History, phys, scans. Typically a patient will present to their doctors with a history of a mass or growth in their head or neck they noticed or that someone else has noticed. Physical exams will confirm this finding and ct scans and biopsies will usually then be ordered to confirm the diagnosis of the head and neck cancer.
Detailed workup. Typically symptoms or signs raise suspicion (neck lump, oral ulcer, hoarseness, swallowing difficulty, local pain, etc.). A careful exam by an ENT doctor (can include exam by a scope such as laryngoscopy) followed by biopsies of concerned areas is a start. Ct or MRI scans are also usually done. Diagnosis is confirmed upon pathology review.
Prognosis H&N CA. Definitely not! There is obviously a wide range of cancer sites in this classification ranging from voice box, which has a 95% cure rate, to base of tongue, which can be very hard to cure. Cure rates will depend on the location as well as the size and the extent or stage of the cancer.
Head and neck cancer. Head and neck cancers span a wide range of sites and cancer types with several causes. Depending on the site and type of cancer, many people are cured or do quite well. Several details about the cancer will substratify it into one with a more or less favorable prognosis if you know more specifically what type of cancer and its location.
Thoroughly. Staging refers to the process of finding the extent of cancer, that is, where the cancer has spread to. Typically, head and neck cancer stages are early, locally advanced or distant spread. The process involves detailed exams (using laryngoscopy too); scans (ct, MRI or pet) and sometimes multiple biopsies.
Standardized. There are several staging protocols, but the american joint commission on cancer staging (ajcc) is the biggest one in the United States. By standardizing exactly how a tumor is "staged" is based on the tumor location, size and extent of invasion, whether or not lymph nodes are affected, and if there is distant metastatic disease. These are put together to give a stage: used for treatment decisions.
Chemo, Radiation. Besides surgery, radiation and chemotherapy are typically used. Radiation is used in both early as well advanced cancers while chemotherapy is used in advanced cancers and those cases where the cancer has recurred.
Combined treatment. Head and neck cancer patients are usually seen in a combined clinic with surgeons, radiation oncologist and medical oncologist. In most early cases, surgery may be adequate but in early throat cancer, radiation is preferred. In advanced cases, combination of surgery, chemotherapy and radiation may be required and the sequence is individualized.
Tobacco usage. Head and neck cancers include cancers involving the throat, tongue, mouth, nose, and sinuses. Cigarette smoking is closely associated with throat cancer and chewing tobacco causes cancer in the mouth. Nasal and sinus cancers happen more often because of genetic predisposition rather than some external irritant like smoke.
Many Causes. Tobacco smoking and chewing is the largest cause of head/neck cancers. A significant number are caused by viruses (epstein barr virus, human pailoma virus); alcohol and less commonly hereitary factors also play a role.
Avoid tobacco & etoh. Early warning signs are - lump in the neck., change in the voice, painless growth in the mouth, bringing up blood, swallowing problems, changes in the skin, constant pain in or around the ear when you swallow can be a sign of infection or tumor growth in the throat. This is particularly serious if it is associated with difficulty in swallowing, hoarseness, or a lump in the neck. Check with ENT doc.
Common ones. Common signs can be a tip off for underlying head/neck cancer. A sore throat that gets worse despite antibiotics, a neck lump that keeps growing, voice hoarseness that get worse despite rest and therapy, or difficulty swallowing that gets worse are some common situations. General signs (major tiredness, unintentional weight loss) can happen. In pts with smoking & alcohol use the are more worrisome.
Low, but... The common smoking-related cancers aren't going to appear in a teen, but there are several cancers of salivary-gland origin that are known to occur at your age. If you have an unexplained mass anywhere, please get it seen by a capable physician.
Well known. Standard contributing factors include chronic smoking, regular/heavy alcohol use, tobacco chewing, poor oral and dental hygiene, betel nut chewing, hpv infection (viral).
Head & Neck Cancer. Many head and neck cancers are due to the presence of the human papilloma virus (hpv), chewing tobacco, excess alcohol use, smoking, and a myriad of poorly understood promoters and carcinogens. A good yearly exam by your dentist and a self awareness for lumps in the neck, white or red patches on the tongue, inner cheek, or palate can detect early lesions well in time for a complete cure.
Many. Ear nose throat (ENT) doctors; surgical oncologists (cancer surgeons), plastic surgeons, radiation oncologists (treat with radiation); medical oncologist (treat with chemotherapy); speech therapists, nutritionists, physical therapists among others.
Many. Don't forget about pathologists: without a diagnosis you have nothing :).
Team work. It takes a team to treat and take care of head and neck patients. There are surgeons to do biopies or surgical removal, radiation and medical oncologist to give chemoradiation as primary or secondary treatment, speech therapist and nutritionist to support and rehab patients, nurses to monitor patients and last but not least pathologist to make diagnosis.
Since surgery is a frequently used in treating head and neck cancers, is there a risk of disfigurement?
Yes. Unfortunately certain surgeries such as neck dissection, lip surgery, etc. Carry the risk of disfigurement. Discussing planned surgery with your surgeon and reconstructive options such as plastic surgery consultation is important. Certain surgeries can be avoided and treatment with combined chemotherapy & radiotherapy can be done instead.
Yes. You want to have an experienced surgeon who's "been there" many times before and can do the best job balancing doing a good cancer operation to rid you of disease with the least amount of collateral damage or disfigurement. In addition, a plastic surgeon sometimes participates in cases for expert reconstruction after a big cancer operation. Discuss this thoroughly with your head and neck surgeon.
Depends on surgery. The risk for disfigurement depends on the extent of the surgery. With modern advances in head and neck reconstruction, we have very good methods to fix the defect that the cancer removal causes. Non-surgical treatment options, while avoiding the risks of surgery, carry their own set of complications. Your head and neck surgeon should be able to help you with the various options.
Yes. Yes, significant risk, depending on the area of the cancer. The best way to treat these cancers would be at a major medical center, where cancer resection and reconstruction can often be done during the same procedure. In your area - Stanford Medical Center.
Unfortunately, yes. It is important that all cancerous tissue be removed to prevent recurrence, thus the removal of tumors can result in cosmetic (disfigurement) and functional (speech, swallowing and chewing) problems for patients.