Tag Archive for: head and neck cancer
What Do Patients Need to Know About Head and Neck Cancer Research?
What Do Patients Need to Know About Head and Neck Cancer Research? from Patient Empowerment Network on Vimeo.
Is there developing research that head and neck cancer patients should know about? Dr. Jessica Geiger explains how treatment approaches are evolving and how patients can stay up-to-date on the latest advances.
Dr. Jessica Geiger is a medical oncologist at the Cleveland Clinic. Learn more about Dr. Geiger.
See More From The Pro-Active Head and Neck Cancer Patient Toolkit
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Expert Advice for Newly Diagnosed Head and Neck Cancer Patients |
Transcript:
Katherine Banwell:
Cancer research is developing rapidly. What are you excited about when it comes to head and neck cancer research?
Dr. Jessica Geiger:
Well, I think there’s a lot of different clinical trials that are coming out in what we call the neo-adjuvant space so before you go for a surgery. Again, head and neck cancer is a little bit different when we think of other more common cancers.
And what I mean by that is it’s one thing to be able to surgically remove cancer or to ablate it completely with radiation. The problem with the head and neck area as you can imagine, it’s such a small area. There’s a lot of precious real estate there, as I always describe to patients. And so, it’s one thing to cure the cancer, to cut it out completely. But then we have functional and sometimes cosmetic concerns after that, too. So, I think one of the biggest things that we are always trying to look to be successful in is are there therapies, are there treatments where we can shrink down the initial cancer so that the resulting surgery or the fields of radiation are not so severe? So, we’re maintaining the cure rates that we have. We’re improving on the cure rates that we have. But also thinking about how can we improve the quality of life and the function and the cosmetic outcome after their cancer treatment? And I think that’s really exciting.
Katherine Banwell:
It is. It’s great. And I’m sure there’s been so much development in the field, even in the last 10 years.
Dr. Jessica Geiger:
There has. And another comment to make on that point, too, when we’re thinking about clinical trials especially. There’s really two big subsets of squamous cell cancer, head and neck squamous cell carcinoma, and that’s HPV-positive that’s related to the HPV, the human papilloma virus and HPV-negative. HPV-negative is what we think of historically as being caused by years of smoking often with heavy drinking. That’s kind of the traditional head and neck cancer patient. But over the last couple of decades now, there’s a completely different disease that we have recognized. And that’s related to HPV. And these patients tend to be light or never smokers at all. They tend to be younger, different demographic of patients. The good news is those cancers seem to respond better to cancer treatment, particularly radiation- and chemotherapy-based.
So, as I mentioned before, trying a neo-adjuvant approach to kind of reduce the impact of surgery or the impact of radiation, particularly with HPV-related disease. We know that it’s a different disease that behaves much better than HPV-negative. So, trying clinical trials to what we call de-intensify therapy. So, maintaining the high cure rate. But reducing the toxicities related to treatment so that – you know, these are younger patients. They’re cured of their cancer. But they still require a feeding tube. Or they have a lot of chronic pain in the neck. They have a lot of morbidity with the treatment. And so, trying to reduce that down to again, maintain high cure rates, but help with quality of life in the years to come.
Katherine Banwell:
How can patients stay up-to-date on developing research?
Dr. Jessica Geiger:
That’s a really good question.
Every once in a while, there are sound bites or news articles that are kind of in the mainstream press and in the mainstream news. I would just encourage patients to – if they read something or see a headline to reach out to their oncology team and have a discussion. What is this research? What does it mean for me? Does it apply to me? How is this information being used for cancer treatment? How would this impact my treatment or my follow up? It’s really hard to kind of navigate through what is, in terms of research, what is immediately clinically impactful or clinically meaningful at that time.
Katherine Banwell:
Are there any websites that you recommend to patients?
Dr. Jessica Geiger:
The American Head and Neck Society has a good website. And there’s a couple of other, depending on what state you live in or regions of certain states.
There’s a lot of different support groups for head and neck cancer patients that I would encourage patients to reach out. Because especially in the regional, geographic location where you are, it may be worthwhile to be able to have those conversations. Because you can walk down the street and not know if somebody’s had it. But I’ve had more patients over the last several months, especially HPV-related disease patients who have mentioned something to me along the lines of, “I had mentioned to an acquaintance or a friend of a friend. And suddenly, I know three or four other people who have had this cancer. And I had no idea. And now we’re talking about how we have to carry a water bottle with us all the time because we can’t swallow dry foods. And how we have to be very mindful of what we’re eating when we order at a restaurant.” And so, just trying to navigate a bigger world, narrowing it down to where you live to have those meaningful contacts of other patients who have gone through what you have gone through.
