When It Comes To Chemotherapy And Radiation Sometimes Less Is More
For patients who do require treatment, the severe discomfort and complications of radiation combined with chemotherapy rank as the biggest concerns, says Dr. Hu. So he is encouraged by the early results of a study under way at Perlmutter Cancer Center to evaluate reduced doses of radiation and chemotherapy to minimize side effects without compromising efficacy.
Weve found that if a patient with an early-stage tumor responds rapidly to standard treatment, they can benefit from a midcourse adjustment, says Dr. Hu. We can reduce the radiation dose by 15 percent and switch from high-dose chemo to low-dose chemo administered weekly. For the patients treated with this experimental strategy so far, the success rate has been 90 percent, with less than 10 percent of them requiring surgery. Dr. Hu expects this novel approach to become an established protocol option at Perlmutter Cancer Center within a couple of years.
Stage 4 Throat Cancer Prognosis
Stage 4 throat cancer prognosis is an explanation on the progression of the disease, its signs and symptoms, the survival rate of the patient and effective treatment options.
Every year more than 34,000 cases of throat cancer are registered in the United States alone. Unfortunately, in a majority of cases, the cancer is already in an advanced stage by the time it is diagnosed. While the early stages are treatable, prognosis is quite poor in the advanced stages. Throat cancer occurs when cells undergo harmful genetic mutations. These mutations cause an abnormal growth of cells which results in the death of healthy living cells, thus causing tumors. Any specific cause of this abnormal multiplication is still unknown, however, most doctors blame unhealthy lifestyle as potential causes that trigger throat cancer in the body.
Throat Cancer Prognosis Stage 4
This cancer is classified into four stages. As mentioned above, excessive smoking and drinking are the leading causes of throat cancer. In recent times, even HPV infections are considered to be a potential cause for the development of throat cancer.
The signs and symptoms will vary, depending on the stage of cancer. The most common signs are lumps in the neck, trouble in swallowing, sore throat, hoarseness, disfigurement of the neck or face, hardening of the skin, coughing up blood, and ear pain.
The Following Stages Are Used For Hpv
In stage I, one of the following is true:
- one or more lymph nodes with cancer that is HPV p16-positive are found but the place where the cancer began is not known. The lymph nodes with cancer are 6 centimeters or smaller, on one side of the neck or
- cancer is found in the oropharynx and the tumor is 4 centimeters or smaller. Cancer may have spread to one or more lymph nodes that are 6 centimeters or smaller, on the same side of the neck as the primary tumor.
In stage II, one of the following is true:
- one or more lymph nodes with cancer that is HPV p16-positive are found but the place where the cancer began is not known. The lymph nodes with cancer are 6 centimeters or smaller, on one or both sides of the neck or
- the tumor is 4 centimeters or smaller. Cancer has spread to lymph nodes that are 6 centimeters or smaller, on the opposite side of the neck as the primary tumor or on both sides of the neck or
- the tumor is larger than 4 centimeters or cancer has spread to the top of the epiglottis . Cancer may have spread to one or more lymph nodes that are 6 centimeters or smaller, anywhere in the neck.
In stage III, one of the following is true:
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Can I Do Anything To Prevent The Development Of Oropharyngeal Cancer
You may not be able to prevent oropharyngeal cancer, but you can take steps to lower your risk. Changes you can make include:
- Dont start smoking. If you smoke or use tobacco products, quit. Continuing to smoke greatly increased the risk of developing a second cancer in the mouth, throat or voice box or lung. Ask your healthcare provider for help. They have many resources and can put you in touch with the information need or other health professionals that can help you quit.
- Dont drink alcohol regularly or heavily. Alcohol increases the cancer-causing effects of tobacco, so its especially important to avoid this combination.
- Avoid human papilloma virus infection. Ask your doctor about the HPV vaccine. Multiple sex partners and oral sex increases your risk of HPV.
- Eat a healthy, well-balanced diet and exercise regularly.
- See your healthcare provider and dentist on a regular schedule. They can check your mouth and throat and catch any changes early in their development.
Tests That Examine The Mouth And Throat Are Used To Diagnose And Stage Oropharyngeal Cancer
The following tests and procedures may be used:
The following procedures may be used to remove samples of cells or tissue:
If cancer is found, the following test may be done to study the cancer cells:
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Hpv Is Common But Some Types Cause Cancer
An estimated 80 to 90 percent of the population have an infection of HPV, a virus that causes the most common sexually transmitted infection. About 7 percent of people have a form that affects the oral cavity, and 1 percent contract the most pathogenic strains. In most cases, the immune system clears the virus within a year or two, but types 16 and 18 can remain dormant for years, even decades, before precancerous cells give rise to a tumor.
