World Head and Neck Cancer Day 2022
Posted on: 27 July 2022
To mark World Head and Neck Cancer Day (27th July 2022) Professor Sinead Brennan, Consultant Radiation Oncologist and Clinical Associate Professor in Clinical Medicine, at the School of Medicine talks about head and neck cancers, treatments available and what we can do to protect ourselves from this type of cancer.
What is head and neck cancer?
SB: Head and neck cancers are a group of tumours that occur in the head and neck area, such as the oral cavity, pharynx (throat), larynx , nasal cavity, paranasal sinuses or salivary glands.
What are the incidence rates internationally ?
Head and neck cancers represent 6 % of all new cancer diagnoses worldwide. Historically oral cavity cancer and laryngeal cancer were the most common subsites, but these are now decreasing in frequency as a direct result of public health campaigns to reduce tobacco and alcohol consumption. However there has been a rise in the incidence of oropharyngeal cancer due to the increasing prevalence of HPV infection. Internationally in the western world almost 70% of all head and neck cancer is related to the Human papilloma virus.
What can we do to prevent head and neck cancer?
We know that the majority of head and neck cancers are caused by either smoking and alcohol or Human Papilloma Virus (HPV) infection. Therefore, the majority of head and neck cancers are actually preventable by avoiding smoking, reducing your alcohol intake and ensuring all teenagers get their HPV vaccination.
What treatments are available?
Treatment includes combinations of surgery, radiotherapy chemotherapy and sometimes immunotherapy. St James Hospital is the highest volume head and neck cancer centre in Ireland. All patients are discussed at a multidisciplinary meeting where recommendations are made for treatments for each individual patient. Patients often present at an advanced stage of disease and therefore may require both surgery and radiotherapy treatment.
Early detection is key to improve the chances of cure but also to minimise the extent and amount of treatment needed for patients. 80% of all head and neck cancer patients require radiotherapy treatment at some stage of their illness and for many patients it can cure cancer without the need for potentially debilitating surgery which can sometimes involve removal of parts of the mouth, throat or the voice box which can have a significant impact on patient’s quality of life. Radiotherapy is a type of high energy ionising radiation that destroys cancer cells. Chemotherapy is used in advanced stage cancer in combination with radiotherapy treatment.
Are treatments successful?
Overall cure rates are improving especially for patients whose cancers are caused by HPV infection and who are non- smokers, where cure rates are over 90%. However, treatment for head and neck cancer is still associated with significant side effects such as dry mouth and swallowing problems.
At St Luke's Radiation Oncology Network (SLRON) there is a large multidisciplinary team to support patients during their treatment and help manage any side effects that patients may have, including radiation oncologists, specialist nurses, radiation therapists, dieticians, speech and language therapists, physiotherapists, social workers and psycho-oncologists.
Advances in radiotherapy technology and high quality radiotherapy have been shown to improve patients’ chances of survival by up to 20% and also importantly reduce side effects and improve patient’s quality of life.
Do clinical trials have a role in the treatment of head and neck cancers?
Clinical trials offer patients the opportunity to access novel treatments and new methods of treating cancer. Participating in clinical trials has been shown to have a survival benefit for patients. Many clinical trials also look at ways of reducing side effects of treatment. St Luke's Radiation Oncology Network and St James Hospital have participated in many clinical trials in head and neck cancer with international collaborative groups such as CRUK in the UK, NRG in the USA and also with the Canadian Cancer Trials Group. These trials have focussed on reducing side effects and improving quality of life in patients with HPV positive oropharyngeal cancer who are often long-term cancer survivors, preventing dysphagia in patients with laryngeal cancer, individualising radiotherapy in patients who have undergone surgery in oral cavity cancer, combining immunotherapy with chemotherapy and radiotherapy, and currently the use of neoadjuvant immunotherapy for patients undergoing surgery for oral cavity cancer and post operative chemotherapy and radiotherapy, which is the first study to involve all four cancer treatment modalities in Ireland.
The new HRB funded Irish Research Radiation Oncology Group (IRROG) is a national dedicated radiotherapy clinical trials group which is partnered with Trinity College Dublin and the Wellcome-HRB CRF at St James Hospital, and will be part of the Cancer Trials Ireland Network. As Clinical Lead for IRROG, Professor Brennan hopes to provide more patients the opportunity to become involved in clinical trials and expand our international collaborations to give Irish patients access to the latest treatment advances.
Trinity St James’s Cancer Institute: https://www.stjames.ie/cancer/
The Irish Cancer Society: https://www.cancer.ie/