Head and neck cancers with Prof. Dr. Wolfgang Stödtner

1. In which parts of the head and neck are tumors most commonly found?

Tumors in these areas are primarily malignant, originating from the lining of the upper aerodigestive tract. They most commonly occur in the oral cavity, oropharynx, and tonsils, but are also found in the larynx and pharynx.

2. What are the risk factors?

The risk groups are smokers, people who frequently consume alcohol, and those suffering from HPV infections.

3. How are head and neck cancers treated?

We treat these diseases through a combined approach determined by the tumor board. When possible, we surgically remove the tumor radically. Sometimes this necessitates a total laryngectomy. In the early stages, we can apply transoral laser partial cordectomy, which, after radical tumor removal, allows for decannulation, i.e., closing the tracheostomy. Chemotherapy and radiation therapy also play an important role in the treatment of these types of cancer.

4. What are the symptoms?

The most common symptoms are swelling of the neck, swelling of the tongue and oral cavity, wheezing, difficulty swallowing, and enlarged lymph nodes. Some patients also suffer from pain when swallowing.

5. Smoking poses numerous health risks, including: * **Cancer:** Smoking is a leading cause of lung cancer, but it also significantly increases the risk of cancers of the mouth, throat, esophagus, bladder, kidney, cervix, and pancreas. * **Heart Disease and Stroke:** It damages blood vessels, leading to atherosclerosis (hardening of the arteries), which increases the risk of heart attacks, strokes, and peripheral artery disease. * **Respiratory Problems:** Smoking causes chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis, making breathing difficult. It also exacerbates asthma and increases the risk of pneumonia and tuberculosis. * **Reproductive Issues:** In women, smoking can lead to reduced fertility, premature birth, low birth weight babies, and Sudden Infant Death Syndrome (SIDS). In men, it can cause erectile dysfunction. * **Other Health Problems:** Smoking weakens the immune system, increases the risk of diabetes, causes premature aging of the skin, and can lead to vision problems like macular degeneration and cataracts. * **Addiction:** Nicotine is highly addictive, making it difficult to quit even when aware of the dangers.

Smoking is the most crucial factor for the appearance of head and neck tumors. Even a good prognosis for HPV-positive carcinomas worsens in smokers.

6. What is the difference between cancer in the nasal cavity and in the paranasal sinuses?

Cancer in the nasal cavity leads to difficulty breathing through the nose, nosebleeds, and unilateral discharge. Tumors in the paranasal sinuses often show no symptoms, making them undetectable. They are discovered late, when metastases appear in the lymph nodes or invasion of the nasal cavity occurs.

7. What is salivary gland cancer?

Salivary gland tumors in the parotid gland are detected early due to the visible swelling they cause in the face and ear areas. An exception are deeply growing tumors, more commonly known as „iceberg tumors.“ These are diagnosed at a late stage because they lack symptoms. In more serious cases, deep tumors can press on major neck vessels, leading to dizziness. They can also compress the Eustachian tube, causing fluid buildup in the middle ear. Submandibular gland tumors manifest as external neck swellings and are easily palpable through the mouth and neck.

8. The recommended treatment for head and neck cancer depends on several factors, including the specific type and stage of cancer, the location of the tumor, and the patient's overall health. Common treatment options include: * **Surgery:** This is often the primary treatment for early-stage head and neck cancers. The goal is to remove the tumor and any affected lymph nodes. * **Radiation Therapy:** This uses high-energy rays to kill cancer cells. It can be used alone or in combination with other treatments. * **Chemotherapy:** This uses drugs to kill cancer cells, either throughout the body or in a specific area. It is often used for more advanced cancers or when cancer has spread. * **Targeted Therapy:** These drugs target specific molecules or pathways involved in cancer growth. * **Immunotherapy:** This type of treatment helps the body's immune system fight cancer. In many cases, a combination of these treatments will be recommended. The treatment plan is highly individualized and is determined by a multidisciplinary team of medical professionals, including oncologists, surgeons, radiation oncologists, and speech therapists, among others. It is crucial for someone diagnosed with head and neck cancer to consult with a qualified medical professional to discuss their specific situation and the most appropriate treatment plan.

For advanced tumors, the primary method is radical surgical resection, followed by removal of lymph node metastases and concurrent chemoradiotherapy. Among new therapies is targeted treatment with antibodies. It is tailored to the specific tumor unit. It is administered by oncologists after genetic analysis.

9. What are your guidelines and advice for prevention?

Early diagnosis is key. Smokers, in particular, should undergo regular laryngeal endoscopy, oral cavity examinations, and pharyngeal examinations. Quitting cigarettes is beneficial at any stage of life and significantly improves the chances of treatment even for advanced-stage tumors.