DOI: 10.1097/01.COT.0000289863.26863.1c
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Issn Print: 0276-2234
Publication Date: 2002/11/01
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Excerpt
The Surveillance, Epidemiology and End Results (SEER) data from the National Cancer Institute reported that there were some 51,000 cases of upper aerodigestive tract cancer from 1975 to 1998. Sites of these cancers included the lip (7,621 cases); tongue (11,032); gum (2,081); floor of the mouth (6,188); other parts of the mouth (3,970); total palate (3,877); tonsils (5,505); oropharynx (1,509); nasopharynx (2,120); pyriform sinus (3,444); hypopharynx (1,771); and other oral cavity cancers (1,936).
The absolute cure rates for patients with squamous cell carcinomas of the head and neck have changed only slightly over the past 15 years, hovering at approximately 40%.
Nevertheless, advances in organ-sparing surgery, refined chemotherapy and radiotherapy regimens, and sophisticated restorative techniques have altered the way oncologists care for these patients.
As a result, report head and neck cancer specialists, patients who are able to access the services of interdisciplinary teams, whether during the first- or second-line treatment, functional restorative, or palliative phases of their care, can now look forward to better outcomes.
The patient with squamous cell carcinoma of the head and neck starting treatment for advanced disease faces a different future compared with those of 15 to 20 years ago, notes Jan S. Lewin, PhD, Associate Professor and Director of Speech Pathology and Audiology in the Department of Head and Neck Surgery at the University of Texas M. D. Anderson Cancer Center in Houston.
“In terms of curing the cancer, we have not been able to improve survival that much,” she said. “The area where we have shown dramatic improvements and dramatic advances is in the area of restoration and quality of life.”
For instance, said Dr. Lewin, “Twenty years ago, patients with advanced tumors were resigned to the use of a gastrostomy tube to eat, because the prognosis for swallowing and eating by mouth was very poor. Now we know so much more about treatment strategies designed to maintain or restore the functional connections between the brain and muscle activity to be able to swallow. As a result, people are far less likely to become functional cripples after big surgeries or treatments with radiation and chemotherapy.
