BY UE STUDIO

Updated Monday, December 5, 2022-13:29

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Under the name of head and neck cancer, various malignant tumors are grouped that generally originate inside the mouth, nose and throat.

In Spain, between 12,000 and 13,000 new cases are diagnosed each year and, according to Ricard Mesía, head of the Medical Oncology Service of the Catalan Institute of Oncology (ICO) in Badalona and president of the Spanish Group of Head and Neck Tumors (TTCC) and of the Spanish Foundation for the Treatment of Head and Neck Tumors (FETTCC) has been changing the profile of these patients in recent years.

"Currently, the incidence of tobacco-related tumors is decreasing slightly each year. However, head and neck tumors related to the human papillomavirus are rising sharply," explains the expert, who also points out how the prevalence of this disease is growing significantly due to the impact of treatments that improve the survival of more patients each year.

In this sense, immunotherapy has represented an important advance.

"For the first time, it manages to improve the survival of a percentage of patients who until now had little life expectancy, such as metastatic patients. We are still at figures of around 10% who are alive at five years, but before these long survivors were anecdotal".

These cancers, however, continue to have important sequelae, as explained by José Luis Cebrián, head of the Oral and Maxillofacial Surgery Service at Hospital La Paz in Madrid and president-elect of the Spanish Society of Oral and Maxillofacial and Head and Neck Surgery (SECOM CyC). .

"Although we always try to reduce the sequelae with our treatments, there are associated stigmas that cause many patients to withdraw and affect their personal lives. Normal situations such as talking or eating with friends can be complicated and require an effort for the patient and also a lot of understanding from others".

The importance of prevention

The risk factors that affect the appearance of this type of tumors have been identified, as explained by Pedro Díaz de Cerio, otolaryngology assistant at Hospital San Pedro de Logroño and member of the oncology and head and neck surgery commission of the Spanish Society of Otolaryngology and Head and Neck Surgery (SEORL CCC).

"Tobacco and alcohol consumption and human papilloma virus infection are the most important. Other factors such as exposure to formaldehyde, asbestos or toxins such as Betel nut consumption are less important."

The fact that they are related to consumption habits emphasizes the importance of awareness campaigns.

"After a period in which the number of smokers decreased significantly, young people have resumed this habit. Alcohol consumption, even in large quantities, has also returned to normal. The consequences of the abuse of these risk factors they will be seen in the long term. On the other hand, the irruption of the human papillomavirus as an etiological factor requires information campaigns for young people", explains José Luis Cebrián.

The importance of the multidisciplinary approach

Multiple professionals play a key role in its diagnosis, treatment and follow-up, as Pedro Díaz de Cerio points out.

"The global management of head and neck cancer is a multidisciplinary task in which medical oncologists, radiotherapy oncologists, otolaryngologists and maxillofacial surgeons and a number of other specialists in health sciences such as speech therapists, psycho-oncologists, specialized nursing, rehabilitation doctors, etc. are involved. ... The Spanish Foundation for the Treatment of Head and Neck Tumors is a recently launched initiative that brings together all of us who treat head and neck cancer and that seeks to improve and increase the quality of life of our patients".

However, on some occasions the onset of symptoms may not be noticed,

"This forces the performance of aggressive surgical and oncological treatments that generate a large number of sequelae, in addition to the well-known decrease in life expectancy. Therefore, early diagnosis, being aware of early warning signs and symptoms, makes let's detect tumors in their early stages" adds Díaz de Cerio.

Some of these symptoms are dysphagia or difficulty swallowing, the sensation of pain in the ear, persistent hoarseness, ulcerations or the presence of unexplained masses in the neck, among others.

In recent years, much progress has also been made in diagnostic imaging techniques.

"The new magnetic resonances can perform special sequences that allow us to better understand the tumor and its entire extension, and positron emission tomography or PET provides additional information such as tumor activity and its extension to other organs," says Jordi Giralt, chief of the Radiation Oncology Service of the Vall d'Hebron Hospital in Barcelona and president of the Spanish Group of Head and Neck Radiation Oncology (GEORCC).

Advances in treatments

The treatment of head and neck tumors is based on surgery, radiotherapy, and systemic treatments.

These can be given as a single treatment or in combination.

That is why multidisciplinary treatment is so important.

"Radiotherapy has advanced a lot in these years. We now have techniques that allow us to treat with great precision, protecting neighboring healthy tissues much better. We use image-guided radiotherapy techniques, that is, with the patient in the treatment position, we make a X-ray very similar to the CT scan to see that the patient's position is correct. If it is not, the treatment table can be moved to correct the position. This allows us to perform very precise treatments", adds Jordi Giralt.

José Luis Cebrián points out how there have also been significant improvements in surgeries for these tumors.

"The main milestone in recent decades has been the irruption of reconstructive surgery techniques that make it possible to replace the removed tissues with others from the patient. This has exponentially increased the quality of life of patients trying to return them to the situation prior to the Today, techniques related to 3D Medicine such as virtual planning and surgery and bioprinting facilitate these reconstructive tasks, customizing treatments for each specific patient."

On the occasion of the first Congress of the Spanish Foundation for the Treatment of Head and Neck Tumors, which will be held in Madrid on December 15 and 16, more than 200 specialists will meet in Madrid to delve into multidisciplinary treatment and advances in diagnosis and treatment of these tumors.

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