Head and neck cancer: advances that help personalize treatment

The days of caring for all head and neck cancer patients the same are coming to an end. This is the result of research inspired by U.S. physicians, thanks to recent advances in the use of new drugs, unique surgical innovations, and lower doses of radiation therapy. Baptist Health Miami Cancer Institute – Patients are living longer and have a better quality of life.

April is Oral, Head and Neck Cancer Awareness Month. According to the National Cancer Institute, approximately 67,000 cases of head and neck cancer are diagnosed in the United States each year. Of particular concern is the increase in the number of young people suffering from oral cancer. Previously, most head and neck cancers were found in patients who smoked, but doctors say the recent increase is due to the proliferation of the human papillomavirus (HPV).

lower risk

Anyone can get head and neck cancer, but the risk is higher for people who use tobacco or alcohol and have HPV infection. “Today, there is one very effective way to prevent many head and neck cancers, and even cervical cancer, and that is the HPV vaccine,” he says. Noah Kalman, MD, MBAa radiation oncologist at Miami Cancer Institute.

According to the Centers for Disease Control and Prevention, HPV is the most common sexually transmitted disease in the United States. Although the body fights off her HPV infection, the virus's effects on certain cells may cause him to develop HPV-related cancers years later, and some HPV types may be different from others. more likely to cause cancer than types. Pre-exposure vaccination can help prevent these cancers. The HPV vaccine is recommended for children and young adults ages 9 to 26 years and is also offered to adults ages 27 to 45 years.

Noah Kalman, MD, MBA, radiation oncologist at Baptist Health Miami Cancer Institute

Vaccinations are most effective before you start becoming sexually active, but they can also help prevent cancer if you get them later. Dr. Kallman recommends discussing your specific vaccination needs with your primary care physician or gynecologist. Additionally, people who were vaccinated in the early 2000s, when shots first became available, may consider newer versions of the vaccine that protect against more types of HPV.

Where does head and neck cancer occur?

Head and neck cancer can occur in the tonsils, tongue, and throughout the mouth, including the gums, palate, and cheeks. It also occurs in the salivary glands, sinuses, nose, larynx (or voice box), and lower throat.

As with most cancers, early detection is the key to a good outcome. The most common symptoms include a mass or lump in the neck, difficulty swallowing, hoarseness, blood in the saliva, and/or a pain in the throat that does not heal.

If it's cancer

The good news is that many head and neck cancers are treatable. “Surgery, radiation therapy, and systemic therapy have made tremendous advances,” Dr. Kallman says. “This includes the use of more tumor-killing drugs that in the past were primarily used for other types of cancer, blood-based biomarkers for early detection, and new technologies such as single-port robotic assistance systems. included.”

This single-port system is designed to fit into the narrow space of the throat and is used at the institute for some oropharyngeal cancer patients. The device is inserted through the throat, so no incisions are required.

Dr. Kallman is specifically studying radiation dose tapering for certain HPV-positive patients. Current radiation therapy regimens were developed many years ago, when most head and neck cancers were related to smoking, he said, and HPV-related cancers were associated with other types of head and neck cancers. It added that the response to treatment was better than that of patients.

“We are reshaping the standard of care, and research is focusing on whether treatments can be successful with less intense treatments, for example by significantly reducing radiation doses,” he says. The goal is to de-escalate treatment and maintain good disease control while reducing radiation toxicity.

Side effects and toxicities of radiation therapy may include sensitive skin, sore or dry mouth and throat, loss or change in taste, difficulty swallowing or speaking, and fatigue.

clinical trial

Our institute offers a number of services. clinical trial For head and neck cancer patients. Among them are:

· Maintenance of swallowing function in resected oral squamous cell carcinoma: Examination of the effect of radiation dose (save): Randomized trial.

· A Phase II Randomized Study of Proton and Photon Radiotherapy in the Treatment of Unilateral Head and Neck Cancer – Research to better determine the healthy tissue-sparing benefits of proton and photon therapy.

· Photobiomodulation to demonstrate safety and reduce incidence of oral mucositis in adult head and neck cancer patients – This study included head and neck cancer patients receiving radiation therapy with or without chemotherapy.

· A Phase II, double-blind, randomized trial of topical gabapentin in Mucolox™ for the treatment of oral paresthesia. Opening soon.

· A randomized, double-blind, placebo-controlled study to determine the efficacy and safety of AAV2-hAQP1 gene therapy in participants with radiation-induced parotid hypofunction and xerostomia.

It's important for patients to look for cancer programs that provide comprehensive care, Dr. Kallman says. “Not all cancer programs are able to combine these cutting-edge treatments with robust, specialized treatment and rehabilitation programs, as well as much-needed survivorship clinics,” he says. .

For example, Miami Cancer Institute has oral medicine specialists based in South Florida's only board-certified cancer center, and our survivorship program focuses on healing, recovery, wellness, and disease prevention. All services included.

“Our Brain Fitness Lab helps reverse and prevent chemotherapy-induced cognitive impairment, and our exercise programs help patients safely transition to an active life,” says Dr. Kallman. “We provide rehabilitation and pain management, psychosocial services, stress management and resilience training, nutrition and social work services, and support groups and education programs.”

Click here to learn more about head and neck cancer treatment at Miami Cancer Institute. here.