From 2011 to 2018, the mortality rate among patients with head and neck cancer within a year from the moment of diagnosis was about 40-42% from cancer of the pharynx, 31-37% from cancer of the oral cavity and 4-5% from cancer of the lip, according to oncologists. At the same time, not only smoking and alcohol abuse, but even poor oral hygiene can lead to the development of this kind of oncological diseases. How dangerous diseases manifest themselves and what are the difficulties of their diagnosis – in the material of “Izvestia”.
The most common types of head and neck cancer are lip and oral mucosa cancer, nasopharyngeal cancer, and cancer of other parts of the pharynx, according to oncologists at the international conference “Oncology of the 21st century. Innovations in Medical Science in Practical Health Care “.
According to the data announced at the conference, in Russia from 2011 to 2018, the mortality rate among patients within a year since the diagnosis of malignant neoplasm was about 40–42% of pharyngeal cancer, 31–37% of oral cancer and 4–5% of cancer. lips.
The problem of head and neck tumors is worldwide, doctors emphasize. The matter is aggravated by another sad fact – every second patient with oncological diseases of the head and neck organs continues to smoke even after the diagnosis is made. “A certain average portrait of our patient: a smoker with an experience of 30-40 years, exhausted, often with chronic obstructive pulmonary disease, continues to smoke, sometimes to consume alcohol. Therefore, their quality of life is inevitably low, ”notes a senior researcher at the Department of Radiation Therapy with the modification of the Moscow Oncological Research Institute. P.A. Herzen Artem Gevorkov.
According to the oncologist, 57% of patients with head and neck tumors previously drank, 37% continue to drink, 17-29% smoke, 65-67% have previously smoked. Of these, 29–32% drink and 22–33% smoke 20–30 cigarettes a day. Among smokers, there are more young patients, many employed and unmarried.
What is it and how common is it
“Head and neck cancer” is a term used to describe a number of different cancers that develop in or around the throat, larynx, nose, sinuses, and mouth. Roughly speaking, from the shoulders and above, everything can relate to this group, said oncologist, doctor of medical sciences, professor Sergei Tyulyandin in a conversation with Izvestia. “In particular, cancer of the tongue, larynx, nasopharynx. In fact, all bone tumors related to the skeleton of the head, as well as the thyroid gland, ”he explained.
Head and neck cancer is the sixth most common cancer in the world. “Of the seven billion population of the planet, it is found in 800 thousand people. In the structure of oncological morbidity, it is about 3% of all malignant tumors in men and 1.5% of all malignant tumors in women. It seems a little. In fact – a lot, especially when it comes to you or a loved one, ”notes the head of the surgical department of head and neck tumors of the N.N. N.N. Petrova Zamira Radjabova.
According to her, in 2019, more than 24 thousand new cases of malignant head and neck tumors were registered in Russia. At the same time, according to statistics, in 60% of cases, head and neck cancer is detected at a late stage of the disease, 60% of patients die within five years. And 80% of patients diagnosed at an early stage recover, she said.
As for age, according to the president of the Russian Society of Specialists in Head and Neck Tumors, Head of the Department of Head and Neck Tumors at the N.N. N.N. Blokhin Ali Mudunova, the average age of patients at the time of diagnosis of cancer of the oral cavity, pharynx and larynx is 62 years for men and 65 years for women. Patients over the age of 65 account for almost half of the newly diagnosed head and neck cancers each year. At the same time, men have a 2–5 times higher risk of developing head and neck cancer than women.
Is it difficult to detect at an early stage
Many types of such tumors can be diagnosed at an early stage, because they are mostly felt immediately, notes oncologist Sergei Tyulyandin.
– If a swelling appears on the tongue, then, as a rule, it appears in the form of an ulcer. Another thing is that many do not pay attention to this or they themselves are treated and do not go to the doctor until the pain becomes excruciating. Lip cancer is generally an external manifestation, therefore it is diagnosed quickly. It is much more difficult to diagnose invisible tumors, for example, in the nasopharynx, which the patient begins to feel only when it begins to block the air flow and interferes with the passage of food. If we are talking about the larynx, then these are violations in the voice, in swallowing.
The problem is different: a tumor of even the smallest size in this anatomical zone very often metastasizes already in the early stages, the interlocutor of the publication notes.
– First of all, this concerns the lymph nodes, and at the same time, the tumor can metastasize already hematogenously, giving metastases far beyond the head and neck. And this becomes a very big problem for treatment, because it most often requires surgery, and it is very difficult to operate in this area and the lymphatic collectors, where this tumor can shoot, are numerous and their removal cripples a person. Therefore, it is very difficult for surgeons to operate in this zone – it is small in size, but very saturated with structures that are essential for normal life.
What causes head and neck cancer
The main reason for the development of this kind of oncology is smoking, emphasizes Sergei Tyulandin. “Also strong alcohol. Very often, tumors in this area are combined with viruses, for example, with the Epstein-Barr virus. As for the lip, then the sun, ultraviolet light can affect. Some believe that persistent chronic inflammation of the mucous membranes from hot food may also play a role, ”he added.
Speaking about tumors of the oral cavity, oropharynx and larynx, the main factors of tumor development are the lack of oral cavity sanitation, smoking and alcohol, as well as chronic diseases, Mikhail Byakhov, oncologist and candidate of medical sciences, said in a conversation with Izvestia. “But the first three factors are the main ones, and when they add up, it is very likely that this person can develop this kind of tumor,” he stressed.
In addition, as previously reported by Svetlana Kutukova, a chemotherapist at the St. Petersburg Oncological Dispensary, smoking not only provokes a tumor, but also reduces the effectiveness of chemotherapy and radiation therapy, as it reduces the sensitivity of damaged cells to the most effective targeted drugs, as a result of which chemotherapy in smokers are ineffective.
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