Head and neck cancers represent a group of cancers that affect the throat, larynx, nose, sinuses, and mouth. While these diseases only represent almost 3 percent of new cancer cases in the U.S., they affect vital functions, including swallowing and speaking. Cancer of the head and neck region is treatable, especially when detected early.
Dana-Farber’s Head and Neck Oncology Program is dedicated to treating patients with head and neck cancers.
What are the risk factors for head and neck cancer?
Individuals who drink alcohol, particularly beer or hard liquor, and use cigarettes, cigars, pipes, or smokeless tobacco, are at a higher risk for developing head and neck cancer. Risk also increases with age, particularly those over 45, and for men, who are twice as likely to get head and neck cancers.
Exposure to certain viruses — such as certain strains of the human papilloma virus (HPV), which can cause cervical and genital cancers, and Epstein-Barr virus (EBV), a common latent virus that can weaken the immune system when triggered — can increase your risk of developing cancer in the head and neck region. Other risk factors may include Fanconi anemia, a rare condition that affects the bone marrow, and poor oral hygiene, which can encourage the growth of bad bacteria that can lead to gum disease, tooth decay and cavities that feed virus development and thus cancer.
What are the symptoms of head and neck cancer?
Symptoms for head and neck cancer can include:
- Trouble swallowing
- A persistent sore throat
- Cough
- A change in voice
- Ear pain
- A lump in the mouth, neck, or throat
While these may be caused by other, non-cancerous conditions, check with your doctor if you exhibit any of these symptoms.
How is head and neck cancer diagnosed?
If cancer is suspected, your doctor may order a CT scan, MRI, or PET scan to further investigate, or conduct a biopsy to test cells for cancer. This may include an endoscopy or laryngoscopy.
How is head and neck cancer treated?
Treatment for head and neck cancer depends on its location and stage, but many patients receive a combination of treatments that may include surgery, radiation, chemotherapy, immunotherapy, and/or targeted therapies.
These treatments may affect your ability to speak or swallow, so it is important to discuss treatment options and how they may impact your life. At Dana-Farber, depending on your treatment, your team may include experts in head and neck surgery, medical oncology, radiation oncology, dentistry, oral surgery, reconstructive surgery, nutrition services, social work, and speech, voice, and swallowing therapy.
Immunotherapy utilizes a person’s immune system to fight cancer cells. Treatment options may include targeted antibodies and immunomodulators that can optimize how your immune system responds to the disease. At Dana-Farber, researchers and physicians have found immunotherapy to be helpful for certain patients before surgery, and are exploring its use as maintenance to delay or reduce recurrence. Targeted therapies may be available as a personalized treatment option based on the specific features and genetic changes of the cancer.
Clinical trials are also an option for many patients, even those who have not yet begun treatment.
What are the side effects of head and neck cancer treatment?
Head and neck cancer occurs in a sensitive area, and its treatment often affects important life functions like speaking and eating. Your treatment team may include speech pathologists, nutritionists, and pain management experts who can help you with these difficult side effects. Surgery may also affect your physical appearance, but new methods of robotic surgery and reconstruction are increasingly making it easier to treat head and neck cancers while sparing your appearance and ability to eat, swallow, and speak.
Part of the treatment team should also include a dental professional. Head and neck radiation has a lasting affect on saliva flow which isprotective to tooth enamel. Saliva contains immunity and buffering ability to counteract what we eat and drink daily. Radiation to the head and neck has been proven to slow down the rate of saliva flow. A dentist can take impressions for fluoride trays that the patient can wear during treatment of cancer and use following for prevention of dental decay. Also, the dental staff should see these patients on a more regular interval of four times a year. We as a team can help these patients manage the discomfort that comes with dry mouth and continue to care for teeth with proper care and skill.