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Getting To Know More About Head & Neck Cancer

Dr. Eugenio Regala internal medicine practitioner who specializes in oncology at The Medical City in Pasig City and at the University of Santo Tomas in Manila.

Press Release 

 

An emerging healthcare issue around the world these days is cancer of the head and neck. This type of malignancy affects squamous cells, a type of flat epithelial cell that covers many areas of the human body and that lines the inside of many organs.   

As the type of cancer is named, it is found in areas of the head and neck such as the oral cavity (lips, tongue, the inside of the cheeks and the hard palate), the pharynx or throat leading to the esophagus, the larynx or voicebox, the paranasal sinuses and nasal cavity, and the salivary glands.

Currently, head and neck cancers rank as the 6th most common malignancy globally. There is an estimated 650,000 cases worldwide, almost a third of which succumbs to death annually. Such prevalence is linked to the continued habit of tobacco and alcohol consumption, which are the most notable risk factors for the disease.   

Infection with the human papillomavirus (HPV), specifically HPV type 16, has also been found to cause oropharyngeal cancers involving the tonsils or the base of the tongue.

Symptoms depend on where the lesion is. For instance, an individual with nasopharyngeal cancer would present with inflamed lymph nodes on the neck, and abnormalities in the concerned organs or areas, such as nose bleeding or problems with hearing. Cancer in the oral cavity would present with visible lesions on the tongue or anywhere inside the mouth, such as white or red patches and sores.

A step ahead in the battle 

In the Philippines, the good news is that doctors are proactive and vigilant in addressing the concern regarding head and neck cancers.

“We are seeing a lot of head and neck malignancies—perhaps not as prevalent as lung or breast cancer, but we see a lot of them already,” says Dr. Eugenio Regala, an internal medicine practitioner who specializes in oncology at The Medical City in Pasig City and at the University of Santo Tomas in Manila. “The most common type is nasopharyngeal. Then I see some cases involving the oral cavity, tongue and larynx, particularly among smokers.”

  

Increased attention on head and neck cancers is a fortunate consequence of intense research and studies exploring the promise of a breakthrough type of cancer treatment called immunotherapy.   

Compared to the traditional standard of care treatment of chemotherapy, immunotherapy brings about much less side effects, and is more suitable for patients with co-morbidities such as heart disease or diabetes. It works on the cellular level, preventing malignant cells from being able to replicate and overtake good, healthy cells.

The promise of immunotherapy 

Immunotherapy has been hailed as a “miracle drug” for its astounding positive effects in treating many types of malignancies, and it is already used as first-line treatment for certain cancers.

This means that patients do not undergo chemotherapy anymore, but rather go straight to immunotherapy treatment, which has been shown in studies to prevent progression of the disease and add more years of survival.

In the Philippines, “currently, immunotherapy is usually given as second or further line of treatment [of head and neck cancers]. We have to wait for more trials before it can be considered for first line of treatment.” According to Dr. Regala, present studies seek to investigate the effects of a particular immunotherapy drug called pembrolizumab alone, and in combination with chemotherapy.

Dr. Regala notes that a lot of rigorous screening and testing is necessary to establish the type of cancer, and then to determine the suitability of a patient for immunotherapy. “For head and neck [cancers], diagnosis involves combination of histological report, staging, scans, and imaging procedures, plus clinical assessment. All these play an important role in coming up with diagnosis. Then we offer appropriate treatment based on the findings,” he explains.

A bright future ahead

Despite the work that still has to be done, Dr. Regala affirms the sentiment of the healthcare industry toward the exciting promise that breakthrough treatments like immunotherapy bring. It’s not so much a miracle in that it may instantly cure any and all cancers completely, but that it now provides additional treatment option for many patients.

“It’s really a big welcome for us to have immunotherapy. With all these advancements, we are able to tailor-fit treatment for patients,” he says, and he thinks that this is the future of dealing with cancer.

“I think treatment is really going to be personalized. There’s no such thing as one-drug-fits-all, or one kind of treatment that’s good for everyone. It depends on the patient’s tumor biology, patient’s preferences and current medical condition—all these play a very important role for the doctor to choose the most appropriate treatment,” he explains. And with immunotherapy, doctors can help patients fight cancer better and stronger. ###