WE HAVE WALKED IN YOUR SHOES

PART I AN OVERVIEW OF ORAL AND HEAD AND NECK CANCER

“W E H AVE WALKED I N YOUR S HOES ”

PA RT I

AN OVER VIEW OF ORAL AND HEAD AND NECK CANCER

SUPPORT FOR PEOPLE WITH ORAL AND HEAD AND NECK CANCER (SPOHNC) P.O. Box 53, Locust Valley, NY 11560 1-800-377-0928 www.spohnc.org

It contains basic information about oral and head and neck cancer and provides resources for patients and families facing a diagnosis of oral and head and neck cancer.” © 2002 Support for People with Oral and Head and Neck Cancer. Inc. does not endorse treatments or products mentioned in this booklet. Support for People with Oral and Head and Neck Cancer. . The information in this booklet has been compiled by survivors and represents the wisdom. This information is not intended to replace any information and/or recommendations made by health care professionals. its treatment and rehabilitation. their families and friends Forward This booklet is a component of the SPOHNC Patient Information Folder.D E D I C A T I O N In honor of all oral and head and neck cancer patients. experiences and resources from those “who have walked in your shoes. Inc. Please consult your health care team before participating in treatments or using products.

To increase your awareness of the many ongoing issues related to oral and head and neck cancer. SPOHNC welcomes all patients with oral and head and neck cancer. Many patients. Support for People with Oral and Head and Neck Cancer (SPOHNC) is such a support group. This organization. and healthcare professionals to participate in its local and national programs of support. a newsletter.Introduction The best care a patient with oral and head and neck cancer can receive will include not only treatment for the cancer and associated side effects. who have difficulty coping with these issues. Having access to helpful information and support services may help people to cope with their individual circumstances. treatment and recovery. is published nine times each year. and promoting their physical and emotional health. Until ways are discovered to profoundly reduce the occurrence and severity of oral and head and neck cancer. At times. their families and friends. the length of time that treatment and recovery may require. Support groups can provide information on a variety of disease-related topics and help individuals become less anxious and depressed. the involvement with a large number of health care professionals. Members of support groups help each other to cope with or overcome a health or other problem that they all share. Members of this organization “have walked in your shoes” and are ready to offer you information. This is the only national newsletter of its kind in the United States offering information. but also for any psychosocial issues that he/she may face. These factors will influence the way in which an individual views himself/herself and his/her ability to cope with the diagnosis. is dedicated to meeting the needs of patients with a rare disease. Cancer patients and their families face many challenges in learning to live with their disease. This organization can have a positive impact on meeting the psychosocial needs of oral and head and neck cancer survivors as well as preserving. become depressed and need support. Such social support can have a powerful positive effect on one’s health and recovery from cancer and other disabling conditions. Meeting with others to share experiences provides an effective and rewarding alternative to coping with serious problems all alone. support and encouragement. SPOHNC can be a vital component of your healing process. Active chapters of SPOHNC are now meeting in many parts of the United States where you will find friendly faces and open arms of support. as well as the patient’s concerns about health insurance coverage. A N O V E R V I E W O F O R A L A N D H E A D A N D N E C K C A N C E R / PA R T I 3 . support and encouragement. Founded by a survivor of oral cancer. the patient who has cancer of the head and neck may feel overwhelmed with the challenges of physical changes and the side effects of treatment. employment and financial security. restoring. News From SPOHNC. Support groups can enhance a patient’s knowledge about his/her disease and replace feelings of helplessness and uncertainty with a sense of mastery and control. which began with nine members in 1991.

