Vigilance in detecting neck and head cancer

Head and neck cancers, although not common, often go undetected. Ear, Nose and Throat consultant, Mr Andrew Moore, from The Montefiore Hospital in Hove, says it’s time to become more vigilant to improve patient outcomes.

 “As with most cancers, head and neck cancers are more treatable the earlier they are detected. However, because of their relatively hidden location and little public awareness compared with other forms of the disease, it is hard for patients to connect a nagging sore throat or persistent mouth ulcers with something more sinister,” he said.

The last 10 years has seen an increase in head and neck cancers, especially among younger sufferers.

While I used to see patients in their 60s - typically heavy smokers and drinkers - I am now seeing an increasing number of patients in their 40s and even as young as mid-20s.

While the biggest risk factor remains alcohol and smoking, the Human Papillomavirus (HPV), a viral infection that is passed between people through skin-to-skin contact, has increasingly become a factor.

Genital HPV infections are common and highly contagious and there is a strong link between this and head and neck cancer in people with more past sexual partners.

Cancer caused by HPV tends to be found at the back of the throat, at the base of the tongue and around the tonsil areas.

Many young patients present late with symptoms as they think a persistent sore throat can’t possibly be cancer. Girls aged 12-13 in the UK are now vaccinated against HPV, which should in time both protect them from cervical cancers and – it’s believed – future partners from HPV-related oral cancers.

Risk factors:

• Around 85% of head and neck cancers are caused by smoking. Alcohol is also linked to this form of cancer, and if you drink and smoke, you can increase the risk of mouth cancer by about 30 times
• Exposure to the HPV-16 virus

Symptoms of head and neck cancer to look out for:

See your GP if you have had a persistent sore throat for longer than four weeks, particularly on one side, and pain in the ear, a croaky voice for more than four weeks, persistent mouth ulcers, any lumps or changes to longstanding lumps in the neck.

Have regular dental check-ups – your dentist should spend a few minutes feeling your neck and checking your mouth, gums and tongue for signs of cancer.

Treatment:

If you have been referred to an ENT consultant you will be given a fibre-optic endoscopy – a tiny camera which goes up the nose to gain a view of the back of the throat and voice box. That may be enough to reassure you there are no worrying signs. However, if the consultant has any concerns, you may be sent for an MRI or ultrasound.

Treatment depends on the exact location of the tumour and the stage of the cancer. If the cancer is at an early stage, it may be treated by surgery alone.

The good news is that cancer caused by HPV tends to respond better to treatment than other types of head and neck cancer.

Mr Andrew Moore is an ENT consultant, specialising in head and neck cancers, and holds clinics at The Montefiore Hospital in Hove on Tuesday mornings.

This article was originally published in the Brighton and Hove Independent Friday 21 September 2018.