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Head and Neck Cancer: Unveiling Risks and Prevention · Talking FACS

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  Welcome to Talking FACS, and thank you for tuning in to Cancer Conversations
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  on Talking FACS, a podcast collaboration between the University of Kentucky
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  Markey Cancer Center and the UK Martin-Gatton College of Agriculture,
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  Food and Environments Cooperative Extension Service.
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  We will share with you the latest developments in cancer prevention,
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  diagnosis, treatment and research from the experts at Markey Cancer Center,
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  Kentucky's only National Cancer Institute designated Comprehensive Cancer Center.
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  Talking Facts is hosted by the UK Family and Consumer Sciences Extension Program.
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  Our educators share research knowledge with individuals, families,
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  and communities to improve quality of life.
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  Hello and welcome to Cancer Conversations on Talking FACS.
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  This is a collaboration between the UK Markey Cancer Center and the Cooperative
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  Extension Service in Kentucky. I'm your host, Mindy McCulley,
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  Extension Specialist for Instructional Support with Family and Consumer Sciences Extension.
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  We are housed in the Martin-Gatton College of Agriculture, Food, and Environment.
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  Even before we are born, one of the earliest discoveries is the sound of our
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  mother's voice, and perhaps after we're born, we start to hear our own voice.
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  So, perhaps if we have a diagnosis of cancer of the head or the neck,
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  and that affects the things that we hear or our ability to speak,
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  that is going to be quite devastating.
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  So our guest today is Dr.
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  Melina Windon, who is an assistant professor for ear, nose, and throat.
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  And she's going to talk to us about what it means to have a cancer diagnosis
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  of ear, nose, and throat.
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  So welcome, Dr. Windon. Thank you so much for having me.
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  First of all, share with me, what is your your specialty is ear nose and throat
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  surgery? So what does that really mean?
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  So ear, nose, and throat surgeons take care of lots of different diseases that
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  involve hearing, our ability to speak, and our voice.
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  And my particular subspecialty training, so what that means is I did some additional
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  training after an ENT surgery residency, is called head and neck surgery.
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  So what I'm particularly focused on is cancer of the head and neck.
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  What that means is anything cancerous or even non-cancerous mass or lesion that
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  would need to be removed above the collarbones, so north of the collarbones,
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  but outside the brain is how you can think about.
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  And in some instances outside the eye as well, although some of our diseases do extend into the eye.
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  And so that's my responsibility. I also have some additional specialty training
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  to do reconstructive surgery of the head and neck.
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  So if we have to take out a tumor of the tongue, say,
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  or a large portion of the skin of the head or neck that requires reconstruction,
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  so we have to put tissue back into that area to restore our cosmetic outcome
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  or the patient's ability to speak or to swallow,
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  then we can do that by bringing in tissue from elsewhere on the body that we can spare.
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  So sometimes from the leg or from the arm.
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  And that's actually a transplant, a type of transplant surgery.
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  So I'm especially trying to do the reconstructive portion of that as well.
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  That sounds fascinating.
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  What are some risk factors that might put people at risk for head or neck cancer?
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  So the most common risk factor is actually maybe up for debate at this point.
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  The reason for that is head and neck surgery has a long history.
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  And for the majority of that history, the number one risk factor for cancer
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  of the head and neck would be tobacco exposure.
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  So smoking or chewing tobacco, smoking cigars, even secondhand smoke can be
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  a risk factor for the development of head and neck cancer. There has been a
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  shift, however, recently.
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  And by recently, I really mean the past 20 years, because we've started to realize
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  that another major risk factor for head and neck cancer is the HPV virus.
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  So, and that's something that not a lot of folks know.
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  We hear about HPV causing cervical cancer, and that's in a lot of our public
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  health messaging on social media, through television.
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  When we go to our primary care doctor's office or primary care provider's office,
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  you hear about HPV causing cervical cancer.
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  However, HPV, which stands for human papillomavirus, actually causes more throat
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  cancer than it does cervical cancer.
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  And throat cancer of this specific type is actually one of the more common cancers
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  that we see right now that come into our offices with the diagnosis of cancer.
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  So I would say the two major risk factors for the development of head and neck cancer
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  are smoking and the exposure to the HPV virus. Third one is heavy alcohol use.
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  And we know that patients who smoke cigarettes, but they also have a history
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  of drinking alcohol heavily, have a higher risk than those who just do either
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  of those two exposures independently.
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  That we either are heavy drinkers and don't smoke or are tobacco users,
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  but they don't drink heavily.
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  Oh, okay. My next question then is, what can I do to prevent a head or neck cancer?
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  So it would seem pretty obvious then, don't smoke or drink heavily,
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  but I'm sure there are other things as well.
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  There are. So yeah, of course, much easier said than done to put down the path of cigarettes.
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  There are lots of ways that we can help you do that and those who are listening
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  that may be smoking, there are lots of different medications that can be helpful.
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  There's counseling that can be helpful.
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  And so I would encourage you all to speak to your physician about that or your
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  primary care provider about that to understand ways that might be acceptable
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  to you to be able to help you.
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  Help you reduce your risk there.
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  Another way is that we actually have a vaccine now for preventing HPV.