skin. the teeth. the oropharynx consisting of the back one-third of the tongue. Minor salivary glands located throughout the oral cavity produce thick mucinous saliva. the mucosal lining inside the lips and cheeks (the buccal mucosa).Oral and Head and Neck Cancer What is oral and head and neck cancer? Oral and head and neck cancer is a term given to a variety of malignant tumors that may occur in the head and neck region. and the part of the throat behind the mouth. which keeps the mouth moist. the bottom (floor) of the mouth under the tongue. helps digest food and is responsible for a wide array of other protective and physiologic functions. the gums. 4 W E H AV E W A L K E D I N Y O U R S H O E S . the nasopharynx. while the major salivary glands (parotid. the thyroid. the eye and the ear as well as the lymph nodes in the neck. cancers of the brain are not included in this category. What other parts of the head and neck may be involved in a diagnosis of oral and head and neck cancer? Other anatomical sites in the head and neck area that may be the site of malignant tumor formation include the paranasal sinuses and the nasal cavity. the soft palate. the larynx (voice box). the hypopharynx. the front two-thirds of the tongue. the tonsils. and the small area behind the wisdom teeth. helps maintain healthy teeth. However. the bony top of the mouth (hard palate). Cancers of the scalp. muscles and bones of the head and neck may also be considered cancers of the head and neck. submandibular and sublingual) produce the majority of serous (watery) saliva. DIAGRAM OF PRIMARY SITES What is the oral cavity? The oral cavity includes the lips. the pharynx.

The risk may be even greater to those individuals who in addition to the use of mouthwash.Are all cancers of the oral cavity and head and neck alike? Each of the regions mentioned above can be further divided into subsites. What are the major risk factors for developing oral and head and neck cancer? The two major risk factors for developing cancer of the oral cavity and head and neck are the use of tobacco (including smoking. Continuous and simultaneous exposure to biological. Prolonged exposure to direct sunlight has been associated with cancer of the lower lip. it is not surprising that people diagnosed with a specific oral and head and neck cancer have difficulty finding information and support to meet their specific needs. The risk appears to be higher among those individuals who also smoke and drink alcohol. In addition. also use tobacco and alcohol. with so many anatomical sites and cell types.000 survivors of oral and head and neck cancer living in the United States. many of these anatomical sites can be further delineated by cell type. Do other factors play a role in causing cancer of the oral cavity and head and neck? Another possible causative factor of oral cancer is the neglect of oral hygiene. Statistics from the National Cancer Institute indicate that there are more than 500. chemical and physical forces including wood and metal dusts and noxious fumes and chemicals may also contribute to the development of head and neck cancers such as tumors of the paranasal sinuses. How many people are diagnosed with oral and head and neck cancer? According to the American Cancer Society. This number increases dramatically to about 500. the importance of these diseases is heightened by the functional problems and aesthetic differences that are commonly associated with these types of cancers and their treatments. although this data is preliminary and must be confirmed by larger studies. Research to explain a genetic basis for tobacco and alcohol induced cancers is growing. This number has been increasing in recent years. Other cancers originate in other types of cells. Poorly fitted dentures and sharp and broken teeth that can cause irritation and infection have been associated with increased risk of cancers of the oral cavity. Most cancers of the oral cavity and head and neck begin in the squamous cells that comprise the mucosal lining of the structures of the head and neck area. People who use both tobacco and alcohol are at greater risk for developing these cancers than people who use either tobacco or alcohol alone.000 new cases worldwide. Consequently. chewing and dipping) and the use of alcohol. A N O V E R V I E W O F O R A L A N D H E A D A N D N E C K C A N C E R / PA R T I 5 . Eighty-five percent of head and neck cancers are linked to tobacco use.000 Americans are diagnosed with oral and head and neck cancer each year excluding superficial skin cancers but including cancer of the larynx and thyroid. Recent studies suggest that the daily use of mouthwashes with high concentrations of alcohol may also increase the risk of oral cancer. What percentage of cancers is oral and head and neck cancer? Although oral and head and neck cancers account for only 4-5% of all cancers diagnosed in the United States. more than 60.

