Save your neck — and head.

In recent years, great strides have been made to improve awareness of head and neck cancers. And here in Indianapolis during Head and Neck Cancer Awareness Month, St.Vincent Cancer Care is doing its part by offering screenings and educating the public on the importance of early detection.

One doctor who conducts these screenings is otolaryngologist Tod Huntley, of the St.Vincent partner Center for Ear Nose Throat & Allergy (CENTA). Here, Dr. Huntley explains the definition of head and neck cancer, its often unnoticed symptoms, and when to seek a specialist for an evaluation.

Head and neck cancer: What is it?

The term head and neck cancer describes a wide range of malignant tumors originating in the upper aerodigestive tract. “It’s a diffuse group of cancers involving the voice box, throat, mouth and lips, nose, sinuses, salivary glands – some of the most complex anatomy and most vital structures in the body,” Dr. Huntley said. “These are the structures that control your ability to chew, swallow, see, speak, hear – all of the special senses you take for granted all day long.”

How common is it?

Head and neck cancers make up 3% to 5% of all cancers in the United States, with 50,000-60,000 new cases annually. “The number of people who get it is certainly smaller in comparison with higher profile cancers such as breast and lung,” Dr. Huntley said. “But in many regards it’s much more devastating, because of where it occurs. When a person has to have a large portion of his tongue removed, it’s readily evident that something has happened as soon as he tries to speak. When a woman loses the ability to swallow because of cancer of the throat, this completely changes her life. You can’t easily hide the effects of this cancer unless it is discovered early in its course.”

What are the symptoms of head and neck cancer?

“The cancers we’re dealing with often don’t get discovered until late,” Dr. Huntley said. That’s why it’s important to be aware of the symptoms, and talk to your doctor if you’re experiencing them. Many of these cancers present with symptoms that are attributed to common, benign ailments.

“For example, voice box cancer presents with hoarseness, and maybe a funny feeling in the throat or breathing problems that might be mistaken for asthma,” Huntley said. “Tonsil cancer may present as a persistent sore throat, often with pain that extends into the ear. Sinus cancer may present with significant nasal blockage, or maybe recurrent, unexplained nosebleeds. And cancer of the mouth can often present initially as a small, discolored patch of tissue or painless ulcer. All of these cancers start with a small lesion at first, and if caught early, they can often be treated easily. But they can be relentless in invading bone and other structures if the symptoms are ignored until the cancer is large. The important point is to see your physician if the symptoms persist for several weeks.”

Dr. Huntley examines a patient.

What are the major risk factors for head and neck cancer?

Tobacco and alcohol use are the two leading causes of cancer in the mouth, throat, and voicebox. And when the two substances are used together, the risk multiplies. Also, in recent years, the incidence of throat cancer has increased among people 50 and younger due to the sexually transmitted Human Papilloma Virus (HPV). “Well known as the leading cause of cervical cancer in women, HPV is also a proven cause of cancers of the tonsils, throat, and tongue base,” Dr. Huntley said. “”We are seeing it now in younger, non-smoking people, and it’s replacing cigarettes as the number one cause of throat cancer in this age group.”

When should you get examined for head and neck cancer?

Because many of these cancers present with innocuous symptoms, they are often ignored because they are thought to be just a persistent benign problem. “This is why we have to get the word out about early detection,” Dr. Huntley stressed. “When symptoms such as sore throat, a painless lump in the neck, hoarseness, a persistent nose blockage with bleeding, or a cold sore doesn’t improve after a few weeks, it should be brought to a physician’s attention.”

What happens during a head and neck cancer screening?

Luckily, some forms of head and neck cancer can be detected with a simple office exam. An oral cancer screening can be performed by an otolaryngologist or your dentist, and consists of a simple exam in which the physician looks and feels in the mouth with a gloved finger. No special equipment is required for the exam. “These generally are surface cancers, and are often visible to the naked eye or with an endoscope, but only if they are looked for,” Dr. Huntley said. “And if a cancer is suspected, we can generally diagnose it easily at that time with a simple, nearly painless biopsy.”

Where can you get a screening?

“We have a partnership with St.Vincent is truly unique,” Huntley said. “We have assembled a world-class team of physicians from all the specialties that treat this kind of cancer—surgery, medical oncology, radiation oncology, oral surgery– and we see patients together as a team at our weekly multidisciplinary clinic at the Center for Ear, Nose, Throat & Allergy (CENTA). We will see such patients within a week, and examine the patients together. We discuss the case as a group, and present the treatment options and our consensus opinion to the patient at that same visit. This is one of the few places in the country, and the only place in Indiana that does this. We have a team of pathologists present at the clinic who can perform and interpret biopsies, often on the spot.” If a head and neck cancer is found, then CENTA and St.Vincent are well equipped to treat the head and neck cancer quickly, and with the latest technology, Huntley added.

How are these cancers treated?

Once the diagnosis is made, the team works with the patient to plan the appropriate treatment. This might include surgery, radiation treatments, or chemotherapy. Sometimes it might require a combination of therapies. “The key is that we partner with the patient during this process,” emphasized Dr. Huntley. “We don’t look at it like we are just treating a cancer. We are treating a person with cancer. And no two people – or their cancers — are alike.”

And if surgery is contemplated, CENTA’s team of specialists is at the leading edge of minimally invasive procedures. They are among the first in the country, and the first in Indiana, to offer da Vinci® robotic surgery for head and neck cancer, which allows surgeons to remove throat cancers endoscopically, and with fewer side effects.

Dr. Huntley concluded by stating, “Our goal, ultimately, is to get rid of the cancer, and just as importantly, to preserve function and quality of life. But we can only do so if people are aware of the problem, pay attention to their symptoms, and go to their health care providers when appropriate.”


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