When Is a Sore Throat a Serious Threat? When It’s a Head and Neck Cancer.

Woman with sore throat touches neck wonder if it is head and neck cancer | cCARE | San Diego & Fresno, CA

By Joel M. Lamon, M.D., F.A.C.P. and Chris A. Straka, M.D.

Head and neck cancer symptoms can be deceiving, which is why speedy self-honesty is the best policy for survival

Head and neck cancers are cancers of the cells that line the head and neck cavity areas, which include the passages from the nose and mouth back toward the throat and down slightly toward the vocal cords. Although head and neck cancers only make up 4% of all cancers in the United States, they still pose a great danger.

Much of this danger comes from their symptoms being ignored by the patient. The characteristic initial symptoms of head and neck cancers are pain or soreness in the mouth or throat, voice changes and/or neck swelling.

Unfortunately, these are common symptoms and it can be difficult for patients to know when to seek medical care. This often leads patients to dismiss their symptoms until the disease is more significant and harder to cure.

With head and neck cancer symptoms, be honest & be fast

“Honesty is the best policy,” says Dr. Lamon. “If you can’t explain what’s changing in your body, you must be honest with yourself and seek medical evaluation from a professional.”

The symptoms are confusing and so is the term head and neck cancers, because all cancers found in these areas are not classified as such. Head and neck cancers are found in the internal lining of tissues and do not begin in an individual organ.

This is what differentiates head and neck cancers from something like thyroid cancer or brain cancer, even though the thyroid is located in the neck and the brain is in the head. The most common head and neck cancers are squamous cell carcinomas and begin in the oropharynx (base of tongue and tonsil area), oral cavity and larynx.

Drs. Lamon and Straka encourage all patients, particularly those with risk factors such as smoking, to seek prompt medical care if they have any of the symptoms mentioned above for more than three to five days.

Early diagnosis increases chances of survival

Early diagnosis of head and neck cancers can lead to better long-term survivability. The main reason we want patients to seek medical attention as soon as they realize there is a serious health issue is because catching cancer early gives us more treatment options and allows us to stop the cancer before it spreads.

Head and neck cancers often spread to nearby lymph nodes in the neck. Patients may notice swelling in the neck or difficulty swallowing when this occurs. The cancer shows significant symptoms and is typically diagnosed before it spreads beyond the head and neck to other areas such as the lungs, though this extent of spread can be seen in recurring cancer patients.

Tobacco use and HPV increase chances of these cancers

Tobacco use is the primary risk factor for head and neck cancers with the overconsumption of alcohol coming in a close second. In many cultures, men are more likely to engage in tobacco and alcohol use, creating the statistic of men being more likely to develop head and neck cancers than women. Oncologists have recently discovered the human papillomavirus (HPV) has also become one of the leading causes of these cancers. Advancing age and poor dental hygiene can contribute to head and neck cancers as well.

To help prevent head and neck cancers from forming, we suggest ceasing the use of any forms of tobacco, limiting alcohol consumption and getting the pre-adolescence HPV vaccine. It is also important to practice proper dental hygiene.

Unfortunately, cancers of the head and neck due to tobacco use or HPV can occur decades after use or infection. It is best to never begin using tobacco in any form, including combustible (cigarettes), contact (chew) and noncombustible (vaping), though we don’t yet know the extent of harm caused by the last form.

HPV vaccination can prevent up to 75% of head and neck cancers and could prevent the majority of these cancers in future generations. However, vaccination in adults does not prevent cancer due to prior exposures.

 Related Reading: Tobacco, Lung Cancer & Quitting Smoking FAQ

Treating head and neck cancers

“The best way to treat head and neck cancer is to avoid ever getting it,” says Dr. Straka. “Head and neck cancer treatment is complicated, and I would encourage all head and neck cancer patients to seek expert, multi-disciplinary care as early as possible after diagnosis.”

Although head and neck cancers are often aggressive and can be life threatening, many of them can be cured with cancer treatments. The type of treatment used depends on the stage, location and type of head and neck cancer a patient has. Surgery, radiation, chemotherapy or any combination of the three can be used to treat these cancers.

Radiation is given to patients for whom surgery is not possible or would not fully remove the cancer. Chemotherapy is often given alongside radiation to enhance it. Many studies are currently being performed to see if chemotherapy could be replaced with more directed therapy depending on tumor biology. The new therapies could better target the tumor without affecting as much healthy tissue throughout the rest of the body.

What does head and neck cancer survival look like?

Depending on when they are detected, head and neck cancers have a fairly high survivability rate. Early stage oropharynx cancer caused by HPV carries a long-term survival rate up to 90%. Other head and neck cancers generally have a 50%-70% survivability rate, depending on the sub-type and stage.

If the head and neck cancer is tobacco-related, the patient may already have other health issues caused by tobacco use. This can include cancer in the lungs and other areas of the body, which may make overall survival less likely.

The difficulty with head and neck cancers is the extent of treatment needed can affect quality of life even after remission. Surgery can deform the treated area, making it feel abnormal due to shifted anatomy. Radiation can affect salivary glands and cause dry mouth, which can lead to or increase dental issues. Of course, full remission is the goal, but we and our patients must consider any lesser quality of life or ongoing discomfort when choosing a treatment plan.

Working as a team to cure cancer

“It’s important to recognize that people with head and neck cancers require extensive treatment up front with a lot of support during and after that treatment,” says Dr. Lamon.

Support both in the clinic and at home will help patients meet nutritional needs, manage pain, balance emotions and find the unique treatment plan that gives them the best results. Cancer diagnosis and treatment have a large emotional impact by themselves. Patients may also have to overcome the mental stress of tobacco cessation or visible changes to their body during treatment. Head and neck cancers and their treatment can greatly affect self-image as the side effects cannot be hidden by clothing.

“Head and neck cancer treatment can be very difficult physically and emotionally,” says Dr. Straka. “At cCARE we understand this and we pride ourselves on taking care of the whole patient: body, mind and spirit.”

cCARE has a team of radiation oncologists, medical oncologists, surgical oncologists and dieticians who work together to create a unique treatment plan for each patient. We continue our care beyond treatment by offering palliative care and Survivorship Care to ensure we support our patients during every step of their journey. Our extensive experience in treating head and neck cancers allows us to maximize supportive care and survivability while minimizing the burden of short- and long-term effects.

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