physical therapists. less serious conditions. How will treatment be determined? The choice of treatment for an individual patient will depend primarily on the anatomic site and the size and type of the primary tumor and the stage of the disease. How will the doctor make a diagnosis? To determine the cause of symptoms. otolaryngologists (ear. general health. What will the doctor do if the diagnosis is cancer? If the diagnosis is cancer. persistent swollen glands in the neck or other neck masses. loss of smell. a sore throat that does not go away. treatment of cancer in this area often requires the integrated efforts of a team of health care professionals in various disciplines including head and neck surgeons. The patient with oral and head and neck cancer will undoubtedly interact with a very large number of health care professionals depending on the location and extent of the cancer. magnetic resonance imaging (MRI). Other symptoms may include white or red patches on the gums. medical oncologists. a bloody nasal discharge or coughing up blood. nose. tongue. and/or a specialized examination scope. or other substances from the body may be ordered as well as X-rays. perform a physical examination. Any previous treatment will also influence the decision of a new treatment. CT (or CAT) scan. gums and cheeks. or a change or hoarseness in the voice. Laboratory tests that examine samples of blood. prosthodontists. to which parts of the body. and tongue using a small mirror and/or light. and the final decision will involve discussion among the patient and members of his/her multidisciplinary team. persistent nasal congestion and ear pain. difficulty swallowing. if so. Examinations and tests that will be conducted may vary depending on the signs and symptoms exhibited by the patient. unexplained facial pain. oral pathologists. What is a multidisciplinary team? Because of the complexity of the head and neck. changes in denture fit. dentists. urine. dietitians. oral surgeons. more than one treatment option may be available. throat. A doctor or dentist should check any of these symptoms. lips. Included in these exams and tests may be a physical exam that will include visual inspection of the oral and nasal cavities. radiologists. Oftentimes. occupation and the side effects and consequences of treatment as well as the experience of the treating physician are also considerations in determining which treatment to follow.What are some symptoms of cancer of the oral cavity and head and neck? Common symptoms of cancer of the oral cavity and head and neck include a lump or sore that does not heal. The person's age. plastic surgeons. radiation oncologists. Staging is a careful attempt to learn whether the cancer has spread and. 6 W E H AV E W A L K E D I N Y O U R S H O E S . and order diagnostic tests. PET scan and biopsy. or lining of the mouth. and throat surgeons). the doctor will want to learn the stage (or extent) of disease. These symptoms may be caused by cancer or by other. neck. nurses. speech and swallowing pathologists. and social workers. Knowing the stage of the disease helps the doctor plan treatment and offer prognostic information. the doctor will review a patient’s medical history. The doctor may also feel for lumps in the neck.

Loss or alteration of taste. There are presently many different treatment protocols which include one or more of these modalities depending on the treatment setting and the goals of therapy. the face and neck may be swollen and the patient may look different. and sores in the mouth. Consequently. jaws and salivary glands that may occur as a result of treatment.Will there be side effects from treatment? It may be difficult to limit the effects of cancer treatment so that only the cancer cells are removed or destroyed. However. Radiation may come from a machine outside the body (external radiation therapy). Such surgery may change the patient’s ability to talk. swelling may last for a longer period of time as this surgery can slow the flow of lymph. It can also come from radioactive materials placed directly into or near the area where the cancer cells are found (internal radiation therapy or brachytherapy). each person reacts differently to treatment. Some side effects may be temporary. the results of clinical research during the last fifteen years have expanded the use of chemotherapy as an option with surgery and/or radiation therapy. Surgery to remove a larger tumor may involve the removal of the cancer and some of the healthy tissue and structures around it. which may collect in the tissues. Swelling in the face and neck area usually goes away within a few weeks. radiation therapy may also damage healthy cells. These side effects will vary depending on the type and extent of the treatment and the area being treated. while others may be permanent. decrease in appetite which may affect nutrition and A N O V E R V I E W O F O R A L A N D H E A D A N D N E C K C A N C E R / PA R T I 7 . Physical therapy including appropriate exercises and treatments may help with these problems. If the doctor suspects that the cancer has spread to the lymph nodes in the neck. treatment is planned to keep side effects to a minimum without compromising adequacy of treatment. they may also be removed (neck dissection). Before beginning radiation and chemotherapy to the head and neck area. if lymph nodes are removed (neck dissection). Patients who receive radiation to the head and neck may experience redness. chew or swallow. After surgery. a dry mouth (xerostomia) or thickened saliva. What is radiation therapy? Radiation therapy or radiotherapy is a treatment involving the use of high-energy sources to kill cancer cells. What are the side effects of surgery? Surgery to remove a small tumor in the mouth may not cause any lasting problems. difficulty in swallowing or nausea. How is cancer of the oral cavity and head and neck treated? The conventional modalities used in the management of the oral and head and neck cancer patient have included surgery and radiation alone or in combination. irritation. However. However. it is essential that the patient see a dentist who is familiar with the changes in the mouth. Chemotherapy may also be used alone with palliative intent. healthy cells and tissues may also be damaged sometimes causing side effects. What are the side effects of radiation therapy? In the process of killing cancer cells. In addition. The patient’s shoulder and neck may also feel weak and stiff after a neck dissection. Surgery may be followed by radiation treatment and in some cases chemotherapy.

