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Head and Neck Cancer Boasts a Particularly High Recovery Rate, Says Jefferson Otolaryngologist

Research could prove beneficial to better understanding and curing of all types of cancer, adds research colleague

Head and neck cancer currently accounts for approximately 5 percent of all cases of cancer diagnosed annually in the United States. So says William M. Keane, MD, The Herbert Kean, MD Professor of Otolaryngology-Head and Neck Surgery and Chairman of the Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospital and Jefferson Medical College, Thomas Jefferson University.

“Nevertheless,” Dr. Keane stresses, “its symptoms should not be ignored, especially since head and neck cancer also accounts for one of the most significant cure rates among all cancers – about 70 percent – particularly when discovered early.”

Focus on Head, Neck, and Throat
Head and neck cancer refers to malignant tumors that originate in cells that line various areas of the head, neck and throat, including the mouth, nose and larynx.

Tobacco and Alcohol Users Most Susceptible
Consumers of tobacco (smoked or chewed) and alcohol – especially users of both – are at greatest risk. “However, although they are the minority, non-smokers and non-drinkers can develop cancerous lesions as well, so be alert to the warning signs, ” Dr. Keane advises.

Warning Signs
Dr. Keane pinpoints prolonged hoarseness and difficulty in swallowing, as well as a lump in or around the nose, mouth or throat, as primary warning signs of possible head and neck cancer. “Should any of these symptoms persist after a month, see a physician for an evaluation as soon as possible,” he advises.

Diagnostic Techniques
The primary care physician should evaluate the patient’s medical history and perform a physical examination – particularly, with the aid of a small mirror and/or lights, to examine the patient’s nose, and mouth and larynx. As part of this examination, the doctor should feel for lumps on or in the face, neck or mouth.

If warranted, the physician will refer the patient to an otolaryngologist (ear, nose and throat specialist) for further tests, beginning with a more detailed examination of the interior of the nose, mouth and throat, utilizing a long, slender fiber optic medical instrument called an endoscope. This procedure is performed right in the doctor’s office.

A needle biopsy, which is the removal of some tissue from the patient in the area where a lump or tumor has been detected, is another procedure that can be performed in the office. After performing the biopsy, the otolaryngologist sends it to a laboratory for examination under a microscope by a pathologist to determine the nature of the lump as to whether it is malignant or benign.

In addition, the doctor may arrange for the patient to undergo special x-ray exams, including a CT scan or MRI scan for abnormal tissue of the head and neck area, and PET scan for a look at specific tumor cells.

“All of these techniques are minimally invasive and produce minimal discomfort yet provide critical information for diagnosis and treatment planning,” Dr. Keane notes.

Determining Treatment Options and Effectiveness
When a tumor is diagnosed as being malignant, the otolaryngologist, who specializes in head and neck surgery, consults with specialists in radiation therapy, chemotherapy and rehabilitation medicine. The multidisciplinary team’s purpose is to design a customized treatment program, based on the type of tumor, location, and extent as well on the patient’s age and general state of health.

“In addition to eradication of the disease, modern surgery, radiation and chemotherapy treatment allow for organ preservation and function and minimizing change in appearance while affecting cure in most cases,” emphasizes Dr. Keane.

Following treatment, the otolaryngologist monitors the patient with examinations and x-ray studies for several months to years as part of a surveillance process to be certain that the tumor does not recur.

Research Could Shed Light on ALL Cancers
According to Jay L. Rothstein, PhD, Associate Professor of Otolaryngology, Microbiology and Immunology, the Kimmel Cancer Center at Jefferson, “We are currently involved in studies to develop new treatment options for cancer utilizing gene therapy. The use of gene delivery to alter cancer progression will not only further improve the cure rate of head and neck cancers but may also help relieve other types of cancer-related diseases as well.

“Currently,” Dr. Rothstein elaborates, “Jefferson researchers are identifying genes that appear to cause changes in tissues of the head and neck. This research may help explain some of the earliest changes that lead to cancer and will assist us in exploring newer treatments of these cancers through the use of gene delivery methods to alter cancer gene expression. In particular, we are focusing on the causes and the treatment of thyroid malignancies and thyroid autoimmune disease. Along these lines, we have developed several animal models that represent human disease better than any previously available. In addition to these exciting new mouse strains, we are also using patient specimens to explore the validity of these new ideas.

“The information we obtain from this research is helping to expand our understanding of the relationship between cancer and other diseases, such as autoimmune disease, which is caused when an individual's immune system starts reacting against his or her own tissues. In this way, our research will contribute toward better understanding and treatment of cancer and associated autoimmune disease,” Dr. Rothstein concludes.