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Head And Neck Cancer Diagnosis
Before you begin treatment, your care team will need to diagnose which type of head and neck cancer you have. This is a key first step in developing the best treatment plan for you.
At Memorial Sloan Kettering, sophisticated pathology and imaging tests provide our care teams with a lot of information. The radiologists and pathologists who perform these tests focus on head and neck cancer. This training gives our team the expertise to ensure that you get the right diagnosis. We personalize your care as much as possible.
Throughout the course of your treatment, we'll continue to use some of these tests to track the size of the tumor and assess your response to treatment.
Physical Exam for Head and Neck CancerYour doctor will thoroughly examine the head and neck area, feeling for abnormalities, looking inside the mouth and throat, and using mirrors and lights to examine hard-to-see areas. An experienced doctor may be able to detect problems that a less-experienced one might not observe.
EndoscopyIn some cases, your doctor may use an endoscope (a thin lighted tube with a camera at its tip). This tool is helpful in examining areas of the head and neck that are more difficult to reach. The tube may be inserted through the nose or mouth. A topical anesthetic (a medication applied directly to the nose and throat) can make the examination more comfortable for you.
The exact name of the endoscopy procedure depends on where the tumor is located. For example, you may need a nasopharyngoscopy, pharyngoscopy, or laryngoscopy. Occasionally, a doctor will perform a more thorough type of endoscopic examination called a panendoscopy. This procedure requires general anesthesia.
BiopsyYour doctor may be able to make a diagnosis based on a needle aspiration of the tumor. However, many people need to have a surgical biopsy. During a biopsy, a surgeon removes a small amount of abnormal tissue from the area where the cancer is suspected. A pathologist then examines the sample under a microscope and works with the other members of the care team to make a diagnosis.
At MSK, we have a team of pathologists whose sole focus is diagnosing cancer of the head and neck. This specialization allows us to make the most-precise diagnosis possible. A more-precise diagnosis can improve the effectiveness of your treatment or spare you from treatment that won't work against the disease.
Diagnostic Imaging for Head and Neck CancerAs part of making a diagnosis, a radiologist takes special X-rays of your throat. These may include CT scans, PET scans, MRIs, or a Panorex. (A Panorex is an X-ray that shows the full upper and lower jaw, plus the sinuses.)
Additional imaging tests may include a barium swallow (which helps show abnormalities in the esophagus), dental X-rays, chest X-rays, and radionuclide bone scanning (a sensitive method of measuring bone activity).
These imaging tests provide more details about the tissue. If cancer is found, the scans can show how deep the cancer is and if it has spread.
At MSK, our radiologists use the most-advanced imaging technologies to safely detect and monitor cancer. Our extensive knowledge of head and neck cancer allows us to choose the imaging approach that's best for you and to define the precise extent of the tumor.
HPV Testing for Throat CancerAt Memorial Sloan Kettering, human papillomavirus (HPV) testing is routine for many people with throat cancer. We use a variety of different testing options to help us classify a tumor.
People with an HPV-positive throat cancer have a better prognosis than those with other forms of the disease. We may be able to offer you a less-intensive treatment plan that reduces your side effects without affecting your chances for a cure.
Thyroid Nodule Assessment for Thyroid CancerOur doctors are experts at evaluating thyroid nodules to determine whether you have thyroid cancer. If so, they can determine the cancer's risk level. We will offer treatment options to you based on whether your disease is low-risk or high-risk.
We provide thyroid nodule assessment at multiple locations. For people in New Jersey we offer a specialized thyroid nodule assessment program at our Basking Ridge location.
Genomic Testing for Advanced Head and Neck CancerGenomic testing is also called tumor sequencing or molecular profiling. It involves looking at the cells taken from a tumor to see if there are any genetic mutations (changes in the genes) that could be linked to the type of cancer you have.
For people with advanced head and neck cancer, our experts use a testing approach called MSK-IMPACT™. This test, developed by MSK experts, screens for mutations in more than 450 genes at once.
Based on which mutations we find, we may be able to help you avoid treatments that won't work for you. In some cases, we may be able to recommend a drug that has been approved for the specific changes in the tumor you have. Or you may be able to join a clinical trial testing a new approach, such as a targeted therapy or immunotherapy.
Genetic information about the tumor can help us predict the chances that the cancer will return after treatment.
Almost all of these genetic changes are found only in cancer cells, not in normal cells, which means they cannot be passed on to your children.
Prevention, Causes, And Risk Factors For Head And Neck Cancer
There are a number of different factors that can increase your risk of head and neck cancer. These include using tobacco, drinking alcohol, and being infected with human papillomavirus (HPV), among others.
Not everyone who is diagnosed with head and neck cancer has a known risk factor. Sometimes there is no clear reason why the disease develops.