Patients may have none of these side effects or just a few. each patient will react differently to the prescribed treatments. vomiting. and stages of cancer. it has been added to the options of radiation and surgery. patients should report any side effects to their doctor or nurse to find resources for managing these effects.earaches may also be present. cell types. loss of appetite. cells that line the mouth and the digestive tract. skin rash and itching. Some loss of hearing may result from the use of certain drugs commonly used in treating head and neck cancer. side effects of treatment will vary also. Consequently. nausea. and cells in hair follicles may also be affected resulting in such side effects as lower resistance to infection. and swelling of the feet or lower legs may also occur. Some patients may also notice swelling or drooping of the skin under the chin and changes in the texture of the skin. to improve the outcome of local treatment and to kill any microscopic cancer cells that may have traveled to distant sites and escaped detection. anatomic sites. healthy cells including blood cells that fight infection. What are the side effects of chemotherapy? Side effects of chemotherapy will depend on the drugs that are given. However. For more advanced tumors. Patients may complain of a stiff jaw and may find it difficult to open their mouth as wide as before treatment (trismus). Do all people have the same side effects of treatment? Because of the differences in treatment. 8 W E H AV E W A L K E D I N Y O U R S H O E S . loss of balance. What is chemotherapy? Chemotherapy is a cancer treatment using anticancer drugs. numbness/tingling in the hands and feet. and hair loss. No two people have exactly the same diagnosis nor do they react exactly the same to treatments. joint pain. sores in the mouth and on the lips. Fatigue. diarrhea. particularly radiotherapy. effects on the kidneys. Most people have no serious long-term problems from chemotherapy. Many anticancer drugs destroy rapidly growing cancer cells. However. Other types of drug therapy are used to decrease the side effects of cancer and its treatment.

MD 21287 410-955-4446 www. Suite 99311 Stockton.VA 22314 703-299-0150 www. NY 11560 800-377-0928 www. Locust Valley.org American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) One Prince St. Box 53.org American Head and Neck Society 601 N..oralcancerfoundation.Resources ORAL AND HEAD AND NECK RESOURCES AND WEB SITES Support for People with Oral and Head and Neck Cancer (SPOHNC) P.org American Society of Clinical Oncology (ACSO) 1900 Duke St. Alexandria.org Oral Cancer Foundation 3419 Via Lido #205.gov A N O V E R V I E W O F O R A L A N D H E A D A N D N E C K C A N C E R / PA R T I 9 . CA 95209 800-425-3678 www. Newport Beach.org International Association of Laryngectomees (IAL) 8900 Thornton Road.larynxlink.WA 98228-1972 360-676-7325 www.nih.spohnc. Baltimore.cancer. Suite 200.org Combined Health Information Data Base--Oral Health database (head and neck cancer) www.chid.. Alexandria.org Let’s Face It Box 29972 Bellingham.com Government Site for Head and Neck Cancer www.acor. Caroline St.faceit.O.gov/cancer_information/cancer_type/head_and_neck Association of Cancer Online Resources (ACOR) Electronic support groups www.entnet. CA 92663 949-646-8000 www.headandneckcancer.VA 22314 703-836-4444 www.asco.

GENERAL CANCER RESOURCES American Cancer Society (ACS) National Office 1599 Clifton Rd.cancersupportivecare. Inc. Suite A.oncolink.nih.cancercare. Bethesda. NE. Suite 1.gov/cancer_information Department of Veterans Affairs Home Page www.com National Library of Medicine 8600 Rockville Pike. 275 Seventh Ave. NY 10001 (800) 813-4673 www..gov National Coalition for Cancer Survivorship (NCCS) 1010 Wayne Ave. New Smyrna Beach.com/drug_assistance.nlm..sohnnurse.html National Patient Travel Center (formerly NPATH) 4620 Haygood Rd.org Cancer Care. Free information and publications 800-4-CANCER cis.VA 23455 800-296-1217 www. New York..npath.org Cancer Information Service (CIS) Available 9 AM.nih.gov Society of Otolaryngology and Head-Neck Nurses (SOHN) 116 Canal Street. MD 20910 888-YES– NCCS www.canceradvocacy. MD 20894 www.org Oncolink .com 10 W E H AV E W A L K E D I N Y O U R S H O E S .4:30 PM in your time zone..cancer.University of Pennsylvania Cancer Center www.va.Virginia Beach.org NCI’s CancerNet Cancer Information www.gov Drug Assistance Programs from Pharmaceutical Companies www. 5th Fl. FL 32168 386-428-1695 http://www..nci.cancer. Silver Spring. GA 30329 800-ACS-2345 www. Atlanta.

