Written By: Tamatha Rutherford, MCD, CCC/SLP-CBIS
This week is Oral, Head, and Neck Cancer Awareness Week. But why is this such a hot topic in the Speech-Language Pathology world right now? The answer- survivorship.
Historically, my experience with HNOC was the traditional one, older population, with carcinogenic exposures… These typically required significant surgical resection and aggressive treatment to cure the disease, which, often left a significantly impair- if not devastated mechanism for swallowing and communication. Typically, the life expectance after cancer management was short.
In 1987, statistical analysis from the CDC revealed “ The survival rate for persons with cancer of the oral cavity and pharynx is among the lowest of the major cancers, with a 5-year relative survival rate of 52% (1). In contrast to some other cancers (e.g., breast, colorectal, and prostate cancers), the overall survival rate from oral and pharyngeal cancer has not improved during the past 16 years.” These tumors were typically Squamous cell carcinoma of the head and neck (HNC) – the sixth most common cancer worldwide, resulting in over 600,000 new diagnoses annually.
So, what does this mean today? We now know that treatment of HPV+ Cancer tumors does not require the same high-intensity radiation or necessarily surgical resections, dependent upon staging. The tumors respond better to treatment and the resulting toxicity to adjacent structures is less. We also know that HPV is most commonly transmitted through sexual contact, so, this growing population is now younger, disproportionately male, and live a lot longer after treatment. (Patients with HPV-attributed throat cancer have a disease-free survival rate of 85-90% over five years. In contrast, the traditional patient population of excessive smokers and drinkers with advanced disease has a five-year survival rate of approximately 25-40%).
This really changes the landscape of management for this population. Why? These survivors are younger, live longer, and have prolonged issues with regard to swallowing.
Because radiation is the gift that keeps on giving, over time the mechanism changes, and swallowing becomes more difficult. In HNOC, interventions can be efficacious along a lengthy time continuum. Whether interventions are at Cancer staging, during medical management, right after medical management or even to manage late effects. There is so much to learn about this population and the unique challenges for the clinician and survivor alike.
Want to learn more about the assessment and management of the HNOC population?
There is a three-part series for the assessment and management of HNOC, two of which are already available streaming through Summit and the last installment will be presented via Live Webinar.
Check out my live webinar on April 28th for Long-Term Effects and Management Head, Neck, and Oral Cancer (HNOC).
Explore online continuing education courses from Tamatha below:
Visit summit-education.com for more information.
American Cancer Society. Cancer facts and figures–1990. Atlanta: American Cancer Society, 1990; ACS no. 5008-LE.