April 3 2020
by Elena Bolshakova, MD, ENT (Minsk, Belarus) and Dr. Why
This is the third post in the “Oncovirus” series. Head and neck cancers (tumors that arise from oral cavity, pharynx, larynx, nasal cavity, and sinuses) rank as the sixth most common cancer worldwide.
An estimated 599,637 new cases and 324,794 deaths occur every year. Head and neck cancers account for about 4% of all cancers in the United States. This year, an estimated 65,630 Americans (48,200 men and 17,430 women) will develop head and neck cancer and 14,500 will die (10,760 men and 3,740 women).
Smoking, chewing tobacco, and drinking alcohol were long considered the main risk factors. Not anymore! At least 3% of oral cancer, 12% of pharyngeal cancer, and 30–60% of oropharyngeal carcinoma cases are caused by HPV infection.
The incidence of HPV-associated head and neck cancer steadily risen since 1973. In particular, one study suggested that the annual number of HPV-associated oropharyngeal cancers in the US will overtake the incidence of invasive cervical cancer cases from other causes in the United States by 2020 (Here were are!).
The good news:
HPV-associated cancers tend to have better survival and outcomes;
It is very sensitive to a combination of chemotherapy and radiation;
It has 90%+ survival rate, if diagnosed early;
Several HPV vaccines are available. Vaccination decreases prevalence of oral HPV infection 16-fold.
Things to remember:
Head and neck cancer can be often diagnosed on physical examination;
Your dentist shall examine oral cavity, salivary glands, and submandibular lymph nodes at the beginning of each dental appointment;
Your internist/family physician shall examine oral cavity, pharynx, nasal passages, and lymph nodes on each visit;
See your Ear, Nose and Throat (ENT) doctor, if you have protracted (>2 weeks) one sided sore throat/pain, difficulty swallowing, tonsillitis or swelling anywhere around the neck, unless explained by a tooth infection, or other obvious causes.
Note and do not ignore any asymmetry in your neck, cheeks, and sides of your face when looking in the mirror. One is not supposed to have unilateral chipmunk cheeks or any “lumps and bumps” around the neck.