ssa..VA 22314 800-658-8898 www. M. Arlington. Finding the Joy in Today Sefra Kobrin Pitzelle Hazelton Press.. Suite 300. Addicus Books.D. Lydiatt. M.D. Lang and Richard B.1994.D. Norman Coleman. 1999. Patt Oxford University Press. MAGAZINES.. P. Understanding Cancer: A Patient’s Guide to Diagnosis.D. New York. The Wellness Community Guide to Fighting for Recovery from Cancer Harold H. Cancer Resource Survivors Kit 50-minute video & 150-Page book: Advice & list of national cancer information resources Life Care Concepts.Tarcher/Putnam’s Sons. M. Johnson. 2001. You Don’t Have to Suffer: A Complete Guide to Relieving Cancer Pain for Patients and Their Families Susan S. and Perry J. Inc. Prognosis & Treatment C. NEWSLETTERS Cancers of the Mouth & Throat William M. Inc. 2001. BOOKLETS.gov Social Security Disability 800-772-1213 www. New York 800-401-2233 www/cancerresources.medicare.gov/disability/ BOOKS. New York. 1995.org Medicare 800-633-4227 www.1999.com A N O V E R V I E W O F O R A L A N D H E A D A N D N E C K C A N C E R / PA R T I 11 .National Hospice and Palliative Care Organization (NHPCO) 1700 Diagonal Rd. John Wiley & Sons. The Johns Hopkins University Press. Surviving Cancer Emotionally: Learning How to Heal Roger Granet. Omaha.nhpco. New York. Benjamin J. M.

spohnc. companion audio tape Angel River Press. Box 53 Locust Valley.TN 37068-2268 615-790-2400 http://www.org 12 W E H AV E W A L K E D I N Y O U R S H O E S . 2000. 1996.D.com “News From SPOHNC” P. 800-726-4173 www.com Making Informed Medical Decisions:Where to Look and How to Use What You Find Nancy Oster.O.O. NY 11560-0053 1-800-377-0928 www. Coping Magazine P. O’Reilly Press. Lucy Thomas and Darol Joseff. Heal Faster Peggy Huddleston Book and 40 min. M.Prepare for Surgery. Box 682268 Franklin.healfaster.copingmag.

ENT: A physician specializing in diseases of the ears. with a needle and a syringe. Adverse event: A toxicity or undesirable effect usually of treatment. does not invade nearby tissues or spread to other parts of the body. lighted tube (called an endoscope) to examine the inside of the body. Epstein-Barr virus: A common virus that remains dormant in most people. Carcinoma: Cancer that begins in the lining or covering of an organ. nose and throat. Aspiration: Removal of fluid from a lump. Adenoid cystic carcinoma: A rare type of cancer that usually begins in the salivary glands. Clinical Trial: A research study that evaluates the effectiveness of new interventions in people. A N O V E R V I E W O F O R A L A N D H E A D A N D N E C K C A N C E R / PA R T I 13 . Adjuvant therapy may be chemotherapy. Adenocarcinoma: Cancer that begins in cells that line certain internal organs and that have glandular (secretory) properties. Erythema: Redness of the skin. 3-D Conformal: Radiation beams shaped to match a tumor’s shape. The shaping is accomplished by Radiation Therapy (3D-CRT) special equipment.Glossary of Acronyms and Terms Adjuvant therapy: Treatment given following the primary treatment to increase the effectiveness of the primary treatment. often a cyst. CAT. Endoscopy: The use of a thin. Buccal mucosa: The inner lining of the cheeks and lips. radiation therapy or hormone therapy. CT: A test using computers and special x-rays to create images of various parts of the body for evaluation. diagnosis. Carcinogen: Any substance that causes cancer. Chemotherapy: Treatment with anticancer drugs. Dysplasia: Abnormal changes in the way tissue cells look under a microscope. External radiation: Radiation therapy using a machine located outside the body to aim high-energy rays at a tumor. or treatment of cancer. It has been associated with certain cancers. Complete response: Tumor(s) has disappeared as a result of therapy. CBC: Complete blood count. Biopsy: The removal of cells or tissues for examination under a microscope. including nasopharyngeal carcinoma. Brachytherapy: Sources of radiation energy that are implanted directly into or near the tumor. Computerized Axial Tomography scan. Drug resistance: Failure of cancer cells to respond to chemotherapy. Benign: Not cancerous. Cachexia: Breakdown of muscle mass resulting from rapid weight loss. Epiglottis: The flap that covers the trachea during swallowing so that food does not enter the lungs. Edema: Swelling of a body part caused by an abnormal build-up of fluids. prevention. Erythroplakia: A reddened patch with a velvety surface found in the mouth. CXR: Chest x-ray. the upper part of the larynx or the voice box. Each study is designed to evaluate new methods of screening. Dysphagia: Difficulty with swallowing. Diagnosis: The process of identifying a disease by the signs and symptoms. CNS: Central Nervous System.