Learn more about the risk factors for head and neck cancer.
TobaccoTobacco use includes both smoking and smokeless tobacco (snuff and chewing tobacco). People who are exposed to secondhand smoke are also at a greater risk of head and neck cancer.
If you smoke or chew tobacco, you can reduce your risk of head and neck cancer — and the risk to those around you — by stopping now. If you've been diagnosed with throat cancer or are in treatment, it's not too late to quit.
Learn more about Memorial Sloan Kettering's tobacco treatment program.
AlcoholDrinking alcohol is a major risk factor for head and neck cancer.
Tobacco and Alcohol TogetherThe combination of tobacco and alcohol use increases the risk of head and neck cancer even more than either of the two alone. Studies have shown that people who use tobacco and alcohol together have a substantially greater risk of mouth cancer than people who only smoke or who only drink. According to the National Institutes of Health, nicotine and alcohol together account for around 80 percent of mouth cancer in men and around 65 percent of mouth cancer in women.
HPV 16 and HPV 18Human papillomavirus (HPV) is most commonly associated with cervical cancer. There is, however, a strong link between HPV infection and head and neck cancer. This is particularly strong in relation to cancer that begins in the oropharynx (the middle part of the throat). In fact, HPV-positive oropharyngeal cancer is the fastest-growing type of head and neck cancer in the United States.
Your risk of developing HPV-positive oropharyngeal cancer depends in part on the strain of HPV to which you were exposed. For instance, some strains cause warts on the skin, mouth, or genitals but rarely, if ever, cause cancer. Other strains have a higher risk. These have a greater association with cancer. The strains most commonly linked to head and neck cancer are HPV 16 and, less often, HPV 18.
Thankfully, for most people, including those with high-risk HPV, the body will get rid of the infection on its own. Unfortunately, there is no way to predict who among those with HPV 16 or 18 will go on to develop cancer.
Betel Quid and GutkaPeople who chew betel quid or gutka, which are more common in parts of Asia, have an increased risk of head and neck cancer.
Radiation ExposureA history of radiation in the head and neck area increases the risk of salivary gland cancer and thyroid cancer.
AgeSome cancers, like those that begin in the mouth, can take years to develop. For example, most people diagnosed with mouth cancer are over 40. The average age of diagnosis is 60.
People diagnosed with HPV-positive oropharyngeal cancer, on the other hand, tend to be younger.
Ultraviolet LightLip cancer and skin cancer are more common among people who spend time in the sun. Tanning bed use can also increase the risk of lip cancer.
Other Head and Neck Cancer Risk FactorsOther factors that may put you at a greater risk of head and neck cancer include:
Here are the top ways to reduce your head and neck cancer risk:
It's also important to schedule regular checkups with your dentist. This is particularly important if you use tobacco or drink heavily. Many oral cancers are found during routine dental appointments.
Head and Neck Cancer ScreeningCancer screening refers to the exams recommended by doctors to detect cancer before symptoms develop. The purpose is to find cancer at its earliest, most treatable stages.
At present, no screening method has been proven to improve survival for people with head and neck cancer. However, Memorial Sloan Kettering's doctors advise a yearly physical exam of the head and neck by your primary care doctor. MSK experts also recommend a yearly routine dental evaluation. This should include an examination of the neck and inspection of the oropharynx and the mouth. To learn more, see our Screening Guidelines for head and neck cancer.
Memorial Sloan Kettering provides numerous prevention, screening, and wellness services. Our experts organize head and neck cancer screening days each spring in conjunction with Oral, Head, and Neck Cancer Awareness Week, sponsored by the Yul Brynner Foundation. This is a free service to the community to help increase awareness of head and neck cancer. For dates and locations, visit our Public Events Calendar.
Head And Neck Cancers
Content
Cancers of the head and neck present significant challenges for diagnosis, treatment and functional recovery after treatment is finished. For this reason, patients with head and neck cancer are best treated in high volume centers teams with the expertise and experience to achieve treatment success and restore function and quality of life.
Our team consists of fellowship-trained oncologists, speech-language pathologists, registered dietitians and nurses who work together to insure comprehensive and efficient diagnosis and treatment. Treatment options include ablative surgery with microvascular reconstruction; re-irradiation; and systemic treatment with both conventional chemotherapy, immunotherapy and targeted agents. Our primary goal is to efficiently and effectively deliver treatment and to restore patients to their pre-cancer functional status.
Our multidisciplinary team is organized within the Baylor St. Luke's Medical Center Dan L Duncan Comprehensive Cancer Center at Baylor Medicine. Our patients receive leading-edge care through customized treatment plans and access to the latest advancements in clinical research. All aspects of patient care are emphasized, including diagnosis, treatment, symptom control, and nutritional support. If you have questions or want to make an appointment, call (713) 798-5900.
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