorous fellowship training and from years of successfully treating a large number of cancer patients.
Hypopharyngeal Cancer
What causes Hypopharyngeal Cancer?
The most common risk factors for hypopharyngeal cancer include tobacco and alcohol consumption. When combined, these two risk factors significantly increase the risk of developing these cancers. In addition, poor nutrition may increase the risk of getting hypopharyngeal cancers. Plummer-Vinson syndrome causes people to have poor nutrition because of rings of thin tissue in the esophagus which make it hard to swallow; this syndrome is associated with increased risk of hypopharyngeal cancer.
How common is Hypopharyngeal Cancer?
According to the latest data, cancers of the hypopharynx are rare, with only 2000 to 4000 cases in the United States every year.
What are the signs and symptoms of Hypopharyngeal Cancer?
The most common symptoms of hypopharyngeal cancer include a persistent sore throat, ear pain on one side, a lump in the neck, difficulty swallowing, and a change in voice. If you develop any of these symptoms, contact our team at Endeavor Health Advanced Neurosciences Center to book an appointment with our head and neck cancer specialists.
How are Hypopharyngeal Cancers treated?
The main treatment options for hypopharyngeal cancers include surgery, radiation therapy and chemotherapy. The exact treatment regimen is decided between the doctors and patient and is dependent on tumor stage, side effects and patient preferences.
Laryngeal Cancer
What is the Larynx?
Also known as the voice box, the larynx is a structure within the neck that sits above the trachea. It makes it possible for you to make sounds and lets air pass from the throat to the trachea and lungs. The larynx is divided anatomically into three areas including the supraglottic (above the vocal cords), glottis (at the level of the vocal cords), and subglottic (below the vocal cords)
The larynx serves three important functions: breathing, speaking and swallowing. When cancer develops in the larynx, these functions can become impaired.
What causes Laryngeal Cancer?
As with most cancers of the mouth and throat, laryngeal cancer is most caused by tobacco and alcohol consumption. Smoke from cigarettes, pipes and cigars all increase the risk of developing laryngeal cancer. In a small proportion of cases, laryngeal cancer is caused by the human papillomavirus. Long and repeated exposure to wood dust, paint fumes and certain chemicals used in metalworking, construction and textile industries can increase the risk of laryngeal cancer.
How common is Laryngeal Cancer?
There will be approximately 12,500 new cases of laryngeal cancer diagnosed in the United States this year according to the American Cancer Society. The lifetime risk of getting laryngeal cancer is about 1 in 200 in men and 1 in 840 in women. Most people diagnosed with laryngeal cancer are 55 or older, and the average age at diagnosis is 66 years old.
What are the signs and symptoms of Laryngeal Cancer?
The most common symptoms of laryngeal cancer include persistent throat pain, difficulty swallowing, ear pain, coughing up blood, changes in voice and development of a neck lump. If you develop any of these symptoms, contact our team at Endeavor Health Advanced Neurosciences Center to book an appointment with our head and neck cancer specialists.
How are Laryngeal Cancers treated?
The three main treatment options for laryngeal cancers include surgery, radiation and chemotherapy. These treatment options can be used alone or in combination with each other, depending on the location, type and stage of the cancer. In cases of advanced laryngeal cancer, removal of the larynx (known as laryngectomy) is performed.
Nasopharyngeal Cancer
What is the Nasopharynx?
The nasopharynx is the upper part of the throat behind the nose and near the base of the skull. It is a box-shaped area and acts as a passageway for air traveling from the nose into the throat.
What causes Nasopharyngeal Cancer?
The most common type of cancer in the nasopharynx is termed nasopharyngeal carcinoma or “NPC,” of which there are several subtypes. A less common cancer in the nasopharynx is lymphoma because there is immune (lymphoid) tissue present in this area.
NPC is most common in certain regions of the world including Southeastern China, Singapore, Vietnam, and the Middle East. This is in part due to certain dietary habits in these areas including the consumption of high amounts of salt-cured fish and meat starting at a young age.
Infection with Epstein-Barr Virus (EBV) and human papilloma virus (HPV) are associated with NPC but the link is being actively studied. Newly diagnosed nasopharyngeal cancers are always tested to determine if they are related to EBV and/or HPV.
How common is Nasopharyngeal Cancer?
Nasopharyngeal cancer is rare, and in the United States there is less than one case diagnosed for every 100,000 people each year. Overall, cases of NPC have been decreasing over time due to environmental and lifestyle changes.
What are the signs and symptoms of Nasopharyngeal Cancer?
Most people with nasopharyngeal cancer notice a lump in their neck as the first sign of this disease, which is caused by the cancer spreading to the lymph nodes in the neck. Other symptoms that can be due to NPC, include hearing loss, recurrent ear infections on one side, nasal blockage, nosebleeds, headaches, facial pain or numbness. If you develop any of these symptoms, contact our team at Endeavor Health Advanced Neurosciences Center to book an appointment with our head and neck cancer specialists.
