Checkup on Health: Tobacco users must beware head and neck cancers
By Paul Donald, M.D.
Director of the Center for Skull Base Surgery at UC Davis Medical Center, Sacramento.
Most smokers are already well aware of their increased risk of acquiring lung cancer. Fewer people know about the patients I see every day, those with cancer of the lips, mouth, nose, throat, sinuses or larynx (where the voice box is located).
These cancers account for about 6 percent of all cancer diagnosed annually in the U.S. Ninety percent of these cancer victims can blame their illness directly on tobacco use.
It is especially disturbing to me to hear about the recent upsurge in cigar smoking. Many believe that this habit is safer than smoking cigarettes. Not true! All tobacco products, whether they are inhaled or not, put users at risk for head and neck cancers. The cancers I see would be nearly nonexistent if it weren’t for the use of not only cigarettes, but also pipes, cigars, dip, snuff and chew.
Head and neck cancers used to be predominantly a men’s disease. Now women’s smoking rates are increasing, and this is no longer the case. As a result, women are being diagnosed with these cancers in about equal numbers as men. Another disturbing trend is the use of smokeless tobacco products by young teens and even children. While head and neck cancers typically appear when patients are in their 40s or 50s, we are starting to see cancer in even younger people because of early tobacco use.
Tobacco products in combination with alcohol are a particularly deadly mix. The increased risk is 2.5 times the rate expected from using both of these substances.
Advanced cancers of the head and neck region have poor survival rates compared to many cancers. Fewer than 60 percent of these victims with advanced disease survive five years after being diagnosed. And many survivors are left with severe disfigurement and disability. Lifelong problems with breathing, hearing, swallowing and speaking are common.
Death rates and disability can be reduced with early diagnosis. Regular checkups with both a physician and dentist can help spot signs that a person has not become aware of, such as a hard lump in the neck or a questionable lesion on the tongue or cheek.
Being aware of the symptoms associated with head and neck cancers can also help. Keep a high level of suspicion and consult your doctor if you experience any of the following:
- A sore in the mouth that does not heal.
- Loosening teeth or dentures that no longer fit.
- Difficulty or pain while opening your mouth or swallowing.
- A chronic or bloody cough.
- A sensation of a lump in the throat.
- Trouble breathing.
- Ear pain.
- Some people with cancer first experience an unexplained weight loss without being aware of other symptoms.
For those who survive cancer, coping with its aftermath is the next step. Because of the complexity of the head and neck region, rehabilitation is extremely important. Surgery and radiation and chemotherapy may leave nerves, muscles or other structures damaged, leading to a variety of problems.
A team approach is generally used to work towards recovery. A speech pathologist and physical therapist commonly help the patient regain speech, swallowing and eating abilities and resume other activities of daily living. Nutritionists are consulted to ensure an adequate diet plan, whatever the disability. Social service care providers and psychologists assist both the family and the patient to adjust to change.
If you have read this far, chances are that you or someone you love uses tobacco products. I can't overemphasize how important giving up this habit is to good health. While the person must be motivated to stop, more aids than ever are now available to assist people in this difficult process.
New medications that help control addictive urges can be combined with nicotine replacement gum, patches or sprays. Establishing a plan with a doctor is often instrumental to success. The old method of quitting “cold turkey” is very difficult with these highly addictive substances.
Every difficult journey begins with the first step. If you are using tobacco products, bring yourself to the doctor’s office to begin the process of quitting for good. Hard as it is, it is a happier journey than coping with cancer.