Getting ahead of head and neck cancer –

Many symptoms of head and neck cancer are hard to ignore – a lump in the neck, persistent hoarseness, a mouth sore that won’t heal – which is good news for early detection until symptoms are gone. not ruled out.

“Anyone can get a mouth ulcer or be hoarse, but if these things don’t go away in a week or two, you should see a doctor,” said Dr. David Goldenberg, head of the department of otolaryngology. – Head and neck surgery. at Penn State Health Milton S. Hershey Medical Center. “You can find most of these signs and symptoms yourself, but don’t ignore them. Early diagnosis can mean a much better prognosis.

According to the National Cancer Institute. About 15,000 people have died from the disease.

The umbrella term head and neck cancer covers several different types, including the oral cavity, which is the lips and everything inside the mouth up to the tonsil area; the oropharynx, which includes the back of the mouth, the base of the tongue, and the tonsils; and the larynx, which is the voice box and vocal cords. Other areas include the nose, paranasal sinuses, and nasopharynx

“Most of these cancers have spread to the neck,” Goldenberg said. “We therefore assume that any lump on the side of the neck in a person over 40 is cancer until proven otherwise.”


Common signs of oral cancer are red or white patches or a non-healing sore in the mouth or on the tongue. People with oropharyngeal cancer often feel like something is stuck in their throat, have difficulty swallowing, or have muffled speech, Goldenberg said. Hoarseness, difficulty swallowing, and coughing up blood can be signs of laryngeal cancer.

Head and neck cancers may present with pain radiating to the ear. A lump on the side of the neck is usually the first indicator of head and neck cancer, he said.

The overall incidence of head and neck cancers decreased with a decrease in smoking – a definite risk factor, especially when associated with alcohol consumption, which appears to enhance the carcinogenic effect of tobacco, Goldenberg said.

However, cases of oropharyngeal cancer are on the rise.

“The new villain is the Human Papillomavirus or HPV“, Goldenberg said. “It’s the same virus that causes cervical cancer in women, and this increase in oropharyngeal cancers is due to multiple sexual partners, multiple oral sexual partners and marijuana use.”

HPV-related head and neck cancers often appear 20 to 30 years after exposure to the cancer-causing virus, Goldenberg said.

“That’s why we’re pushing so hard for young people to get the HPV vaccine,” he said. Vaccination against HPV can be started at age 9 and is recommended until age 26. In 2018, the vaccine was extended to adults up to 45 years old.

In general, head and neck cancers are treated with surgery, radiation therapy, chemotherapy, or a combination of the three. However, head and neck cancers resulting from smoking and/or alcohol are harder to defeat because they are often more aggressive, while HPV-related cancers have a much better prognosis, Goldenberg said.


One of the most challenging aspects of head and neck cancer is its stigma, not only because it can be sexually transmitted, but also because it affects a very visible part of us, Goldenberg said.

“Humans are social beings, and these cancers affect the house of our communication,” he said. “What do we do when we’re together?” We eat, we drink, we chat. So removing part of someone’s tongue or throat is not something we can hide easily, and it impacts the ability to interact and socialize.

A multidisciplinary team that includes the surgical team, oncology team, speech therapists, dentists, nutritionists, social workers, and support groups ensures the best results.

“Our treatments are becoming more specific and personalized,” Goldenberg said. “Our surgical resections are less invasive, our reconstruction techniques better. Additionally, as we learn more about the molecular changes in these cancers, we are better equipped to provide immunotherapy that often replaces toxic chemotherapies. So there is always hope. »


Prevention is sometimes possible, he says.

  • Do not smoke or drink alcohol.
  • Do not chew tobacco.
  • Get vaccinated against HPV.
  • Take advantage of community screenings and those offered during regular dental exams.
  • Don’t ignore early signs of head and neck cancer

The Medical Minute is a weekly health report produced by Penn State Health. Articles feature the expertise of faculty, physicians, and staff, and are designed to offer relevant and timely health information of interest to a broad audience.

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