How is Nasopharyngeal Cancer treated?
Generally, the treatment of nasopharyngeal cancer includes either radiation alone or a combination of chemotherapy and radiation. In cases of recurrent cancer, where the cancer returns after being treated, surgery can be performed. Given the complexity of this surgery, this should only be performed by surgeons with extensive training and experience.
Oral Cavity Cancer
What is Oral Cavity Cancer?
The oral cavity (commonly referred to as the mouth) contains several structures which are key for speaking, eating and breathing. These include the tongue, the mandible (lower jaw), the maxilla (upper jaw), buccal mucosa (inside of the cheek) and the lips.
What causes Oral Cavity Cancer?
The most common causes of oral cavity cancer include tobacco, alcohol and betel nut consumption. These substances cause damage to the cells in the lining of the mouth and alter their ability to control growth. When this happens, the cells grow rapidly and uncontrolled, which leads to the development of a cancerous tumor.
How common is Oral Cavity Cancer?
There will be approximately 58,540 new cases of oral cavity and oropharyngeal cancer diagnosed in the United States this year according to the American Cancer Society. The average age of diagnosis is 64 years old, but up to 20% of cases occur in people younger than 55 years old.
What are the signs and symptoms of Oral Cavity Cancer?
The symptoms of oral cavity cancer can include painful sores in the mouth, recurrent bleeding from the mouth, bad breath, loose teeth or dentures that do not fit correctly, difficulty opening the mouth, numbness in the lower teeth or lips, and pain with swallowing. If you develop any of these symptoms, contact our team at Endeavor Health Advanced Neurosciences Center to book an appointment with our head and neck cancer specialists.
How is Oral Cavity Cancer treated?
Generally, oral cavity cancer is treated with surgery. The goal of surgery is to remove the tumor and some surrounding normal tissue (known as a margin). Removal of cancerous lymph nodes from the neck is commonly done during surgery as well which is called neck dissection. If the surgery is extensive, reconstructive surgery is often performed during the same operation to rebuild structures that were affected by the cancer.
Oropharyngeal Cancer
What is an Oropharynx?
The oropharynx is the part of the throat located at the very back of the mouth. The four subsites of the oropharynx are the tonsils, soft palate, base of tongue and posterior pharyngeal wall. The tonsils are the walnut-shaped structures located on either side of the oropharynx and are made up of tissue that helps fight infections. The base of tongue refers to the third of the tongue that is not visible when the mouth is open. The soft palate is the part of the roof of the mouth behind the hard palate. Finally, the posterior pharyngeal wall is the back wall of the oropharynx which is visible at the very back of the throat.
What causes Oropharyngeal cancer?
Previously the most common risk factors for developing oropharyngeal cancer were tobacco and alcohol consumption. However, the human papilloma virus (HPV) is now the most common cause of oropharyngeal cancer.
How common is Oropharyngeal cancer?
There will be approximately 58,540 new cases of oral cavity and oropharyngeal cancer diagnosed in the United States this year according to the American Cancer Society. The average age of diagnosis is 64 years old, but up to 20% of cases occur in people younger than 55 years old. The incidence (number of new cases) of oropharyngeal cancer has been increasing over time.
How is HPV related to Oropharyngeal cancer?
Up to 80% of newly diagnosed cases of oropharyngeal cancer in the United States are caused by HPV. Certain strains of the virus are more likely to cause cancer than others. Spouses or partners of patients with oropharyngeal cancer caused by HPV are not at a higher risk of developing this cancer themselves.
What about the HPV vaccine?
The HPV vaccine is recommended by the CDC as a routine vaccination for both males and females at age 11 or 12. It is also recommended to get vaccinated through age 26 years if not adequately vaccinated when younger.
It is important to know that HPV vaccination prevents new HPV infection but that it does not treat existing infections or HPV-related diseases.
What are the signs and symptoms of Oropharyngeal Cancer?
The most common symptoms of oropharyngeal cancer include difficulty swallowing, a sore throat which is persistent and not associated with an upper respiratory tract illness, a lump in the neck, bleeding from the mouth, muffled voice, unintentional weight loss and difficulty opening the mouth. If you develop any of these symptoms, contact our team at Endeavor Health Advanced Neurosciences Center to book an appointment with our head and neck cancer specialists.
How is Oropharyngeal Cancer treated?
Oropharyngeal cancer treatment has changed drastically over the past several years. While traditionally a combination of radiation and chemotherapy was used, surgery has become a more common treatment method with the advent of minimally invasive transoral robotic surgery (TORS). As always, treatment methods are often combined, and the final method chosen depends on each patient’s unique situation.
What is Transoral Robotic Surgery?
