The UW Hospitals and clinics see more than 500 patients a year with Head and Neck cancers. Our specialists treat patients with cancers of the head and neck including:
Patients treated at UW are seen by a multidisciplinary team of medical specialists including radiation oncology, otolaryngology (ENT surgery), medical oncology (chemotherapy and pain management), neuroradiology and dentistry. Our program also includes a highly skilled supportive staff including speech-language pathologists (speech and swallowing), audiologists (hearing), nutritionists and a nurse coordinator.
This Web site provides more information for those interested in Head and Neck Cancer and treatment options at the University of Wisconsin. Additional information can also be found on the UW Carbone Cancer Center webpage. Please contact Cancer Connect at (800) 622-8922 or 608-262-5223 if you would like to set up a consultation.
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Background
Head and neck cancers represent about 4% of all cancers. Over 40,000 new cases of head and neck cancer are diagnosed every year, and approximately 13,000 people die from head and neck cancer per year. Head and neck cancer can occur in males and females, and occurs mostly in people aged 50-60 years old. The most common type of head and neck cancer is squamous cell carcinoma (SCCa).
Risk Factors
Certain factors including your habits, family history, health conditions and environment can increase your risk of developing head and neck cancer. These include:
- Tobacco - smoking (cigarettes, cigars, secondhand smoke exposure) and smokeless tobacco (snuff, chewing tobacco)
- Excessive alcohol use (more than 2 alcoholic beverages per day for males, and more than 1 per day for females)
- Viral Factors - Epstein-Barr virus (EBV) and Human papillomavirus (HPV)
- Genetic factors
- Voice abuse
- Chronic laryngitis
- Chronic acid reflux
- Wood dust
- Asbestos
- Ionizing radiation
- Marijuana
The most important risk factors of head and neck cancer are tobacco and alcohol. The combination of tobacco and alcohol use creates a substantially greater risk than just tobacco use or alcohol use. Approximately 85-90% of patients with head and neck cancer have a significant tobacco and alcohol history.
Reducing the exposure to these risk factors (including smoking and alcohol cessation) has been found to reduce the risk of developing head and neck cancer substantially, increase the effectiveness of treatment of head and neck cancer and prevent the development of secondary cancers of the head and neck.
Signs and Symptoms
The symptoms of head and neck cancer will vary depending on the specific site of the cancer. Common symptoms include:
Persistant
- Lump in the neck
- Sore (for example in the mouth or on the lip)
- Pain in the neck or throat
- Change or hoarseness in the voice
- White or red patch on the gums, tongue, or lining of mouth
- Unusual bleeding, pain, or numbness in the mouth or nose area
- Numbness in the face
- Swelling or trouble opening the jaw
- Pain in the ear
- Feeling as if something is caught in the throat
- Pain or difficulty in swallowing or chewing
- Blocked sinuses/chronic sinus infections
- Frequent headaches
See your physician if you are concerned that you have any of the symptoms listed above.
Diagnosis
An early diagnosis of head and neck cancer provides the best chance for cure and survival. Regular self-exams as well as physician and dental exams are very important. Head and neck cancers generally start as a local disease focus, and can progress to regional (lymph nodes in the head and neck region) and distant metastasis (spread to other parts of the body). Diagnosis and staging of head and neck cancers are performed using several of the following:
- History and physical exam
- CT, MRI and/or PET scan of the head, neck and chest
- Endoscopic examination and biopsy
- Needle aspiration of neck lymph nodes
- Dental evaluation
- Speech/swallow evaluation
Staging refers to the size and degree of invasion of the primary cancer (T stage), as well as the pattern of spread to the neck lymph nodes (N stage) and whether there is distant metastasis (M stage). All diseases except those with distant metastasis are considered curable; however, the rates of cure and survival decrease as the stage of the cancer increase. Other factors such as bone, nerve and blood vessel involvement and extension outside of lymph nodes capsules can also affect the prognosis of cancer cure.
Treatment Options
Head and neck cancer treatment at the University of Wisconsin is multidisciplinary and involves one, or a combination of therapies including radiation therapy, surgery and chemotherapy. Other specialists involved in the care of patients also include nurses (including a nurse coordinator), radiation therapists, dentists, speech and swallow therapists, audiologists, nutritionists, social workers, support services (including the UW head and neck support group) and pain specialists. The type of treatment offered will depend on the patient and the presentation of their cancer.
Early stage cancers of the head and neck can be treated with one type of therapy:
- Surgery alone
- Radiation therapy alone
Advanced cancers can be managed with a combination of therapies:
- Surgical resection followed by post-operative radiation therapy (with or without chemotherapy)
- Radiation therapy (with or without chemotherapy) for organ preservation followed by a surgical neck node dissection
Primary Surgery is typically used for head and neck cancers in the:
- Paranasal sinuses
- Oral cavity
- Parotid
- Bulky larynx or hypopharynx (pyriform sinus)
Primary radiotherapy or chemoradiotherapy is typically used for head and neck cancers in the:
- Nasopharynx
- Oropharynx
- Larynx
- Hypopharynx
Side effects of treatment for head and neck cancer vary, depending on the type of treatment and the area being treated. Side effects can be temporary or permanent. The following are some of the more common side effects of oral cancer treatment:
- Swelling from surgery
- Sore mouth
- Difficulty chewing, swallowing, or talking
- Changes to appearance, temporarily or permanently
- Weight loss due to a sore mouth, which may make eating difficult
- Inability to wear dentures for a period of time
- Decreased saliva production
- Fatigue
- Dental problems
- Lowered immune system
- Nausea and vomiting
- Mouth sores
- Lack of appetite
- Scarring and lack of movement
New advances in head and neck radiation therapy include the use of IMRT and Tomotherapy. These specialized treatment options allow precision targetting of the cancer, resulting in the sparing of vital structures in the head and neck, including the partod glands (increased saliva production) and the spinal cord, resulting in fewer side effects.
Clinical trials at the UW also provide innovative options for patients with head and neck cancer. A broad array of head and neck cancer clinical trials offer specialized treatments using surgery, radiation, vaccines, chemoprevention, targeted agents and chemotherapy. Clinical trials may be available to patients at any stage of their disease. View a list of open head and neck clinical trials at UW.
More Information
Additional information about treatment for cancer at the University of Wisconsin can be found on the UW Department of Human Oncology clinics page, or the Carbone Cancer Center site.
Additional information on head and neck cancer can be found at:
- National Cancer Institute
- American Cancer Society
- Support for people with Oral and Head and Neck Cancer
To schedule an appointment with our head an neck cancer specialists contact Cancer Connect at (800) 622-8922 or 608-262-5223.
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