Expert Advice for Newly Diagnosed Head and Neck Cancer Patients
Expert Advice for Newly Diagnosed Head and Neck Cancer Patients from Patient Empowerment Network on Vimeo.
What steps should newly diagnosed head and neck cancer patients take following a diagnosis? Dr. Jessica Geiger shares advice to help patients play an active role in their care.
Dr. Jessica Geiger is a medical oncologist at the Cleveland Clinic. Learn more about Dr. Geiger.
See More From The Pro-Active Head and Neck Cancer Patient Toolkit
Related Programs:
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What Do Patients Need to Know About Head and Neck Cancer Research? |
Transcript:
Katherine Banwell:
What three key pieces of advice would you have for a patient who’s just been diagnosed with head and neck cancer?
Dr. Jessica Geiger:
Well, first, obviously, you have to see an oncologist you have trust and faith in.
And whether that oncologist is a surgical oncologist which for this disease would be a head and neck cancer specialist, an ENT, or a head and neck surgeon. So, just make sure that you are comfortable with your team, because it can be a very long process in terms of treatment as well as recovery and ongoing surveillance. That’s number one. I think number two is seek out clinical trials if you have the opportunity to do that. This is a disease that’s not rare, but it’s not as common as breast cancer or colon cancer or prostate cancer. You could go to almost any general practicing medical oncology office, and they may or may not have very many head and neck cancer patients at a given time, because it’s much rarer compared to the other more common adult cancers.
So, if you have the opportunity to seek out a clinical trial, I think that is great because we don’t have a lot of different types of therapies like you see with other cancers.
Katherine Banwell:
Yeah.
Dr. Jessica Geiger:
And then number three, and I can’t stress this enough, even early on in your head and neck cancer journey, again, whether it’s a very early-stage cancer or later-stage cancer. I think getting involved with the appropriate support specialties, meaning speech and language pathology, dental care, occupational therapy. We couldn’t do what we do without some of these support specialties. And especially speech and language pathology for swallowing, it can’t be stressed enough that early intervention can be really meaningful and really impactful on function after head and neck cancer treatment.
Katherine Banwell:
Mm-hm. Dr. Geiger, what is your advice to patients who may feel like they’re hurting feelings by seeking a specialist or even a second opinion?
Dr. Jessica Geiger:
So, first of all, I know it’s easier said than done, you shouldn’t worry about hurting anyone’s feelings. At the end of the day, you need to be in charge of your health. And you need to be an advocate for yourself or an advocate to your family members who may be going through this. So, I think you need to do what is best for you and what you feel most comfortable about. And if that is seeking an opinion elsewhere, I think if your provider – you’re asking for a second opinion gets their feelings hurt or is a bit offended. I would consider that to be a pretty big red flag. I have patients all the time who may ask me for a second opinion, or they want to go to a different institution for an opinion to see what else is out there. And sometimes I even offer to reach out to different contacts that I know at different other institutions if there’s something that I think may be better than what I can offer them with what we have.
Especially when it comes to clinical trials. So, I would just try to empower the patients to – this is your life. This is your health. And you can’t worry about what us in the medical profession are going to worry about. For most of us, I would say there’s a lot of patients. We want to do what is best for each and every one of them. And if it’s not with us, then please let me help you find someone who is better for you.
How Is Head and Neck Cancer Treated?
How Is Head and Neck Cancer Treated? from Patient Empowerment Network on Vimeo.
Once a patient is diagnosed with head and neck cancer, what are their treatment options? Dr. Jessica Geiger provides an overview of current therapies.
Dr. Jessica Geiger is a medical oncologist at the Cleveland Clinic. Learn more about Dr. Geiger.
See More From The Pro-Active Head and Neck Cancer Patient Toolkit
Related Programs:
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Expert Advice for Newly Diagnosed Head and Neck Cancer Patients |
What Do Patients Need to Know About Head and Neck Cancer Research? |
Transcript:
Katherine Banwell:
How is head and neck cancer treated?