The virus can go deep within the crypts of the tonsils, explains Dr. Persky, professor in the Department of OtolaryngologyHead and Neck Surgery at NYU Grossman School of Medicine, and thats probably where it often harbors.
Patients treated for throat cancer by doctors at the Head and Neck Center represent a broad spectrum of the population, but the majority are between 50 and 80 years of age, with men outnumbering women nearly 4 to 1. Typically, the patient is a healthy nonsmoker whose first symptom is a painless lump in the neck, often noticed while shaving, that doesnt subside after a course of antibiotics or steroids.
If a patients tumor is HPV-positive, the longterm cure rate for most stages is 80 to 90 percent.Kenneth S. Hu, MD, Co-Director of the Head and Neck Center at Perlmutter Cancer Center
Do I Have The Symptoms Of Hpv Throat Cancer
Turns out, being infected with a high-risk strain of HPV itself does not cause any symptoms, so unfortunately, most people dont suspect anything until the cancer begin to develop. Signs and symptoms to watch for may include:
A lump in the back of the mouth, throat, or neck
A sore throat that does not go away
A swollen tonsil
Trouble opening the mouth fully
Weight loss for no reason
It can be hard to figure out if something like a sore throat warrants concern, or if its just, well, a sore throat. Follow this rule: Symptoms that persist for more than two weeks need to be checked out. Also, .
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Hpv And Oropharyngeal Cancer
Diagram of the oral cavity and oropharynx. The oral cavity includes the lips, the labial and buccal mucosa, the front two-thirds of the tongue, the retromolar pad, the floor of the mouth, the gingiva, and the hard palate. The oropharynx includes the palatine and lingual tonsils, the back one-third base of the tongue, the soft palate, and the posterior pharyngeal wall.
Human papillomavirus can cause serious health problems, including warts and cancer.
Demographic And Clinicopathologic Characteristics
HPV-OSCC patients were primarily male and white , with a median age of 54 years . HPV-positive patients were more likely to be married , never tobacco users and diagnosed with an advanced N stage than HPV-negative patients. We had a mixed population of patients treated with various treatment modalities. 51% of the HPV-OSCC patients were treated with open surgery and 49% treated with non-surgical therapy. Of the 80 surgical patients, 79 patients received adjuvant therapy: 40 patients received adjuvant concurrent chemoradiation therapy and 39 patients received adjuvant radiation therapy alone. Demographic and clinicopathologic characteristics of the HPV-positive and HPV-negative patients are presented in Table 1.
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What Is Hpv Actually
We know, we know, this article is supposed to be about throat cancer. But before we can dive into that, we need to understand a bit about its #1 cause: the human papillomavirus . There are more than 200 related strains of the virus, and if youve ever had sex, its highly likely youve already been exposed to it.
cervical, vaginal, and vulvar cancer in women
penile cancer in men
caused by HPV usually develop in the part of the throat behind the mouth. This area is known as the oropharynx and includes the tonsils, the soft palate, and the base of the tongue.
HPV is now responsible for 70% of these malignancies, known as oropharyngeal cancers, making them the most common form of HPV-related cancer. It’s currently thought that HPV does not cause most other forms of head and neck cancer, including those in the mouth, lips, or salivary glands.
After Oropharyngeal Cancer Has Been Diagnosed Tests Are Done To Find Out If Cancer Cells Have Spread Within The Oropharynx Or To Other Parts Of The Body
The process used to find out if cancer has spread within the oropharynx or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The results of some of the tests used to diagnoseoropharyngeal cancer are often used to stage the disease.
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Childhood Vaccination Can Prevent Throat Cancer
Theres no screening test to identify those at risk for developing HPV-positive tumors, but three childhood vaccines have been approved by the U.S. Food and Drug Administration to protect against types 16 and 18. Throat cancer can be prevented to a great extent if parents have their children vaccinated around age 12, before they become sexually active, says Dr. Persky. He expects the epidemic to peak around 2040, when the first generation vaccinated as preteens reaches middle age.
Risk Factors For Hpv Throat Cancer
While the vast majority of throat cancers were once caused by tobacco and alcohol use, HPV has flipped that statistic on its head. Nonsmokers and never-drinkers are suddenly getting it, and the average age has dropped from over 60 to between 40 and 55.
The two biggest risk factors: The number of oral sex partners youve had and your gender. Men appear to be four to eight times more likely to get it than women, with white men having the highest rates, Asian and Pacific Islanders the lowest, and blacks and Hispanics somewhere in the middle.