) Immune system: The complex group of organs and cells that defends the body against infection or disease. High risk: When the chance of developing cancer is greater than normally seen in a population. Hematology: Study of blood. H&N: Head and neck. (MRI. LENT: Late effects on normal tissue (long-term side effects). Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. thymus. Fractionation: Dividing the total dose of radiation therapy into several smaller. where 100 indicates completely normal functioning. neck. and lymph nodes and a network of thin tubes that carry lymph and white blood cells. Hgb: Hemoglobin. Fibrosis: Formation of fibrous tissue as a reaction or as a repair process. This system includes the bone marrow. Clusters of lymph nodes are found in the underarms. LPT: Licensed Physical Therapist. store. into all the tissues of the body. Lymphatic System: The tissues and organs that produce. spleen. KPS. Imaging: Tests that produce pictures of areas inside the body. etc.Facial nerve: The nerve that controls muscles of expression of the face. groin. PET. Leukoplakia: A white patch that occurs on the mucous membranes of the mouth that does not scrape off. Intravenous: Injected in a vein. Also used to lessen side effects that may be caused by some cancer treatments. a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. may be considered precancerous. Hypopharynx: The bottom part of the throat. Also called lymph glands. blood-producing organs and blood disorders. Lymph Nodes: Small organs located throughout the body along the channels of the lymphatic system. HN. The removal of a sample of tissue or fluid with a needle for examination. Also called biological therapy or biological response modifier (BRM) therapy. like blood vessels. Immunotherapy: Treatment to stimulate or restore the ability of the person’s immune system to fight infection and disease. Gastrostomy tube: A tube surgically placed through the skin into the stomach to deliver nutrition. 14 W E H AV E W A L K E D I N Y O U R S H O E S . equal doses delivered over a period of several days or weeks. and abdomen. Karnofsky Performance Scale: A score from 0 to 100 that conveys a patient’s ability to function and perform normal daily activities. Head and Neck Surgeon: A surgeon specializing in the surgical treatment of conditions of the head and neck area. LPN: Licensed Practical Nurse. may occur due to treatment and/or disease. chest. Also called IV. These tubes branch. FNA: Fine-needle aspiration. the oxygen carrying portion of red blood cells. CT. and carry white blood cells that fight infection and other diseases. Malignant: Cancerous. Local therapy: Treatment that affects cells in a tumor and the area near it. The lymph nodes store special cells that fight infection and other diseases.