Dr. Jessica Geiger:
The thing about head and neck cancer is even if it’s a very early-stage cancer, certainly if it’s a later stage with very big tumors that have spread, even the small cancers are often treated with many different modalities, many different medical specialties and surgical specialties. So, primarily, it’s going to be treated with head and neck surgery, sometimes with radiation, and then of course, you can require some systemic therapy which is what I do. And systemic therapy could be standard chemotherapy as you think about it. It could be targeted therapy. It could even be immunotherapy.
Katherine Banwell:
Okay.
Dr. Jessica Geiger:
And sometimes we have to use two or three of those different tools to get the job done.
What Are the Types of Head and Neck Cancer?
What Are the Types of Head and Neck Cancer? from Patient Empowerment Network on Vimeo.
What is head and neck cancer? What cancers are included in this classification? Dr. Jessica Geiger provides a definition and reviews the main types of head and neck cancer.
Dr. Jessica Geiger is a medical oncologist at the Cleveland Clinic. Learn more about Dr. Geiger.
See More From The Pro-Active Head and Neck Cancer Patient Toolkit
Related Programs:
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Expert Advice for Newly Diagnosed Head and Neck Cancer Patients |
What Do Patients Need to Know About Head and Neck Cancer Research? |
Transcript:
Katherine Banwell:
What is head and neck cancer?
Dr. Jessica Geiger:
Head and neck cancer is sort of a broad term to include all cancers, all malignancies within the upper aero-digestive system. When we think about head and neck cancer, the vast majority of those cancers are going to be squamous cell carcinomas that start anywhere from the tip of the tongue to the back of the throat to the voice box area. But head and neck cancer can also include cancer of the salivary glands, skull base, or sinus cancers as well.
Katherine Banwell:
What are the types of head and neck cancer? And where can they start in the body?
Dr. Jessica Geiger:
There are several different types. The majority of them are called squamous cell carcinomas. Squamous cell cancers or squamous cell carcinoma encompasses over 90 percent of head and neck cancers.
And those can start anywhere on the tip of the tongue, anywhere in the oral cavity, the tonsils, the back of the throat called the oropharynx, or also in the larynx or around the voice box in those areas. But head and neck cancer can also include salivary gland cancers of which there are dozens of different recognized histologies. These are cancers of the larger, major salivary glands like the parotid glands or the submandibular glands. But they can also include cancers of minor salivary glands that aren’t even named but are found all over the upper aero-digestive mucosa and are there. Head and neck cancers can also include what we refer to as skull-based tumors or midline sinus, peri-sinus cancers as well.
How Is Treatment for Head and Neck Cancer Evolving?
How Is Treatment for Head and Neck Cancer Evolving? from Patient Empowerment Network on Vimeo.
How is head and neck cancer treatment evolving over time? Watch as expert Dr. Samantha Tam from Henry Ford Health System explains current areas of research focus in head and neck cancer – and how researchers are working toward the best care for patients.
See More From The Head & Neck Cancer TelemEDucation Empowerment Resource Center
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Transcript:
Samantha Tam, MD, FRCSC, MPH:
So, treatment of head and neck cancer is constantly evolving with the introduction of immuno-therapeutic agents, understanding the role of that in the treatment of head and neck cancer is currently undergoing a lot of research. And there’s a lot of interest in curiosity about how we can utilize that in conjunction with the more traditional treatments of head and neck cancer. Another major focus in head and neck cancer now is to ensure that we’re not overtreating our patients, especially those with HPV-positive disease, and so understanding the balance between treatment care of the disease as well as maximizing function and quality of life after treatment of the disease has become a major focus in head and neck cancer and is certainly at the forefront of our minds.
Do Telephone-Only Visits Qualify As a Telemedicine Visit?
Do Telephone-Only Visits Qualify As a Telemedicine Visit? from Patient Empowerment Network on Vimeo.
For head and neck cancer patients, do telephone-only visits really qualify as a telemedicine visit? Watch as expert Dr. Samantha Tam from Henry Ford Health System explains care concerns that can be covered in telephone versus video visits – and patients who can benefit from the use of virtual visits.
