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Head and Neck/Oral Cancers

More than 200 patients with head and neck cancer are treated each year at the Johns Hopkins Head and Neck Cancer Center.  The Center combines the collaborative and specialized expertise of team members from a wide range of disciplines.  Cutting-edge, individualized treatments are tailored to each patient's needs, and the latest innovations in head and neck cancer care are found at Johns Hopkins. 

Head and Neck Cancer Experts

Head and neck cancer experts at Johns Hopkins are leaders in their fields and provide patients with comprehensive care designed to meet individual needs.  Multidisciplinary care in a one-day clinic and a remote second opinion service are available.

About Head and Neck Cancer

Head and neck cancers include cancers of the mouth (lip and tongue), the pharynx (or throat), the salivary gland, and the larynx (or voice box). Head and neck cancers occur most frequently in men, who are nearly three times more likely to develop the disease than women.  Early symptoms occur as a lump or nodule, numbness, swelling, hoarseness, sore throat or any difficulty moving the jaw or swallowing. Risk factors include smoking, excessive alcohol consumption and chewing smokeless tobacco. Johns Hopkins physicians have found that people who smoke one pack of cigarettes a day are six times more likely than non-smokers to get cancer of the head or neck. Those who have two alcoholic drinks a day increase their risk 20-fold.

Diagnostic Tests

Otolaryngologists in the Department of Otolaryngology and The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins are among the most experienced in the diagnosis of head and neck cancers. These cancers are diagnosed by clinical examination, imaging tests and other specialized pathologic tests. The head and neck cancer subspecialists are experts at differentiating benign from malignant tumors and accurately assessing the stage of progression.

Patients suspected of disease see a physician within a few days to be evaluated for appropriate tests. Upon receipt of the test results, the physician develops an appropriate and highly individualized treatment plan.

Current Treatments

In head and neck cancer treatment, a particular benefit to our patients is a team of specialists from a variety of departments who meet weekly to review each patient's test results and records to determine the best treatment plan. Specialists include head and neck surgeons, medical oncologists, radiation oncologists, reconstructive surgeons, pathologists, rehabilitation therapists, radiologists, neurologists, oral surgeons and dentists. Each patient's care is coordinated though the multidisciplinary team to achieve the most comprehensive treatment, reconstruction and palliative care available.

After evaluation and consultation with team members, treatment is recommended based on the location, size and type of head or neck cancer. Treatment may include surgery, radiation and/or chemotherapy. Reconstructive techniques are planned before any treatment to optimize the patient's facial restoration, speech and swallowing. For example, one program that was developed at Johns Hopkins five years ago is aimed at preserving speech and swallowing function in situations when standard surgery would result in severe impairment or loss of these functions. Initially, these patients are treated with chemotherapy and radiation. This treatment, on occasion, has cured patients with advanced cancers of the mouth, such as tongue and palate, and cancers involving the larynx or voice box.

New Treatment Approaches

More than a dozen clinical trials are in place for selected head and neck cancer patients at The Sidney Kimmel Comprehensive Cancer Center.

Our physicians are developing a number of sensitive tests that may help detect head and neck cancers early, before the cancer spreads, leading to more effective treatments. One study already has shown that if a patient with cancer has a specific gene mutation, the tumor will be more resistant to radiation therapy.

In another study, our researchers are investigating the use of a vitamin A derivative for prevention of secondary cancers. Here, drugs being studied for the treatment of these disorders include topotecan, taxotere and Taxol, shown to be effective against other cancers; and tirapazamine for patients requiring radiation treatments. Preliminary information suggests that tirapazamine makes a patient more sensitive to radiation and thus enhances the treatment effect.

One of the most exciting studies in progress at Johns Hopkins involves molecular tests to examine surrounding tissue after removal of a cancerous tumor. Researchers are finding this new test so sensitive, that cancer cells once missed during surgery -- enabling the cancer to grow back -- now can be detected. The test has shown remarkable accuracy in identifying the most minute traces of the cancer. This means that surgeons potentially could remove all the cancerous tissue the first time while leaving as much healthy tissue in place as possible. The procedure is undergoing rigorous, confirmatory testing.

The Johns Hopkins Head and Neck Cancer SPORE

SPORE stands for Specialized Program of Research Excellence and the funds are one of the most sought-after by researchers nationwide because they focus on turning research into results – linking basic science discoveries with new tests and therapies that help patients. The Johns Hopkins SPORE program speeds research on new treatments for head and neck cancers.

Head and Neck Cancer Survivorship

Even after treatment finishes, head and neck cancer survivors may have residual side effects including fatigue, difficulty swallowing, dryness or ulcers of the mouth, arm weakness, numbness/tingling/pain in the hands and feet (peripheral neuropathy), and difficulty concentrating. Remember that your body needs time to heal and adjust. It is normal for effects like fatigue to last for up to a year. Always discuss any health concerns and symptoms with your doctor.

As you recover, take charge of your health by eating healthy, exercising and reducing stress. Avoid tobacco and limit alcohol intake. Keep up with screenings for other cancers, like mammograms and colonoscopies.

The Johns Hopkins Head and Neck Cancer Center provides comprehensive care in treatment and post-treatment services for patients with head and neck cancer as well as access to the latest, most promising therapies. The website for Support for Patients with Oral and Head and Neck Cancer (SPOHNC) features information on clinical trials, support groups and volunteer survivor stories. The Head and Neck Cancer Alliance provides support and resources to head and neck cancer patients. The International Association of Laryngectomees maintains a website with resources for laryngectomees and holds conferences for laryngectomees.