Published: Oct. 4, 2010
Updated: Oct. 4, 2010
Neal Ready, MD, PhD, is a medical oncologist and researcher at Duke specializing in lung cancer and cancers of the head and neck.
Head and neck cancer includes many diseases occurring in the face, nose, tongue, tonsils, voice box, and lymph nodes.
Throat cancer is a type of head and neck cancer. There are about 40,000 new cases of throat cancer diagnosed each year. A very heterogeneous group of patients develop head and neck cancers so these types of cancer can affect anyone.
There are two main causes:
The HPV vaccine, which is now recommended to girls to prevent contracting HPV, is active against the same strains of HPV that cause oral cancers.
It's not yet clear why some people with HPV get this throat cancer while others do not. But it does appear that decades can elapse between HPV infection and the appearance of cancer.
The symptoms are common and non-specific to cancer. Patients may have a hoarse voice, pain when swallowing, sores on their tongues or in their mouths that will not heal or go away, and lymph nodes that swell and will not go away.
While these symptoms are common, if the symptoms linger for weeks, individuals should consult an ear, nose, and throat specialist.
Throat cancer caught in its early stages can be treated with surgery or radiation. However, most cases of throat cancer are diagnosed when the disease is locally advanced.
This means there is either a large tumor, or the cancer has spread to the surrounding lymph nodes. In those cases, there is still a chance to cure the patient of cancer.
The two standard treatment options are to surgically remove the tumor, followed by post-operative radiation or give simultaneous radiation and chemotherapy or simultaneous radiation and molecular therapy.
Even advanced stage cancers can be cured. In about five percent of patients diagnosed with throat cancer, the cancer is metastatic, meaning it has spread to other parts of the body. In those cases, we can still treat the cancer, but it is not curable.
Radiation oncologist Dr. David Brizel is studying functional metabolic imaging with PET and MRI scans, in order to better understand how tumor blood flow and sugar utilization can be manipulated in order to treat the cancers more effectively.
Dr. Walter Lee, head and neck cancer surgeon at Duke, opened a tumor bank in which head and neck tumor specimens are stored and can be studied. He also investigates immunotherapy strategies to treat these cancers.
I just opened a stage II clinical trial using RNA and DNA analysis in order to identify specific genetic patterns of those tumors that may respond to treatment with the antibody therapy panitumuab.