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Few people can demonstrate knowledge of head and neck cancers. Meanwhile, they constitute as much as 5 percent. all cancer cases.
With initiative prof. Wojciech Golusiński – President of the Polish Head and Neck Cancer Research Group and prof. Henry Skarżyński – National Consultant in the field of Otolaryngology – 2013 has been declared the Year fight against head and neck cancers. They develop in the nose and paranasal sinuses, mouth, tongue, palate, lip, pharynx, larynx, salivary glands, ear and thyroid gland. Tumors of the brain and eyeball are not classified as head and neck tumors.
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Epidemiologists are observing with concern the constant, avalanche increase in the incidence of this type of cancer in our country and the resulting health risks. Although the risk of developing head and neck cancers is three times higher in men, in recent years it has also increased in women. Head and neck cancers are most common in people over 40, but have also been detected in younger people for some time. To curb these unfavorable trends, the first was developed National Program of Prevention i Early Detection Head and Neck Tumors. The aim of the program is to raise public awareness of cancers localized in the head and neck area, which may contribute to the improvement of treatment outcomes. The educational campaign will be directed to the whole society, but in a special way to general practitioners and ENT doctors. The knowledge provided will enable them to pay attention to the early symptoms of neoplastic disease and refer the patient to the appropriate specialist or treatment center. — Probe 15333 | 300px | 1—
Difficult diagnostics of head and neck tumors
The assumptions of the program were discussed during a debate organized by the Committee of Clinical Sciences of the Polish Academy of Sciences, which took place on April 8, 2013 in Warsaw.
– In Poland, we have about 650 thousand. new cases annually and, unfortunately, as many as 300 thousand. people die, mainly as a result of very late diagnosis. That is why prevention is so important – he said during the debate prof. Wojciech Golusiński. – The fact that women are getting sick more and more often results from the fact that the habit of smoking cigarettes is popular among women. Smokers are at greater risk of developing head and neck cancers. Other risk factors contributing to the development of these cancers include drinking high-proof alcohol (60 g daily for men and 40 g for women), human papillomavirus (HPV) infection, inhalation of paint and varnish vapors, recurrent infections, and poor oral hygiene. Throat cancer in people under 40 is very often associated with the presence of HPV in their body, which is transmitted through sexual contact.
The most common locations of head and neck tumors are: oral cavity (42%), pharynx (35%), and larynx (24%). Prof. Henryk Skarżyński drew attention to the diagnostic difficulties in these diseases. He emphasized that the first symptoms are similar to those we have with banal infections: coughing, scratching, and obstruction when swallowing. – The head and neck are places with many cavities, spaces where the cancer can develop without obvious symptoms of organ dysfunction. This also means that neoplasms are diagnosed late. Often, metastases are detected earlier than the primary focus – explained Prof. Skarżyński.
With such nonspecific symptoms, the patient turns to the family doctor, who may play an important role in the early diagnosis of head and neck cancers. To make it easier for him, leading European experts have created the slogan 1 through 3. This is a summary of the recommendation that GPs refer their patients to an ENT specialist if they find one of the following symptoms for three weeks.
Burning of the tongue, non-healing ulcers and / or red or white patches in the mouth.
– Sore throat.
– Chronic hoarseness.
– Difficulty swallowing or pain when swallowing.
– A lump in the neck.
– Unilateral nasal obstruction and / or bloody runny nose.
Treatment of head and neck tumors
Neoplastic changes in the head and neck area most often affect the mucosa, and consequently, squamous cell carcinoma develops. On the other hand, squamous cell carcinoma and post-cell carcinoma are the most common neoplasms on the lips and in the salivary glands. The survival rate of patients depends on the stage of the tumor. The assessment of this advancement is carried out by diagnostic tests that use endoscopic and imaging techniques (magnetic resonance imaging and computed tomography). He talked about the methods of therapy during the debate prof. Andrzej Kawecki, head of the Head and Neck Cancer Clinic of the Oncology Center in Warsaw.
– In the treatment of head and neck cancers, we use all available methods of oncological therapies – informed prof. Kawecki – surgical procedures, radio- and chemotherapy, as well as molecular drugs. In the case of early detection of the tumor, a minor surgical procedure supplemented with radiotherapy is sufficient. At this stage of the disease, 60-90 percent can be cured. sick. Unfortunately, only 30 percent. patients come to us with an early diagnosis. Others are doomed to extensive surgical resections and more aggressive treatment. In the treatment of head and neck cancers – admitted prof. Kawecki – a lot of progress has been made. New techniques for reconstructive surgery have been developed to restore tissue immediately after resection. New technologies have emerged in radiotherapy, and targeted beams are irradiated, sparing healthy tissue. Treatment is more effective thanks to molecular drugs that are an important complement to radio- and chemotherapy. However, patients who are diagnosed with cancer at an early stage still have the greatest chance of recovery.
Rehabilitation of oncological patients
All oncological patients require not only treatment, but also rehabilitation. Patients with head and neck cancers need rehabilitation more than others. Treatment saves their lives, but significantly reduces its quality. It was pointed out during the debate by Dr. Sławomir Marszałek, a physiotherapist. – Surgery in the area of the head and neck – said Dr. Marszałek – disrupts the functioning of the sensory organs, as well as the work of many systems: respiratory, digestive, lymphatic and others. For example, a patient with a tracheotomy has to learn how to breathe differently. Trouble breathing causes a reduction in overall performance, difficulty bathing and other daily activities. Patients with a larynx removed have to learn to speak again in changed conditions. For example, nervous system disorders are annoying. It may be permanent or temporary paralysis of the half of the face or paresis on the operated side, inability to close the eye, numbness and pain in the head and neck, limbs, disturbance of superficial and deep sensation. There are many negative effects of treatment depending on the tumor site. These patients require comprehensive rehabilitation – emphasized Dr. Marszałek, also psychological and emotional. As a result of the disease and treatment, their entire life has undergone unfavorable changes. Patients with head and neck cancers require emotional support already at the time of diagnosis, and then throughout the entire process of therapy and rehabilitation. The participation of patients in rehabilitation camps is very important, during which they learn the activities that are available to them and can improve their condition. For cancer patients, the following are especially recommended: walks, marches, field trips, Nordic walking, games and physical activities, as well as other health-promoting forms of physical activity.
The Program for Prevention and Early Detection of Head and Neck Tumors assumes the creation of 16 field centers, equipped with appropriate equipment, in which interdisciplinary teams will be established to deal with patients with this type of cancer. Such a team should include: head and neck surgeons (with reconstructive skills), clinical oncologists, otolaryngologists, specialists in diagnostic imaging, prosthetists, physiotherapists, phoniatrists, psychologists. This team will provide patients with multidisciplinary care. A special helpline will be available for patients, thanks to which it will be possible to use nationwide medical telephone consultations. After 8-10 years of operation, the National Program for Prevention and Early Detection of Head and Neck Tumors assumes a reduction in mortality and morbidity due to head and neck cancer in the Polish population.