Each year, approximately 110,000 U.S. adults are diagnosed with “head and neck” cancers. While most diagnoses are in people older than 50, it is increasingly occurring in younger people.
Moreover, while the majority of cases have been linked to alcohol and tobacco use, more cases are being diagnosed without these major risk factors. Infection with cancer-causing types of the human papillomavirus (HPV) is also a risk factor for some types of head and neck cancers, but a vaccine is available against HPV.
In a recent Facebook Live session [1], Geoffrey Young, M.D. [2], chief of head and neck surgery at Miami Cancer Institute [3], and Noah Kalman, M.D. [4], radiation oncologist at Miami Cancer Institute [3], answered common questions about head and neck cancers.
(Watch Geoffrey Young, M.D., chief of head and neck surgery at Miami Cancer Institute, and Noah Kalman, M.D., radiation oncologist at the Institute, as they answer questions about head and neck cancers during a Facebook Live session.)
We hear much about breast cancer, lung cancer and prostate cancer, but we don’t really hear so much about head and neck cancers. Tell us about head and neck cancers?
Dr. Young:
“I like to describe head and neck cancers as pretty much everything above the collarbone, outside of the brain. We deal with throat cancers of the mouth, cancers of the skin in the head and neck area, as well as cancers of the salivary glands and thyroid cancer. So those are the general areas.”
What populations are most affected?
Dr. Kalman:
“Head and neck cancers in general make up about 4 percent of cancers that we see in the United States every year and we really run the gamut, in terms of patient types. More classically, we used to see patients who had risk factors of smoking or alcohol intake, but now we actually see a lot of younger patients in their 50s and 60s who really don’t have significant risk factors.”
There’s a vaccine for HPV and there’s a lot of misinformation right now about vaccines out in the public because people don’t understand and they’re getting bad information. So what is the HPV vaccine?
Dr. Young:
“The HPV vaccine is a cancer preventative vaccine. The current vaccine targets nine potentially cancerous strains of HPV. And so by eradicating these strains and providing immunity, you can significantly reduce a cancer risk. So the vaccine was actually approved up to the age of 26 for many years and has now been upped to the age of 45 [5]. So I am 43 and I had my vaccine, so I recommend that everybody should have it. If you have something that can prevent a cancer with absolutely minimal threat to your health — why not do it. ”
Dr. Kalman:
“In addition to head and neck cancers that this vaccine can prevent, it’s also effective in certain GI (gastrointestinal) cancers, as well as cervical cancer. And there are more that we’re discovering, so it’s really excellent thing to do for cancer prevention.”
What types of symptoms are associated with head and neck cancers?
Dr. Kalman:
“Many of them develop with a sore a lesion in the mouth that starts and really persists. There are many things that you get either from an infection, or say you ate something that was too hot, that over a week or two will go away. But these are things that will persist over time. And then other symptoms that people can get are things such as difficulty swallowing or having pain with swallowing. You can have bleeding in the mouth, and then sometimes you can have something as simple as just a swelling in the neck that that doesn’t go away.”
Earlier today, you both provided free screenings to members of the public. What exactly goes into a screening?
Dr.. Young:
“Mainly, we’re looking for obvious signs of you head and neck cancer — lesions in the mouth, lumps in the neck. These are the type of things we can do in a community screening event. There’s another symptom: changes in your voice which requires looking directly at the vocal chords. This obviously we cannot do in that kind of screening. So anyone who is having those symptoms, we recommend that they follow up and get a camera endoscopy to look down at the vocal cords and in the back of the throat — in areas that we can’t see on a normal screening physical exam.”
Do people need to see a specialist to be screened?
Dr. Young:
“Normally, dentists do most of the oral cancer screenings, and it should be done at least once a year when people do their regular dental visits. And primary care providers can do this as well. We recommend that you have a screening exam at least once a year.”
People may not necessarily have symptoms. Why is it so important to catch this cancer early?
Dr. Kalman:
“Generally, when tumors are caught early there are more options for treatment and our ability to either excise the cancer completely or to treat it effectively is better the earlier we catch the tumor.”