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Understanding Head and Neck Cancers

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Understanding Head and Neck Cancers Understanding Head and Neck Cancers A guide for people with cancer, their families and friends Understanding Head and Neck Cancers A guide for people with cancer, their families and friends First published July 2008; Abridged February 2010 © The Cancer Council New South Wales 2010; ISBN 978 1 921041 72 3 Acknowledgements We thank the Cancer Institute NSW for their support and acknowledge the NSW Oncology Group (NSWOG) Head & Neck for their clinical review of the original edition of this booklet: Dr G Morgan, Surgeon; C Baxter, Senior Speech Pathologist; C Bullivant, NSWOG Project Officer; J Dahlstrom, Anatomical Pathologist; L Dall’Armi, Cancer Nurse Coordinator; M Findlay, Senior Oncology Dietitian; Dr D Forstner, Radiation Oncologist; Dr A Goldrick, Medical Oncologist; R Hield, Consumer; Dr J Hill, Radiation Oncologist; M Nutt, Nurse Care Coordinator; K Pronk, Senior Oncology Dietitian; T Simpson, Social Worker; Dr C Wratten, Chairman and Director, Radiation Oncology; and Dr SC Yeoh, Staff specialist, Oral Medicine & Pathology. We also thank the additional reviewers: K Chapman, Nutrition Program Manager, Cancer Council NSW; Dr J Clark, Head of Fellowship, Sydney Head & Neck Cancer Institute; B & C Gardner, Laryngectomee Association of NSW; C Julien, Clinical Nurse Consultant; A Moloney, Cancer Nurse Coordinator. We acknowledge Dr K Shannon, Chairman, Cancer Institute NSW Oncology Group (NSWOG) Head & Neck, for approving this abridged booklet. Cancer Council NSW wishes to acknowledge Cancer Council Victoria for kindly permitting its resource Cancers of the Mouth, Nose and Throat to be used as the main source for this booklet, and for the adaptation of its illustrations on pages 4-5. The book 100 Questions and Answers About Head and Neck Cancer (E Carper NP, K Hu, MD, E Kuzin, NP; Jones and Bartlett Publishers; 2008) was also used as a source for this booklet. Editor: Laura Wuellner. Designer: Paula Marchant. Illustrator: Greg Smith. Note to reader Always consult your doctor before beginning any health treatment. This booklet is intended as a general introduction to the topic and should not be seen as a substitute for your doctor’s or health professional’s advice. However, you may wish to discuss issues raised in this booklet with them. All care is taken to ensure that the information in this booklet is accurate at the time of publication. Cancer Council NSW is the leading cancer charity in NSW. It plays a unique and important role in the fight against cancer through undertaking high-quality research, advocating on cancer issues, providing information and services to the public and people with cancer, and raising funds for cancer programs. This booklet is funded through the generosity of the people of NSW. To make a donation to help defeat cancer, phone 1300 780 113. Cancer Council New South Wales 153 Dowling Street, Woolloomooloo NSW 2011 Cancer Council Helpline 13 11 20 Telephone (02) 9334 1900 Facsimile (02) 9334 1741 Email [email protected] Website www.cancercouncil.com.au ABN 51 116 463 846 Introduction This booklet has been prepared to help you understand more If you’re reading this about head and neck cancers. booklet for someone who doesn’t understand Head and neck cancer is a English, contact the general term that refers to a Cancer Council Helpline range of different cancers that for services available in occur in areas such as the mouth, different languages nose and throat. This booklet (see page 65). covers four main types of head and neck cancer: oral, pharyngeal, laryngeal and nasal cancers. For information about other types of cancer occurring in the head or neck, call the Helpline on 13 11 20. Many people feel understandably shocked and upset when told they have a type of head and neck cancer. We hope this booklet will help you understand how cancer is diagnosed and treated. We also include information about support services. We cannot advise you about the best treatment for you. You need to discuss this with your doctors. However, we hope this information will answer some of your questions and help you think about questions you want to ask your doctors or other health carers. You may like to pass this booklet to your family and friends for their information. This booklet does not need to be read from cover to cover – just read the parts that are useful to you. Some terms that may be unfamiliar are explained in the glossary. Contents What is cancer? ................................................................. 4 The head and neck region ................................................ 6 Head and neck cancer – key questions .......................... 8 What is head and neck cancer? .........................................................8 What are the symptoms? ...................................................................8 How common is it? ............................................................................9 What are the risk factors? ................................................................10 Diagnosing head and neck cancer ................................ 12 Physical examination and Biopsy.....................................................12 Laryngoscopy and Nasendoscopy...................................................13 Scans and x-rays .............................................................................14 Cancer staging .................................................................................16 Which health professionals will I see? ..............................................17 Treatments ....................................................................... 19 Oral cancer treatment ......................................................................19 Pharyngeal cancer treatment ...........................................................24 Laryngeal cancer treatment ..............................................................29 Nasal and paranasal sinus cancer treatment ..................................34 Palliative treatment ...........................................................................40 Managing side effects ..................................................... 41 Dry mouth .........................................................................................41 Changes in taste and appetite .........................................................42 Nausea, vomiting and weight loss ...................................................43 Mouth sores and ulcers ....................................................................44 Difficulty swallowing and Tube feeding ............................................45 Bone and teeth damage ...................................................................46 Communication and speech ............................................................47 Tracheostomy ...................................................................................49 Other side effects .............................................................................51 Making treatment decisions ........................................... 52 Talking with doctors .........................................................................53 A second opinion .............................................................................53 Taking part in a clinical trial ..............................................................54 Looking after yourself ..................................................... 55 Healthy eating ..................................................................................55 Being active ......................................................................................55 Complementary therapies ................................................................56 Strengthening your relationships ......................................................57 Sexuality, intimacy and cancer .........................................................57 Changing body image ......................................................................59 Life after treatment ...........................................................................60 Seeking support .............................................................. 61 Practical and financial help ..............................................................62 Understanding Cancer program .......................................................62 Talk to someone who’s been there ...................................................63 Caring for someone with cancer ......................................................64 Cancer Council Helpline ................................................. 65 Useful websites ............................................................... 66 Cancer Council library .................................................... 67 Question checklist ........................................................... 68 Glossary ........................................................................... 69 What is cancer? Cancer is a disease of the cells, which are the body’s basic building blocks. Our bodies constantly make new cells: to help us grow, to replace worn-out cells, or to heal damaged cells after an injury. Normally, cells grow and multiply in an orderly way, but sometimes something goes wrong with this process and cells grow in an uncontrolled way. This uncontrolled growth may result in abnormal blood cells or may develop into a lump called a tumour. A tumour can be benign (not cancer) or malignant (cancer). A benign tumour does not spread outside its normal boundary to other parts of the body. However, if a benign
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