Improving Head and Neck Cancer Outcomes

Joe Cantlupe, for HealthLeaders Media , January 8, 2011
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In creating multiple disciplinary approaches, relationships are often neglected in hospitals, Genden says. “Here, we have it under one roof,” he says. “If you have a bump, you see someone at 11, go to the biopsy reading at 12, and then a radiological and medical assist and nutrition and a social worker. You’ve got 35 people working together.”

The hospital’s relationship with ENTA also allows physicians to work past competitive pressures and removes tension, he says.

Success Key No. 4: Increasing HPV cases
Healthcare leaders are bracing for what they consider a potential wave of head and neck cancer cases related to the human papillomavirus, the most common sexually transmitted virus.

“We are seeing more and more of this, and this is something we are watching closely,” says Mount Sinai’s Genden.

“This is a totally different disease than what we have been treating,” he says. For the most part, head and neck cancer has been “treated in the smoker and drinker population. [HPV-related cancers are] something that is the result of the sexual revolution and change of sexual norms over time. It’s going to continue to grow. You’ll see this become prominent over the next years. Journalists haven’t caught on to it.” Some studies have described it as a potential epidemic.

Cancers of the head and neck are usually caused by tobacco and alcohol, but recent studies show that about 25% of mouth and 35% of throat cancers are caused by HPV, according to the Centers for Disease Control and Prevention.

A study from Johns Hopkins University indicates HPV infection as a strong risk factor for otolaryngologeal cancer.

HPV is spread through oral sex and caused by the virus that also causes cervical cancer, with tobacco and alcohol as additional risk factors. A significant issue facing healthcare facilities is that the disease may not manifest itself for 10 to 20 years, he says.

There were approximately 36,000 new oral cancer diagnoses in 2010, the fifth year in a row there was an increase. When found at the early stages of development, oral cancers have an 80% to 90% survival rate, according to the Oral Cancer Foundation. Most of the cancers are found at the late stages, which accounts for a death rate of 45% after five years from diagnosis.

Vaccines have been prescribed for young females. However, “late-stage diagnosis is not occurring because most of these cancers are hard to discover,” the foundation states. “It is a lack of public awareness coupled with a lack of a national program for opportunistic screens which would yield early discovery by medical and dental professionals.”

Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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