Dr. Adam Zanation of Carolina Ear, Nose and Throat and Sinus Center is
an active member of the medical staff at Catawba Valley Medical Center.
Head and Neck cancer is defined as a set of malignancies that occur anywhere
from the nose to the mouth/tongue, the throat, or the voice box (larynx).
While many different types of cancer can occur in these areas, squamous
cell carcinoma is by far the most common. The most common presenting symptoms
are a neck mass large than a grape, speech and swallowing problems, and
unexplained weight loss.
While the traditional risk factors for Head and Neck cancer are tobacco
and heavy alcohol use, this is changing with a new type of Head and Neck
cancer that is becoming more commonplace. Human Papilloma Virus (HPV)
related Head and Neck cancer, over the last 10 years, has become the most
common type of throat cancer, and its incidence is growing in the U.S.
The diagnosis of Head and Neck cancer is usually made by an Otolaryngology/Head
and Neck Surgeon (or ENT doctor).
The pathophysiology of HPV-related Head and Neck cancer is due to the virus’
propensity to infect the lymph cell of the tonsil and the back of the
tongue (an area called the Oropharynx). In certain genetically suspectable
patients, the virus blocks the tumor suppressor genes in these cells,
and then these cells can grow unchecked into malignancy.
Similar to traditional Head and Neck cancer, the HPV-related form often
presents with neck masses and throat dysfunction. The diagnosis includes
a biopsy of the tonsil or tongue tumor or neck mass with an analysis of
the molecular markers for the viral infection. After diagnosis, the patient
is staged with CT scans or PET scans to evaluate the extent of the disease
and possible metastases.
Once staged, the patient’s data is then presented to the multi-disciplinary
tumor conference where healthcare providers from Otolaryngology, Radiation
Oncology, Medical Oncology, Radiology, Pathology, Pulmonology, General
Surgery, and others all review all the imaging, pathology, stage, and
patient information. Finally, an optimized and personalized treatment
plan is made as a group, and this is presented back to the patient.
HPV-related Head and Neck cancer is usually treated with some combination
of surgery, radiation, and chemotherapy. We optimize the treatment plans
with cancer cure as our top priority and then plan to minimize swallowing
and voice dysfunction also.
HPV-related Head and Neck cancer has a high rate of cure, much higher than
Head and Neck cancer that isn’t related to HPV. However, long-term
cancer follow-up with serial exams and scans is still necessary. For more
information on Head and Neck cancer, go to:
Lastly, the HPV vaccine safely provides excellent protection from HPV infection
and reduces cancer risks, including Head and Neck cancer risks. They are
currently approved for anyone under the age of 45. See your primary care
healthcare provider for more information. For more information on the
Adam Zanation, MD, MBA, FACS, is a fellowship-trained Otolaryngologist/Head
and Neck Surgeon specializing in Head and Neck tumors. Learn more at https://carolinaearnosethroat.com.