Recognizing the signs

Mouth and throat cancer typically start with painful and enlarging ulcers. Some patients may also experience loosening of teeth.

A hoarse voice is the hallmark of laryngeal cancer. Skin cancers appear in the form of ulcers, while melanoma usually presents as a dark spot which sometimes ulcerates. Thyroid cancer and salivary gland cancer present as a mass within the gland. Sometimes the first sign of the cancer is the development of an enlarged lymph node in the neck.

Clinical examination, imaging scans and biopsy are integral parts of the assessment of the tumor and determining the stage of the cancer. After determining the stage of the cancer a treatment plan can be put in place. All staging protocols are AJCC/TNM based.

HER Magazine features Nebraska Medical Center’s thyroid cancer survivor Bethany Bauer

Risk factors

Tobacco is the chief cause of UAED cancer, and is implicated in more than 90 percent of cases. All types, including smokeless tobacco, are included.

Alcohol, when used together with tobacco, increases the risk 40 times.

Human papilloma virus (HPV) is associated with about 5 percent of UAED cancers.

Radiation exposure and thyroid cancer e.g. after Chernobyl nuclear reactor explosion, and nuclear bomb blasts in Hiroshima and Nagasaki.

Sunlight and tanning bed exposure with skin cancer.

Certain genetic inherited diseases e.g. neurofibromatosis with melanoma.

Current research and grants

Depression is common experience for a significant number of patients with head and neck cancers. Cases of depression are far higher with cancers of the head and neck compared to cancers inside or on other parts of the bodies due to the fact that they are visible on the patient and often subjected to public scrutiny. A Nebraska Medical Center One surgeon and psychiatrist, has been awarded a NIH grant for $1.6 million to study depression and the effect of its treatment on the outcome of the cancer. Two scientists from The Nebraska Medical Center have also been awarded a $10 million NIH grant to study cellular adhesion molecules.

Possible treatments

UAED cancers are divided into two groups, early and advanced. Early cancers are treated by single approach either surgical or radiation therapy.

In most radiation cases, a new course of treatment called IMRT (interstitial modulated radiation therapy) is used. During this treatment radiation is delivered directly to the cancerous area, while sparing the surrounding and healthy tissues. Laser resections are also used for select cases of laryngeal cancers.

Advanced cancers are treated by surgery, chemotherapy and radiation therapy. In the event that resection of the tumor is not an option, then chemoradiation is used. If the patient is too frail to tolerate chemotherapy, the course of treatment is a so-called targeted therapy. Our radiation oncologist has experience in giving re-irradiation in patients with recurrent cancers.

Skin cancer is treated by surgical excision. In more advanced melanomas, immunotherapy with interferon is added.

Thyroid cancer is treated by surgical resection. Postoperatively most patients are given radio-active iodine to treat any microscopic metastases which might be present.

Salivary gland cancer is subjected to surgical resection, usually followed by radiation therapy.

Sarcomas (soft tissue cancers) are treated by radical surgical resection.

Support for People with Oral, Head and Neck Cancers (SPOHNC)

The Omaha chapter of national self-help support group for patients with oral, head, and neck cancers. Spouses, family, & friends also welcome. Please contact the Social Work Department at 559-4420 for location, time and other information.

The Nebraska Medical Center Survivorship Program

A Survivorship Program at The Nebraska Medical Center are available to patients as point of transitional care before the patient returns to their primary care doctor. Introduction to this program is made following the completion of cancer care at The Nebraska Medical Center. During participation in this program the survivor is offered a multi-disciplinary clinic where social workers, physical therapists, RN case managers and nutritionists develop a "survivorship care plan" based on the survivor's special medical, physical and nutritional needs. Read more

For Physician Referrals or more information on head and neck cancer programs call 1-800-922-0000