Head and Neck Cancer Awareness Month: An Overview of Risk Factors, Symptoms & Treatment

April 5, 2021

Head and neck cancers make up roughly 4 percent of all cancers in the U.S. These cancers may arise in the oral cavity, pharynx (throat), larynx (voice box), nasal cavity, paranasal sinuses, thyroid and salivary glands. Some famous people afflicted with these cancers -- Actor Michael Douglas, George Harrison of the Beatles, Mafia Kingpin John Gotti and movie critic Roger Ebert – have brought attention to the disease.

Who is Most at Risk?

Studies have shown that men, those with human papilloma virus (HPV), and Asians (specifically those born in China) are at higher risk for head and neck cancers.

Men are 2-3 times more likely than women to develop head and neck cancer, however the rate in women has been rising for several decades. Michael Rotkowitz, MD, a Medical Oncologist at the Sidney Kimmel Cancer Center – Washington Township, attributes this to an increased incidence of HPV infection among women.

“While the highest rates of head and neck cancer are in older males, the incidence has been increasing in young, non-smokers, as HPV plays a prominent role in the development of this type of cancer,” says Rotkowitz. Persistent HPV infection is the cause of nearly 70 percent of all oropharyngeal (back of the mouth behind the oral cavity) cancers, says Rotkowitz.

Native Chinese are more at risk for head and neck cancer, perhaps due to early life exposure to carcinogenic agents; environmental pollution from urbanization and industrialization; an increase in the elderly population; smoking; alcohol; betel nut chewing a (popular pastime in Southeast Asia and the Pacific Islands); and HPV infection.

What are the Primary Risk Factors?

“Tobacco (smoked and smokeless) is the most important known risk factor for the development of head and neck cancer,” says Rotkowitz. “There is some evidence of a genetic predisposition to the carcinogenic effects of tobacco, and those who use tobacco and consume alcohol appear to be more at risk than those who use one or the other.”

If you routinely drink alcohol, currently use tobacco products or have used tobacco products in the past, it is important to receive a general health screening examination at least once a year. This simple, quick procedure in which a doctor looks in your nose, mouth and throat for abnormalities and feels for lumps in the neck could be lifesaving, says Rotkowitz. Routine dental checkups are also an important screening tool.

According to Rotkowitz, there is hope for the future as researchers are working to develop screening tests that could detect the presence of certain head and neck cancers based on compounds found in saliva.

Symptoms and Treatment

Head or neck cancer symptoms to look out for include:

  • mouth pain
  • non-healing mouth ulcers
  • difficult or painful swallowing
  • weight loss
  • obstructive sleep apnea
  • hoarseness of voice
  • bleeding
  • or a neck mass.

If diagnosed with a head or neck cancer, the Sidney Kimmel Cancer Center – Washington Township employs a multidisciplinary approach -- including surgeons, medical oncologists, radiation oncologists, dentists, speech/swallowing pathologists, dietitians, psychosocial oncology, prosthodontists and rehabilitation therapists – to treat patients.

About 30-40 percent of patients who present with localized (early stage) disease are treated with either primary surgery or definitive radiation therapy. Five-year overall survival in patients with Stage I or II disease is typically 70-90 percent. Advanced disease (Stage III/IV) is associated with a high risk for recurrence and spreading to other parts of the body, therefore a combined treatment plan of surgery, radiation therapy and/or chemotherapy is generally required to support long-term disease control.

Bright Spots on the Horizon

On June 12, 2020, the FDA expanded the use of Gardasil 9 to include prevention of oropharyngeal and other head and neck cancers caused by certain types of HPV.

Additionally, because of the better prognosis for patients with HPV-associated oropharyngeal cancer, clinical trials are underway with the goal of maximizing long-term cure rates while minimizing toxicity.

“Although there is no proven way to completely prevent head and neck cancer, you can lower your risk by stopping the use of all tobacco products, avoiding alcohol, using sunscreen -- including lip balm with adequate sun protection factor – maintaining proper dental care and reducing your risk of HPV,” says Rotkowitz. “Limiting your number of sexual partners can also reduce your risk of HPV.”

For more information on the Sidney Kimmel Cancer Center - Washington Township and services offered, click HERE