A glimpse at head/neck cancer
By Douglas Villaret, MD, Charlotte Eye Ear Nose and Throat Associates

Questions about your head/neck cancer diagnosis? Call a cancer navigator: 704-384-5373

When many people think of head/neck cancer, they think of smoking, drinking or, more recently, human papilloma virus (HPV), an increasingly prevalent sexually transmitted disease. While these factors increase the likelihood of diagnosis, it is important to note that head/neck cancer is just like any other cancer – random in whom it targets. What follows is information about this often-overlooked disease to help you better understand what it is and how we can help you and your loved ones along the journey.

First, let’s talk a few numbers. Head/neck cancer currently makes up about five percent of all cancers. There are about 53,000 mouth, throat or voice box cancers diagnosed each year. Cure rates vary greatly depending on the site, size, cause and spread of the cancer. The good news is that the campaign against smoking has been at least partially successful, dropping smoker rates to the lowest in history at 19 percent, and as a result many of the subtypes of this cancer are declining in frequency.

HPV is the most common sexually transmitted disease in this country with 79 million (yes, million) people currently infected and 14 million more being infected each year. While less than 0.1 percent will go on to develop cancer, that still means that 6,700 people will develop a cancer of the tonsils or tongue base each year. This appears to be a rising epidemic and one that could be stemmed with currently available vaccines. The silver lining to this is that there is a significant survival benefit if a cancer of the throat is caused by HPV rather than smoking.

Head/neck cancer is unique in its ability to interrupt any of the senses: hearing, smell, taste, vision and feeling. Also, the cancer or its treatment can make both speech and swallowing challenging.

With a focus on increasing quality of life after cancer, research has taken an active role in minimizing side effects due to treatment. One promising innovation that we have brought to the Charlotte area with the help of Novant Health is TransOral Robotic Surgery (TORS). This technique allows us to access difficult-to-reach areas such as the tonsil, tongue base and upper voice box, without having to make any incisions in the neck. While radiation and chemotherapy usually are still needed, the dose is lowered, which also helps minimize side effects of treatment.

Though undergoing treatment for head and neck cancer can be difficult, the good news is that you don’t have to face the journey alone; we have a team of experts who work together to care for your unique needs:

• Cancer patient navigators are special nurses who provide guidance and support
• Radiation oncologists are doctors who design and deliver radiation therapy
• Medical oncologists are doctors who determine the appropriate chemotherapy and help coordinate care and manage side effects
• Surgical oncologists are doctors who plan and perform any surgical removal of the tumor that is necessary. Many head/neck surgeries are performed by an ENT who specializes in cancer.
• Dentists collaborate with your ENT to improve dental hygiene and remove suspect teeth as necessary
• Speech and swallowing therapists help you relearn how to talk and swallow
• Nutritionists recommend the appropriate diet and supplements during and after treatment
• Physical and occupational therapists assist in post-surgical rehabilitation
• Counselors provide emotional support and case management services and can connect you to the new support group in town

Cancer will continue to plague us, but by using new techniques we can improve cure rates while reducing the damage done by just the treatment itself.

Douglas Villaret, MD, is a board-certified otolaryngologist with Charlotte Eye Ear Nose & Throat Associates and is co-leader of the head/neck cancer program at Novant Health Cancer Center in Charlotte. His expertise includes treatment of thyroid, salivary and HPV-related tumors.