nose. Not a surgeon. Oncologist. Paranasal sinuses: Small hollow spaces in the bones of the head surrounding the nose. NCI: National Cancer Institute (part of NIH). A procedure in which a magnet linked to a computer is used to create detailed pictures of areas inside the body. and the tonsils. NED: No evidence of disease. radiation or other treatment. Palliative Treatment: Treatment to reduce symptoms rather than to cure. Monoclonal Antibodies: Laboratory-produced substances that can locate and bind to specific proteins and cells wherever they are in the body. Neurotoxicity: Damage to the nervous system caused by some treatments. Neoadjuvant Therapy: Therapy given before the primary treatment with the intent of improving the effectiveness of the primary treatment. Morbidity: A disease or the incidence of disease within a population. Medical Oncologist: A physician who specializes in the treatment of cancer. numbness and weakness are common symptoms. Obturator: A prosthesis used to fill the space between the mouth and nose. Neuropathy: Malfunction of the nerves sometimes caused by chemotherapy. NIH: National Institutes of Health. Many monoclonal antibodies are being evaluated for purposes of cancer detection or therapy. Palate: The roof of the mouth. Oropharynx: The oropharynx is the middle part of the pharynx. Metaplasia: Change in cells from normal to abnormal. Oncology: Oncologist: A doctor who specializes in treating cancer with drug therapy. The front portion is bony (hard palate) and the back portion is muscular (soft palate). Often seen as sores in the mouth and throat. A N O V E R V I E W O F O R A L A N D H E A D A N D N E C K C A N C E R / PA R T I 15 . Oral pathologist: A dental specialist educated and trained in the area of diagnosis and management of mouth diseases. Morbidity also refers to adverse effects caused by a treatment. Oral surgeon: A dental specialist with special training in surgery of the mouth and jaw. Nasopharynx: The area of the upper throat behind the nose.Marginal mandibulectomy: Partial removal of lower jaw bone. The oropharynx includes the soft palate (the back of the mouth). Maxillectomy: The surgical removal of the upper jaw bone. Osteoradionecrosis: Bone tissue death resulting from inadequate blood supply from radiation therapy. Metastasis: The spread of cancer from one part of the body to another. Neck dissection: A surgical procedure to remove lymph nodes from the neck. may be chemotherapy. Multimodality Therapy: Therapy that combines more than one method of treatment such as chemotherapy and radiation. Mucositis: A complication of radiation therapy or chemotherapy in which the lining of the digestive system becomes inflamed. Otolaryngologist: A surgeon who deals with conditions in the ear. Oncology: The study of cancer. OT: Occupational Therapy. throat and related structures in the head and neck. MRI: Magnetic Resonance Imaging. Cells in the metastatic (secondary) tumor are the same type as those in the original (primary) tumor. the base of the tongue.

Radiation may come from a machine outside the body (external-beam radiation therapy) or from materials (radioisotopes) that produce radiation that are placed in or near the tumor or in the area where the cancer cells are found (internal radiation therapy. such as a tooth. or brachytherapy). after it has been treated. Sarcoma: A cancer of the bone. especially cancer. the chance of recovery. blood vessels or other connective or supportive tissue. Regimen: The plan that outlines the dosage. Prognosis: The likely outcome or course of a disease. Radiation Therapy (also called radiotherapy): Radiation therapy uses high-energy radiation from x-rays. Radiologist: A physician trained to perform and interpret x-ray studies. Relapse: Reappearance of disease after it has disappeared. A computerized image of the metabolic activity of the body tissues used to determine the presence of disease. Regression: Reduction in symptoms or disease process. Radioactive: Giving off radiation. PET: Positron Emission Tomography scan. Precancerous: A term used to describe a condition that may become cancer. implant radiation.” A remission can be temporary or permanent. Refractory: Doesn’t respond to treatment. Risk Factor: Any factor that may increase a person’s chances of developing cancer. fat muscle. such as radioactive iodine used in the treatment of thyroid cancer. the disease is said to be “in remission. Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). neutrons. Remission: When the signs and symptoms of cancer go away. Prosthodontist: A dentist with special training in making replacements for missing teeth or other structures of the oral cavity to restore appearance. Recur: To occur again. Pathologist: A doctor who identifies diseases by studying cells and tissues under a microscope. Prosthesis: An artificial replacement of part of the body.” Radiation Oncologist: A physician specializing in the use of irradiation to treat disease. PDT: Photodynamic Therapy. cartilage. Recurrence is the return of cancer. Salivary glands: Glands in the mouth that produce saliva. comfort and/or health. or the palate. Second Primary: A new tumor unrelated to the original tumor. and other sources to kill cancer cells and shrink tumors.Partial Response (PR): Tumors have shrunk but have not disappeared as a result of treatment. Screening: Checking for disease when there are no symptoms. QOL-Quality of Life: The overall enjoyment of life. schedule and duration of treatment. at the same site as the original (primary) tumor or in another location. 16 W E H AV E W A L K E D I N Y O U R S H O E S . “A patient’s appraisal of and satisfaction with their current level of functioning as compared to what they perceive as possible or ideal. Systemic radiation therapy involves giving a radioactive substance. Many clinical trials measure aspects of a person’s sense of well-being and ability to perform various tasks in order to assess the effects that cancer and its treatment have on the person. PT: Physical Therapist. a facial bone.