See More From The Head & Neck Cancer TelemEDucation Empowerment Resource Center
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Transcript:
Samantha Tam, MD, FRCSC, MPH:
So from a… Telephone-only visits have a lot of drawbacks to them, I think even virtually assessing a patient with regards to how they’re doing generally, a general physical examination is very important. On top of that, we have a lot of sensitive conversations in patients that have head and neck cancer, so it’s important to also read things like non-verbal body language, so definitely the video component is extremely useful for providers that are caring for patients with head and neck cancer. However, in patients that might not have access to video visits, might not have the technology, I think that the number one priority in our minds is that this patient gets the best care that they are able to get, and whether that this means a telephone-only type of a visit is possible for these patients, we adjust our…I guess we adjust our requirements, we adjust our ability to deliver care based on that, so that might mean touching base with the patient on the phone at first in order to understand exactly what they’re going through, talk them through the next steps so that they know what to accept in order to make their care more streamlined later on. I don’t think that telephone visits will completely replace either virtual visits or in-person visits, but I think that, again, they are a tool, and they’re a tool that especially patients that might be more disadvantaged, such as not having access to good Internet might not have access to the technology required for a virtual visit, those patients need to be considered when we consider utilizing telephone-only care.
Is Telemedicine a Mainstay for Head and Neck Cancer Patients?
Is Telemedicine a Mainstay for Head and Neck Cancer Patients? from Patient Empowerment Network on Vimeo.
Will head and neck cancer care continue with telemedicine in the future? Watch as expert Dr. Samantha Tam from Henry Ford Health System shares her perspective on her expectations for the use of telemedicine versus in-person visits with head and neck cancer patients.
See More From The Head & Neck Cancer TelemEDucation Empowerment Resource Center
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Transcript:
Samantha Tam, MD, FRCSC, MPH:
So while COVID-19 has forced us into utilizing telemedicine in context that we might not nearly have used them in the past, I think that telemedicine is here to stay, though perhaps not as wide spreading universal as it has been at the beginning of the pandemic. Telemedicine to me, seems to be a very good adjunct to our in-person visits, I think seeing patients and evaluating them in-person is essential in head and neck cancer throughout the treatment course. That being said, I think that telemedicine really adds a value into patient’s care, there are several ways that we have used this at Henry Ford in order to enhance access to our services, one is with patient intake, when we have some information, we can certainly start to…we can meet with you, get a good clinical history and understand exactly what is going on, and therefore expedite investigations that are required, and then condense our visits to just one in-person visit versus multiple in-person visits. Another way that I have used this is checking in with patients while they’re in the middle of treatment, sometimes patients are getting daily radiation, not close to my office, but I like to check on them to make sure from a symptom standpoint that they’re tolerating their treatment well.
And certainly coming down for a visit would be impossible, so checking in with them virtually has been a good way to monitor treatment side effects and to ensure everything is going smoothly from that standpoint. With surveillance, there have been also options that way to check in with patients that are more on the survivorship end of things to see how things are going that way though, I often do like to see patients in follow up in-person just so that we can also complete an endoscopic examination as clinically indicated.
What Head and Neck Cancer Treatment Side Effects Can Be Monitored via Telemedicine?
What Head and Neck Cancer Treatment Side Effects Can Be Monitored via Telemedicine? from Patient Empowerment Network on Vimeo.
For head and neck cancer patients, which treatment side effects are acceptable to be monitored via telemedicine? Watch as expert Dr. Samantha Tam from Henry Ford Health System explains vital aspects for monitoring treatment side effects, key symptoms for patients to report, and some patient monitoring methods that are helpful in care.
See More From The Head & Neck Cancer TelemEDucation Empowerment Resource Center
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Transcript:
Samantha Tam, MD, FRCSC, MPH:
One of the most important aspects in terms of treatment side effects is understanding what the patient feels with regards to their symptoms and reporting this to the physician. Something that we’re using at Henry Ford currently is remote patient-reported outcomes measurement, which looks at several domains of symptomology that we are monitoring throughout your treatment. These questionnaires can be completed online remotely at home, and don’t necessarily need an in-patient visit. This is a platform that can be utilized to communicate with providers in order to understand what the treatment side effects might be, and also a standardized way to discuss with your physician exactly what kind of side effects you might have from treatment.
So I think it’s important to be a self-advocate for your care, and so certainly as a provider, I’m happy to hear any kind of concerns that you have about side effects from treatment, pain, bleeding. I think one of the big ones is whether or not you’re doing well with swallowing and how your weight has been. Energy level is another major indicator about how much you’re able to take in and how well you’re tolerating the treatment. All these types of components are important things for us to know throughout your treatment course, and I think speaking up about any kind of concerning symptoms you have is important for your provider to know so that we understand exactly what’s going on.
