Dedicated to Discovery. Committed to Care.

Photo: As Robert Lebeau (center) takes a swallowing test at Brigham and Women's Hospital, speech pathologist Terese Hammerle (left) and radiology resident Glenn Gaviola, MD, watch the X-ray screen.

As Robert Lebeau (center) takes a swallowing test at Brigham and Women's Hospital, speech pathologist Terese Hammerle (left) and radiology resident Glenn Gaviola, MD, watch the X-ray screen.

Improving survival

Caused principally by smoking and drinking, cancers of the head and neck strike 40,000 people and kill 13,000 each year in the United States. The Institute treats 300 to 500 new patients annually for all types and stages, from the earliest lesions to the rarest and most challenging cases. Brigham and Women's Hospital and Dana-Farber collaborate through the Head and Neck Oncology Program, which is based at DFCI; surgeries are performed at BWH.

Photo: These time-lapse images show a baruim solution going down Rober Lebeau's throat; this process helped caregivers assess how radiation treatment for tongue cancer has affected Lebeau's swallowing.

These time-lapse images show a baruim solution going down Rober Lebeau's throat; this process helped caregivers assess how radiation treatment for tongue cancer has affected Lebeau's swallowing.

These cancers develop in the mouth and oral cavity, throat, larynx or voicebox, sinuses, and salivary glands. Ninety-five percent are squamous cell tumors, affecting the epithelium (membranous lining) of the mouth, throat, larynx, sinuses, and other structures. The rest are cancers of the salivary glands.

Tobacco use accounts for about 75 percent of the cases; add drinking and the risk is higher. Other factors include viruses, such as Epstein-Barr and the Human Papilloma Virus (HPV), and exposure to irritants such as wood and metal dust, radiation, asbestos, diesel exhausts, and wood stoves. HPV is believed to be causing a rise in tongue and tonsil cancers.

Although they may be easily felt or seen (see related story), such cancers are sometimes obscured by tissue and bone and can go unnoticed or misdiagnosed for months. Sometimes they are spotted by dentists during routine checkups. Many patients find neck lumps and doctors initially treat them with antibiotics, suspecting infections.

Paths of Progress, Fall/Winter 2004

Paths of Progress Archive

Looking for signs

Here are some common warning signs of oral, head, and neck cancers:

  • Red or white patch in the mouth that lasts more than two weeks
  • Change in voice or hoarseness that lasts more than two weeks
  • Sore throat that doesn't subside
  • Pain or swelling in the mouth or neck that doesn't subside
  • Unexplained lump in the neck

Warning signs that occur during the later stages include ear pain, tongue numbness, and difficulty swallowing or breathing.