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  So I'll talk a little bit about how we get exposed to HPV and then how to prevent it with the vaccine.
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  And I know you had, I think, Dr. Hull on the last few months focusing on this.
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  So I don't have to do too much here.
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  So most folks get exposed to HPV during their college-age years or in their early 20s or 30s.
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  And human papillomavirus is a sexually transmitted infection.
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  It's actually the most common sexually transmitted infection worldwide.
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  And it is everywhere. I mean, it is very, very, very common.
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  Sometimes there's concern. Does that mean that somebody who has been infected
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  with HPV is premised US, that sort of thing? No, it's really everywhere.
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  And typically, those folks who are unlucky enough to get a throat cancer from
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  this, and And this is very, very rare, mind you.
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  Those folks don't get it until decades later.
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  And even when they're diagnosed with this, we don't actually recommend that
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  they change their sexual behavior at all.
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  The vaccine comes into the picture because we'd like to give it to children
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  between the ages of, oh man, don't quote me on this, I believe it's 9 through 14, boys and girls.
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  And we actually see the throat cancer more commonly in men, much more commonly in men.
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  And so it's really important that both boys and girls get vaccinated.
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  The vaccine is safe. It's been around since 2009.
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  It's approved for both boys and girls.
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  It is actually also approved now up through age 45, although there isn't a strong
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  recommendation for that.
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  The reason for that is we hope that folks can get vaccinated before they ever
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  get exposed to HPV. And so that really works best when children get the vaccine.
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  So even before anybody wants to think about their child having a sexual exposure,
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  we know that it works best in that age group.
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  So another way that you can prevent is by getting vaccinated or having your
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  children get vaccinated against HIV, the human papillomavirus.
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  There are other lesser well-established risk factors for head and neck cancer.
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  Those are poor oral hygiene and then having a healthy diet and taking good care
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  of your teeth can most likely prevent some head and neck cancers as well.
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  But the other thing is when you do have a small lesion on the inside of your
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  mouth that's not healing or something on your tonsil that you see, it's not healing.
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  One way that that sometimes becomes apparent is when you go to your dentist
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  and they do something called an oral cancer screening.
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  They're looking at all the pink lining of the inside of your mouth and your throat.
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  And they do actually catch a number of these early lesions that can eventually turn into cancer.
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  So if you have a spot that you want someone to look at, I would definitely talk
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  to your dentist about it. You can talk to your primary care provider about it.
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  They can get you in to see an ENT as well, certainly, or a biopsy.
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  Okay. There's so much information there that is unknown to me,
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  so I'm sure unknown to our listeners as well.
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  So what are things that people should look out for? I guess even before they go to see a doctor.
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  So things to look out for are, as I mentioned, things, spots that don't go away,
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  little white or pink, red spots on the inside of the mouth or in the throat
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  that just aren't healing. They're causing persistent pain.
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  Sometimes this can show up as a mass on the neck. What I mean is a lump on the neck.
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  Typically, the story we hear is, oh, I felt this while I was shaving.
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  Usually in an adult man, it typically shows up.
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  And the reason that we take that very seriously is if that lump has been there
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  for more than two weeks, it's really not going away, at that point probably needs a biopsy.
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  A lot of folks end up getting a lot of courses of antibiotics for their treatment of neck masses.
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  And it gets to the point where they end up in our clinic and we're doing a biopsy.
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  So the reason I want to take that seriously is because sometimes if you have
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  a mass on your neck or a lump on your neck, it can mean that there's a very
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  tiny tumor in the very back of
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  the throat in the tonsil tissue that has metastasized the neck lymph node.
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  And I don't want to cause any listeners. Sure. I mean, still the most common
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  thing is that it's just, you know, benign, but meaning not cancerous,
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  but we just want to take those seriously if they last for a long time and they're
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  not changing, not getting better.
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  So I would say a lump on the neck. And then especially if you have issues with
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  swallowing, the other thing is changes in your voice.
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  If your voice sounds very hoarse, and if, you know, especially those listeners
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  who have a history of smoking cigarettes,
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  if your voice sounds hoarse, then at that point, it might be worth it to get
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  in with an ENT doctor to take a look around the voice box and make sure that
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  there's not a small lesion on your vocal cords that could be causing some of that hoarseness.
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  Certainly anything more worrisome, like bleeding from the mouth or throat,
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  we would take very seriously as well. So those are things that I would look out for.
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  That's all very, very helpful, I think, definitely.
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  Dr. Windon I appreciate the time that you've given me this morning.
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  I know that your time is very valuable, and this is such useful information
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  that I know our listeners will benefit from. Well, thank you so much for having me.
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  We're looking in the state of Kentucky. Of course, we have listeners all over
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  the United States and worldwide.
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  This information is applicable to everybody, but certainly in the state of Kentucky, very important.
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  And we have the highest incidence and the highest mortality from head and neck
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  cancer in this state if we compare to other states and also areas worldwide.
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  So, I mean, it's very, very important to get into care.
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  So, you know, I just hope that this information can be useful.
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  Oh, definitely, definitely. And if you're just tuning in, you're listening to
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  Cancer Conversations on Docking Facts.
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  And you can find us wherever you listen to your favorite podcast.
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