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Head and neck cancers, though less well-known than other types of cancer, represent a significant health challenge in the UK and worldwide. In honour of World Head and Neck Cancer Day, we caught up with Professor Chris Nutting, Specialist Consultant Oncologist at the Royal Marsden Hospital, to find out more about the disease.

Professor Nutting is a head and neck cancer specialist with more than 20 years of experience in treating the disease. He is also heavily involved in research into the many cancers that fall under the head and neck cancer umbrella and the development of new treatment pathways.

About head and neck cancer

The term ‘head and neck cancer’ covers a range of tumours that develop in the mouth, throat, voice box, sinuses and salivary glands. Today, these cancers account for around 3% of all cancers in the UK[1]. According to Cancer Research UK, around 12,000 new cases of head and neck cancer are diagnosed each year in the UK.

Head and neck cancers are more common in men than women and are more prevalent in people over the age of 50. Key risk factors for head and neck cancer include smoking, alcohol consumption and infection with human papillomavirus (HPV)[2].

The symptoms of head and neck cancers include a persistent sore throat, lumps in the neck, sores in the mouth, difficulty swallowing and voice changes. Early detection is vital as it significantly improves the prognosis and treatment outcomes. However, it can sometimes be difficult to diagnose head and neck cancers as the symptoms are so similar to those of other minor illnesses. The key difference is that these symptoms continue for a prolonged period.

[1] Cancer Research UK; Head and Neck Cancer Statistics

[2] Macmillan Cancer Support; Causes and Risk Factors of Head and Neck Cancer

Typical treatments for head and neck cancer

The treatment of head and neck cancers typically involves a combination of therapies, tailored to the patient’s specific type and stage of cancer, but often include:

  • Surgery to remove the tumour and some surrounding healthy tissue. In some cases, lymph nodes in the neck may also be removed if the cancer has spread.
  • Radiotherapy is used to destroy cancer cells. It can be a primary treatment or used post-surgery to destroy any remaining cancer cells.
  • Chemotherapy is often used in combination with radiotherapy or before surgery to shrink large tumours.
Latest developments in head and neck cancer treatment

Head and neck cancer treatment pathways are evolving rapidly, with several recent developments improving options and outcomes for patients. These include:

  • Immunotherapy is a relatively new treatment that stimulates the body’s immune system to recognise and attack cancer cells. Immunotherapy is less toxic than chemotherapy and has been shown to offer a much better survival rate.
  • Robotic surgery is a less invasive technique that can be used to treat certain head and neck cancers. It is performed through the mouth, allowing for the very precise removal of tumours and is particularly effective for cancers related to HPV and recurrent throat cancers detected at an early stage.
  • Computer-guided radiation is another more precise treatment option that helps protect healthy cells in the tumour area from damage.
How research and insight are contributing to preventing head and neck cancers

Around 10 years ago, it was discovered that throat cancer can be caused by infection with HPV in men just as it can cause cervical cancer in women. Since then, understanding the role of HPV in head and neck cancers, particularly throat cancers, has been a significant focus for researchers.

It’s been shown that HPV-positive cancers generally have a better prognosis and respond differently to treatment compared to cancers linked to genetics and lifestyle factors. This distinction is leading to more tailored treatment strategies and, in 2018, we successfully campaigned for the HPV vaccine to also be made available to boys. The HPV vaccine was introduced for girls in 2008 and is thought to have reduced cases of cervical cancer by as much as 90%.

The future of head and neck cancer treatment and prevention

The future for head and neck cancer treatment pathways is promising, driven by new technologies and our increased understanding of the disease. However, both new and existing treatments are most effective when the cancer is diagnosed early. Due to the wide range of common symptoms associated with head and neck cancer, early diagnosis can be more difficult. It’s vital that both the public and healthcare professionals understand more about the disease and its warning signs.

Head and Neck Cancer Day is an opportunity to raise the profile of the disease and recognise the substantial progress made in understanding and treating these complex cancers. With new technologies emerging all the time and a deeper understanding of the disease, the future holds hope for improved survival rates for those affected by head and neck cancers.

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