This means that women are likely to build immunity to HPV with fewer sexual partners, whereas men can get repeated infections and may need 10 or more sexual partners before their body develops immunity. As a rule, the longer it takes to develop immunity to the virus, the greater the odds of contracting a strain that causes cancer. For this reason, the risk of HPV-positive throat cancer increases five-fold in people with six or more oral sex partners.
Lets talk about sex for a minute. Between 1984 and 2004, the number of head and neck cancers caused by HPV quadrupled. Experts believe thats a direct result of changes in sexual habits that occurred between the 1950s and 1970s, since it can take as many as 30 years for HPV to turn into cancer. To be blunt, experts say a rise in oral sex is the leading contributor to HPV throat cancer.
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What Is The Prognosis For Tonsil Cancer
When you learn that you have tonsil cancer, you may want to know about your prognosis — an estimate of how serious your disease is and what to expect in the future.
Keep in mind that not everyone wants to learn their prognosis, and that’s OK. But if you do, your doctor is the best person to ask. They do tests to see how large your cancer is and whether it has spread from your tonsils to another part of your body. The results will guide your treatment and help you learn about your outlook.
What Are The Risk Factors And Symptoms
The main risk factors for throat cancer are using tobacco and alcohol. Certain types of throat cancer have other risk factors. For example, HPV is a risk factor for oropharyngeal cancers . The symptoms of throat cancers vary based on the site of the disease, Dr. Wooten says. The most common symptoms include:
- Sore throat that doesn’t go away
- Tender lumps or masses in the mouth, back of throat or neck
- Unintentional weight loss
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What Is A 5
A relative survival rate compares people with the same type and stage of cancer to people in the overall population. For example, if the 5-year relative survival rate for a specific stage of laryngeal or hypopharyngeal cancer is 80%, it means that people who have that cancer are, on average, about 80% as likely as people who dont have that cancer to live for at least 5 years after being diagnosed.
Survival Outcomes And Treatment Decision By Human Papillomavirus Status Among Patients With Stage Ivc Head And Neck Squamous Cell Carcinoma
- 1Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, China
- 2Xiamen Key Laboratory of Chiral Drugs, Medical College, Xiamen University, Xiamen, China
Purpose: To investigate the influence of human papillomavirus status on survival outcomes and treatment decisions for patients with de novo stage IV head and neck squamous cell cancers .
Methods: Patients initially diagnosed with de novo stage IVC HNSCC between 2010 and 2015 were identified from the Surveillance, Epidemiology, and End Results database. Cox multivariable analyses were performed to determine prognostic factors associated with head and neck cancers specific survival and overall survival .
Results: We identified 303 patients who received chemotherapy in this study, including 52.5% of them had HPV-positive disease. HPV-positive HNSCC had better HNCSS and OS compared to those with HPV-negative disease. The results of Cox multivariable analyses showed that HPV-negative status , N3 stage , bone metastases , and lung metastases were associated with worse HNCSS. Similar results were found regarding the OS. The sensitivity analyses indicated that HPV-positive HNSCC patients who were treated with radiotherapy had better survival outcomes. However, no survival benefits were found in those with HPV-positive disease receiving surgery. For HPV-negative patients, no survival benefit was observed among those treated with radiotherapy or surgery.
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There Are Three Ways That Cancer Spreads In The Body
- Tissue. The cancer spreads from where it began by growing into nearby areas.
- Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
What Are The Survival Rates
Survival for throat cancers depends on the type of cancer as well as the stage and location of the cancer. Overall, The most successful cure rates are in the earlier stages, Dr. Wooten says. The staging is important. In later stages, in which the cancer has spread to nearby lymph nodes stage 3 the overall five-year survival is around 50%. And if it spread to distant areas of the body like lungs, liver or bone stage 4 this survival rate drops to roughly 30%.
Specific survival rates are different for different types of throat cancer. Cancers with high survival include cancers of the vocal cords, as well as cancers of the tonsils and back of the tongue that are related to the human papillomavirus . Cancers at the vocal cords have a five-year survival of 80-90%, in part because symptoms are more noticeable, she says, which means these cancers are often caught early.
In addition, survival rates also differ among the specific sites of the tumors. For instance, cancers of the vocal cords have higher survival rates compared to cancers located above the vocal cords or below the vocal cords , Dr. Wooten says.
The overall five-year survival rate for cancer of the voice box is roughly 60%, she says. Fortunately, when its caught earlier, in stages 1 and 2, the survival rate is higher, closer to 80 to 90% for same time frame.
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