Head and neck tumors are a group of neoplasms located in the head and neck area (except the brain). They develop insidiously, as the first symptoms of head and neck tumors suggest a cold. Moreover, they are increasingly developing in young people who do not smoke or abuse alcohol and therefore do not have traditional risk factors. Check the symptoms of head and neck cancers, what is their treatment and prognosis.

Head and Neck Tumorsis the collective name for all cancers located in the head and neck area (except brain and eyeball). Head and neck cancer is the 7th most common cancer in the world.¹ In the world, 600,000 people are diagnosed with head and neck cancer each year, and 350,000 patients die.² Head and neck cancer accounts for 6 percent of all cancers in Poland. two to three times more common than women, but the incidence of head and neck cancers in women continues to increase .¹

Head and neck cancer is half as common as lung cancer but twice as often as cervical cancer.

Head and neck tumors - causes

Causeshead and neck cancersare unknown, but it is known that smokers who abuse alcohol are at risk of developing the disease (men consuming 60 g and women 40 g alcohol, they are at a much higher risk of developing head and neck cancer daily.

Men are 2-3 times more likely to suffer from head and neck cancer, but the number of cases among women is increasing.Head and neck canceris most common in people over 40 years of age, but in recent years all over Europe, including Poland, there has been an increase in incidence among young people, under 40 lives who have never smoked or abused alcohol. In these people, tumors are very aggressive and most often occur in the mouth and throat.

Recently, however, specialists have observed a disturbing trend - malignant tumors of the head and neck affect younger and younger people who have never smoked or abused alcohol. This is closely related to HPV, which is one of thedisease risk factors .¹

- We estimate that in the coming years, the number of HPV-related head and neck cancers will increase to 50 percent. Head and neck cancers usually occur in the 6th and 7th decade of life, however, we observe a disturbing trend - a new population of young patients even before the age of 40, which is closely related to the presence of HPV. Currently, in the Scandinavian countries, e.g. in Sweden, over 90% of middle throat cancers are associated with HPV - warns prof. Paweł Golusiński from the Department of Head, Neck Surgery and Laryngological Oncology of the Greater Poland Cancer Center in Poznań.

HPV-dependent cancers of the head and neck are caused by persistent infection with the human papillomavirus. Unfortunately, it is difficult to protect yourself against HPV and there are no reliable, pharmacy tests that could detect it. Its presence can only be confirmed in a professional laboratory, where the source material is strictly defined (e.g. it is a fragment of a neoplastic lesion).

The spread of the virus is favored by a large number of sexual partners, but theoretically, you can also catch it by kissing. The virus is so sneaky that we often don't even know that we are its carriers. There is also no effective treatment, but a he althy body usually fights off an intruder within 6-8 months. For some people, however, it is different and the virus infection takes a persistent form, which may lead to cancer after many years.4

- HPV-dependent head and neck cancers are more common in men. They can transmit the virus just like women, so vaccination against HPV for girls and boys is very important. It should be remembered that vaccinations protect not only against oncogenic, but also non-cancerous types of HPV that cause papillomas - explains Prof. Paweł Golusiński.

Head and neck tumors - symptoms

Your primary care physician should refer you to a head and neck specialist if you experience any of the following symptoms for three weeks (this is known as the "one through three" rule):

  • sore tongue, untreated mouth ulcers, and / or red or white patches in the mouth
  • sore throat
  • persistent hoarseness
  • pain and / or difficulty swallowing
  • lump in the neck
  • stuffy nose on one side or nose bleeds

The most common locations of head and neck cancers are the mouth (42%), pharynx (35%), and larynx (24%).

If you notice 1 of the following symptoms, which lasts for 3 weeks, see your doctor immediately.

According to an expertProf. Wojciech Golusiński, head of the Department and Clinic of Head, Neck Surgery and Laryngological Oncology at the Medical University of Poznań at the Greater Poland Cancer Center in Poznań

Most patients with head and neck neoplasms (60%) come to their GP too late, in stage III and IV of the neoplastic disease. The chance of a complete cure for these patients is problematic. Most of them die in the first five years after diagnosis.