Speech pathologist: A specialist trained to help with speech and swallowing disorders. XRT: Radiation therapy. SCCHN: Squamous Cell Carcinoma of the Head and Neck. Side effects: Problems that occur when treatment affects healthy cells. Tumor: An abnormal mass of tissue that results from excessive cell division. WBC: White blood cell. Systemic: Affecting the entire body. Stage: The extent of a cancer and whether the disease has spread from the original site to other parts of the body. Tonsils: Small masses of lymphatic tissue on either side of the throat. A N O V E R V I E W O F O R A L A N D H E A D A N D N E C K C A N C E R / PA R T I 17 . Toxicity: The quality of substances that causes ill effects. Tracheotomy: The creation of an opening in the front wall of the trachea for placement of a breathing tube. lymph node involvement (N) and Metastases (M). see stage. Xerostomia: Dry mouth. SCC: Squamous Cell Carcinoma. TNM: A staging system used to assess the size of tumor (T). Tumors perform no useful body function. Standard Treatment: The best treatment currently known for a cancer. Upper Aerodigestive Tract Cancer: Cancer that develops in the tissue lining the upper swallowing and breathing passages. This is a major type of oral and head and neck cancer. Squamous cell carcinoma: Cancer that begins in thin. Thrush: A fungal infection of the mouth or throat. WNL: Within normal limits. Tracheostomy: A surgical opening through the trachea in the neck to provide an artificial airway. Trismus: Stiffness in some or all of the muscles that open and close the mouth thereby restricting the opening of the mouth. flat cells that make up the lining of many areas of the body. Ultrasonography: A study in which sound waves (called ultrasound) are bounced off tissues and the echoes are converted into a picture (sonogram). Creation of a tracheostoma is permanent and cannot be reversed. including the oral cavity. They may be either benign (not cancerous) or malignant (cancerous). based on results of past research. White Blood Cells: Cells that help the body fight infection and disease.Serous: Thin watery consistency. Tissue: A group or layer of cells that together perform specific functions . This procedure involves sewing the entire circumference of the cut trachea to the skin.

M.D. North Shore-LIJ Health System James J. M.. M.D.D.S. Johns Hopkins Medicine Elliot W.A.D. Leupold. F. North Shore-LIJ Health System Karrie Zampini.L.N..O. please call 1-800-377-0928 Support for People with Oral and Head and Neck Cancer.D.A.C. M.. Myers.. Memorial Sloan-Kettering Cancer Center Other informational materials include “We Have Walked In Your Shoes” Part II Radiation Therapy and Chemotherapy For the Oral and Head and Neck Cancer Patient “We Have Walked In Your Shoes” Part III Dental Care for Patients Diagnosed with Oral and Head and Neck Cancer For additional materials.N. F.A.A. Inc. F.Wolk. North Shore-LIJ Health System Jesus E.A.Acknowledgments S P O H N C M E M B E R S Nancy E.S.S. Emeritus Memorial Sloan-Kettering Cancer Center David P. F. North Shore-LIJ Health System David G.M. R. North Shore-LIJ Health System Alex Keller. University of Oklahoma Health Sciences Eugene N. University of Pittsburgh School of Medicine David Myssiorek. President & Founder Bobbie Clyne Lynn Gormley Robert Klauber Ed McCartan Barney Phair Barry Sebastian M E D I C A L A D V I S O R Y B O A R D M E M B E R S Linda K. Greater Baltimore Medical Center Keith Heller. F..C. M. Sciubba.W.C. C. Memorial Sloan-Kettering Cancer Center Jed Pollack.D.C. M. M.. M. Medina. M.S. Strong. (SPOHNC) is a non profit organization dedicated to meeting the needs of oral and head and neck cancer patients.C. Clarke. D. C.. M.D.S.D. 18 W E H AV E W A L K E D I N Y O U R S H O E S . Pfister.S. Ph..D.R..D.S.D.

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