Oral and Throat Cancer – A New Epidemic – October 2011

Oral and Throat Cancer – A New Epidemic

While the incidence of many other cancers is dropping, doctors are seeing a rise in certain types of oral and throat cancer.  For years, when a patient came to my clinic complaining of throat pain, hoarseness or trouble swallowing, my level of concern was peaked only when that patient used tobacco or alcohol.  Smoking (tobacco and marijuana), oral
tobacco, and alcohol were the primary “risk factors” for oral and throat cancer for centuries.  Over the last 10 years, I have seen an increasing number of adults who have NO history of tobacco or alcohol that develop throat and oral cancer from a socially transmitted virus.  This virus, “HPV” (human papilloma virus), had been previously implicated in cancer of the cervix in women.  We are now seeing a near-epidemic of throat and oral cancer from this virus as well.

Symptoms

The typical symptoms of cancer of the throat are pain on swallowing, hoarseness, throat pain shooting to the ear region, or the development of a visible or palpable lump in the neck. Obviously throat pain and hoarseness can also result from a respiratory infection, but the symptoms should resolve within a few weeks in these instances.  Ulcers and sores in the mouth or tongue that do not heal should also be promptly examined.  Patients with these cancers usually have normal blood tests, and show no other abnormalities on a general physical.

Throat cancer spread to lymph gland in neck

Throat cancer spread to lymph gland in neck

Evaluation

Persons with these symptoms should be examined by a specialist (ENT/Otolaryngology).  If the above symptoms persist longer than several weeks, especially in adults with a
history of tobacco, alcohol, marijuana, an endoscopic exam of the voice box and throat should be performed.  When I am concerned about a lesion in the mouth, throat or vocal area, I recommend an immediate biopsy. When biopsies are performed, we can analyze the tissue and determine if the “HPV” virus was the cause of the cancer.  Often, we obtain CAT or MRI scans of the affected area.  Blood tests are generally useless in the diagnosis of these cancers.

Treatment

Small cancers of the mouth, tongue, throat or voice box can be removed surgically with micro instruments, or the laser.  Larger lesions are treated often by combined surgical removal, and chemotherapy/radiation treatments.  It is imperative to begin the diagnosis and treatment as quickly as possible, since the cure rate is better for smaller, contained growths.  I usually obtain the help of both medical oncology and radiation oncology physicians in more complicated cases.

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