The only hope for patients with head and neck neoplasms, regardless of age, is quick diagnosis and minimally invasive treatment. Then 95% of them return to work with a good quality of life. Continuous education of all of us and preventive examinations can ensure success in oncological treatment

In Poland, there is a National Head and Neck Cancer Prevention Program, initiated by prof. Wojciech Golusiński. The centers that implement it are:

  • Greater Poland Cancer Center Maria Skłodowskiej - Curie in Poznań
  • Medical University of Karol Marcinkowski in Poznań
  • Medical University of Silesia in Katowice
  • Oncology Center - Institute of Maria Skłodowskiej - Curie in Warsaw
  • Radom Cancer Center
  • Lower Silesian Cancer Center in Wrocław
  • Świętokrzyskie Cancer Center SP ZOZ in Kielce
  • Medical University of Lodz
  • NU-MED Center for Diagnostics and Oncological Therapy in Tomaszów Mazowiecki
  • Provincial Multispecialist Center of Oncology and Traumatology M. Kopernika in Łódź
  • Provincial Clinical Hospital of them. Karol Marcinkowski in Zielona Góra.

Head and neck tumors - diagnosis

During the visit, the ENT doctor conducts an interview and examines whether there are any visible neoplastic changes in the area of ​​the ears, nose, mouth, middle throat, lower pharynx and larynx.

The patient does not require any special preparation for the visit. On the other hand, if the doctor notices neoplastic changes during it, then he or she will refer you to tests aimed at determining their nature and stage of advancement.

Head and neck tumors - treatment

An early cancer diagnosis gives a chance for a complete cure. Currently, the following treatment methods are used, available depending on the stage of tumor development:

  • radical surgical treatment
  • radiation therapy
  • chemotherapy

Immunotherapy, which stimulates the body's immune system, gives very good results in the treatment of head and neck cancersto fight cancer. This is a method that has received much attention in recent months due to the Nobel Prize awarded to its discoverers. Unfortunately, immunotherapy is not yet available for Polish patients with head and neck cancer as part of drug programs.6

Immunocompetent drugs are registered and reimbursed in the treatment of head and neck cancers in many countries around the world. In Poland, these drugs are not reimbursed in this indication. Currently, immunotherapy is reimbursed in the treatment of melanoma, non-small cell lung cancer, kidney cancer and Hodgkin's lymphoma. Patients with head and neck tumors do not have access to them.7

On June 11, 2022, the President of the Agency for He alth Technology Assessment and Tariffication issued the first positive opinion on the reimbursement of the anti-PD-1 drug nivolumab under the drug program in this indication.

Patients are still awaiting access to treatment. Unfortunately, the sick are not conducive to either the running out of time or the rulers' decisions.

According to an expertbow. Bartosz Spławski, coordinator of clinical trials at the Klinika Cancer Głowy i Szyi CO im. M. Curie-Skłodowskiej in Warsaw

Treatment of patients with head and neck cancers is very severe and often results in permanent injury and functional impairment. Patients undergo surgery and chemotherapy, which have very serious side effects. One of the new treatments available only in clinical trials is immunotherapy. We have great hopes and opportunities for patients with it.

However, in Poland, immunotherapy is not reimbursed in patients with head and neck neoplasms.

Patients with head and neck cancers face a wide variety of problems, and their quality of life is significantly reduced. - The road to cure a patient with head and neck cancer is very long and difficult.

- Therapy is exhausting not only physically but also mentally. It happens that patients stop leaving home after treatment and break off their social contacts. They are ashamed to show themselves in public, have problems with basic life functions such as swallowing or speaking. We try to bring them back to society - explained Dr. Sławomir Marszałek, president of the Association of People with Cancer of the Head and Neck from Poznań. Unfortunately, often after the treatment of head and neck cancers, it is the problem with nutrition that becomes an insurmountable barrier when it comes to the patient's life in society. Patients are ashamed to eat even with their immediate family, which intensifies their sense of rejection.

Ms Beata faces the difficulties of treating head and neck cancersUrbanek-Żywica, patient of the Oncology Center M. Curie-Skłodowskiej in Warsaw.

- Cancer is a terrible disease and we should do everything we can to ensure that affected patients receive the best possible care and treatment. I have been a patient of the Oncology Center for two years. After I was diagnosed with cancer, I underwent radiation and chemotherapy. It was the most difficult experience in my life and it was associated with a long period of regaining the ability to function normally (until today I have a problem with tastes and eating many dishes). Unfortunately, the time of joy after the end of the therapy did not last long - it turned out that the treatment had to be continued. Fortunately, I qualified for a clinical trial with immunotherapy, thanks to which I can function very well, actively and enjoy life despite my illness. I wish this chance to all patients, not only the "chosen ones" - she said.

Head and neck tumors - prognosis

Most head and neck cancers are diagnosed in the late stage of the disease, when traditional methods of treatment are not able to help. Currently, there is no effective therapy at stage III and IV that would improve patient survival. The only treatment available is palliative treatment, aimed at relieving the symptoms of the disease and the accompanying ailments.

More information can be found on the website of the National Head and Neck Cancer Prevention Program - www.oppngis.pl

Category:

Oncology