Transoral (TORS) allows surgeons to reach difficult areas with the help of cutting-edge robotic technology. The surgeon controls this sophisticated robot to remove tissue or tumor from the back of the tongue, the throat or tonsils through the mouth. This typically results in a faster recovery and fewer complications (such as bleeding, infection and trouble swallowing) compared to traditional open surgery, which requires incisions on the face and separation of the lower jawbone.
Transoral robotic surgery is performed by highly skilled, extensively trained head & neck surgical oncologists who have undergone specific credentialing to allow them to perform this type of minimally invasive surgery. If you have been diagnosed with oropharyngeal cancer and are interested in learning more about transoral robotic surgery, contact our team at Endeavor Health Advanced Neurosciences Center to book an appointment.
Salivary Gland Cancer
What causes Salivary Gland Cancer?
Both benign and malignant (or cancerous) tumors can grow in the salivary glands. The benign tumors include pleomorphic adenoma and Warthin’s tumors. There are several types of malignant salivary gland tumors including mucoepidermoid carcinoma, adenoid cystic carcinoma, acinic cell carcinoma and adenocarcinoma.
While most salivary gland cancers do not have a specific cause, there are certain risk factors which are associated with them. These include older age, exposure to radiation and smoking.
How common is Salivary Gland Cancer
Salivary gland cancers are uncommon, with about 2000 to 2500 cases occurring per year in the United States.
What are the signs and symptoms of Salivary Gland Cancer?
Possible signs and symptoms of salivary gland cancer include a lump in the mouth, cheek, jaw or neck, facial numbness, weakness of the muscles on one side of the face, trouble opening the mouth, or pain in the mouth, cheek, jaw or neck that will not go away. If you develop any of these symptoms, contact our team at Endeavor Health Advanced Neurosciences Center to book an appointment with our head and neck cancer specialists.
How are Salivary Gland Cancers treated?
Surgery is often the first and only treatment for salivary gland cancer. The goal of surgery is to remove the entire cancer often with a small amount of healthy salivary gland tissue (termed the margin). Surgery may also include removal of lymph nodes from the neck (neck dissection) depending on the type and stage of the cancer.
Radiation and chemotherapy are generally reserved for treatment of patients after surgery, unless there are reasons that surgery cannot be performed. These include patient preference, tumor location and size.
Skin Cancer
What are the types of Skin Cancer?
There are numerous types of skin cancer. The most common types include basal cell carcinoma, squamous cell carcinoma and melanoma. These cancers are classified based on the type of skin cells that the cancers originate from: basal cells, squamous cells and melanocytes.
The most common type of skin cancer is basal cell carcinoma, making up approximately 80% of all skin cancers diagnosed in the United States.
How common is Skin Cancer?
According to the most recent estimates, about 5 million cases of basal and squamous cell carcinoma are diagnosed each year in the United States. Approximately 100,000 new melanomas will be diagnosed per year.
What are the risk factors for Skin Cancer?
There are several risk factors which make getting skin cancer more likely. The main risk factor is exposure to Ultraviolet (UV) light. UV light damages the DNA inside skin cells which can cause cancers to form. Other risk factors include lighter skin, hair and eye color, family history, older age, and having a weakened immune system.
What are the signs and symptoms of Skin Cancer?
Skin cancers in general will develop in areas of the skin that are exposed to the sun including the head, face and neck. Basal cell carcinoma and squamous cell carcinoma appear in several ways. These can include pink or red bumps, pink growths with raised edges and open sores which do not heal.
Melanomas are usually caught when an individual has a new spot on the skin or a spot that is changing in certain ways. This is known as the ABCDE rule:
- A is for Asymmetry: one half does not match the other
- B is for Border: the edges are ragged or blurred
- C is for Color: the color is not the same all over the spot
- D is for Diameter: the spot is larger than 6 millimeters (~1/4 of an inch) across
- E is for Evolving: the spot is changing in size, shape or color
If you develop any concerning spots on the skin of the head, face, or neck, contact our team at Endeavor Health Advanced Neurosciences Center to book an appointment with our head and neck cancer specialists.
How are Skin Cancer treated?
The mainstay of treatment for basal and squamous cell skin cancers is surgery. The goal of surgery is to remove the cancer entirely with a small amount of normal surrounding skin (termed the margin). Surgery is often done with real-time margin assessment to ensure that no cancer is left behind. Following removal of the skin cancer, reconstruction of the area is performed. In more advanced cases, surgery can include lymph node removal. In rare cases, radiation therapy may be given after surgery if there are risk factors identified during surgery.
Melanoma treatment is generally begun with surgery to remove the cancer. Sampling of lymph nodes in the areas near the cancer (“sentinel lymph node biopsy”) is often performed as well to identify lymph nodes which contain cancerous cells. These lymph nodes are then removed. There are several medications which can also be used to treat melanoma which are classified as immunotherapies. These are administered by medical oncologists.