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Randall Hughes, M.D. Answers Questions On Head and Neck Cancer

Randall Hughes, M.D. Answers Questions On: Head and Neck Cancer

What are the most common types of head and neck cancer?

The term "head and neck cancer" collectively refers to cancers that develop in any of six locations in the body: the sinus cavity, nasopharynx, oral cavity, oropharynx, hypopharynx, and larynx. Head and neck cancers do not include primary brain tumors.

Sinus cancer is probably the least common type, while cancers of the larynx and oropharynx are much more common.

Because the normal surface tissue in the upper aerodigestive tract is made of squamous-cell tissue, the vast majority of head and neck cancers are squamous-cell carcinomas.

What are some common misconceptions about head and neck cancers?

Many people think that head and neck cancers are incurable, when in fact they often can be cured. Many also believe that only elderly smokers get these cancers. That used to often be the case, but it’s not so much anymore.

It’s also a common misconception that surgery to treat head and neck cancers is always disfiguring. This isn’t true – particularly with smaller primary tumors, which can be nicely removed with our UT Southwestern’s minimally invasive laser and robotic procedures.

What are the biggest risk factors for head and neck cancer?

Historically, the large majority of head and neck cancers have occurred in people with a history of tobacco and alcohol exposure – with tobacco use far and away the main risk factor.

Less commonly, people who have worked in the woodworking or leather industries, or have been exposed to certain metal dusts or chemicals may be at risk for head and neck cancer.

Over the last 10 years, there has been an increase in the prevalence of head and neck cancers related to the human papilloma virus (HPV) – the same virus that causes most cases of cervical cancer – and we’re seeing more of those cases at UT Southwestern.

Do HPV-related cases differ from other types of head and neck cancers?

Yes. Patients with HPV-related head and neck cancer tend to be different than most people with the disease. They’re usually younger and healthier overall, with little or no history of smoking, dipping, or chewing tobacco.

HPV (+) tumors are almost always located in the oropharynx – the area around the tonsils and base of the tongue – and are often described by pathologists as being poorly differentiated. When HPV (+) tumors do arise in the larynx or nasopharynx, they may not behave as typical oropharyngeal HPV-related cancers.

HPV-associated head and neck cancers also appear to be more responsive to treatment and have higher cure rates than those unrelated to the virus. Recurrences may happen later and in different locations than is typical with HPV (-) tumors.

Further, there is no evidence that HPV associated with head and neck cancers is sexually transmitted, as is often the case with cervical HPV infection.