Tag Archive for: squamous cell carcinomas

Head & Neck Cancer Care Partner Follow-Up Office Visit Planner

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Head & Neck Cancer Care Partner First Office Visit Planner

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Head & Neck Cancer Patient Follow-Up Visit Planner

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Head & Neck Cancer Patient First Office Visit Planner

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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

Related Programs:

How Is Head and Neck Cancer Treated

How Is Head and Neck Cancer Treated?

What Are the Types of Head and Neck Cancer

What Are the Types of Head and Neck Cancer?

Expert Advice for Newly Diagnosed Head and Neck Cancer Patients

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:

How Is Head and Neck Cancer Treated

How Is Head and Neck Cancer Treated?

What Are the Types of Head and Neck Cancer

What Are the Types of 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?


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:

What Are the Types of Head and Neck Cancer

What Are the Types of Head and Neck Cancer?

Expert Advice for Newly Diagnosed Head and Neck Cancer Patients

Expert Advice for Newly Diagnosed Head and Neck Cancer Patients

What Do Patients Need to Know About Head and Neck Cancer Research

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:

How Is Head and Neck Cancer Treated

How Is Head and Neck Cancer Treated?

Expert Advice for Newly Diagnosed Head and Neck Cancer Patients

Expert Advice for Newly Diagnosed Head and Neck Cancer Patients

What Do Patients Need to Know About Head and Neck Cancer Research

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.  

Should Advanced Non-Melanoma Skin Cancer Patients See a Specialist?

Should Advanced Non-Melanoma Skin Cancer Patients See a Specialist? from Patient Empowerment Network on Vimeo.

Do advanced non-melanoma skin cancer patients need to see a specialist? Dr. Sunandana Chandra explains the benefits of working with a specialist, how she empowers patients, and when she recommends seeking a second opinion.

Dr. Sunandana Chandra is a medical oncologist and Associate Professor of Medicine at Robert H. Lurie Comprehensive Cancer Center of Northwestern University. Learn more about Dr. Chandra.

Katherine:  

Why is it important that patients speak up and have a voice in their care? 

Dr. Chandra:  

Well, I think for person to feel empowered, they have to understand their cancer, in my opinion. 

And that’s part of my responsibility is to try to share what I know about their cancer, my medical and clinical experience dealing with that type of cancer, and really, to try to empower them by giving them knowledge about their cancer, about their diagnosis, about the prognosis, about potential treatment options. And, I really think that that knowledge is really empowering for our patients and their family members, and I think with that knowledge, they can make the most informed decision, and they can help us then figure out what the best management plan for them is. You know, I try to spend a considerable amount of time with my patients and their family members and loved ones to explain all of this at the get-go so that that way, oftentimes, they can go home, they can kind of think about it, come back with more questions. 

Or, if they do some additional research on their own, hopefully some of what I’ve talked about might resonate and might even spur on more questions that usually can be very helpful for us to try to answer, helpful for the patient, I mean. 

Katherine:

Absolutely. Should patients consider seeing an advanced non-melanoma skin cancer specialist? 

Dr. Chandra:

You know, for a “routine” non-melanoma skin cancer of which the most common are basal cell carcinomas, squamous cell carcinomas, they may be tiny spots, maybe one, potentially multiple, that can just be excised and the person can be followed closely. For them, perhaps seeing someone locally, maybe very reasonable.   

But, if the patient themselves is ever worried or unsure, or they feel like they want to see a specialist, I absolutely would encourage that. In addition, for a person who has recurrent non-melanoma skin cancers, you know, multiple occurrences, maybe even more advanced than others, I think that those particular patients going to a specialist or a number of specialists may really help with the most advanced care. Maybe it’ll allow the patient and their team to be more proactive, maybe allow for other options that are maybe not standards of care, maybe novel, but promising.  

And so, I think for patients who are worried or for patients with more high-risk features, more increased number of skin cancers, perhaps more advanced skin cancers, I think having an expert or a team of experts on their team is certainly worth considering. 

Katherine:

What is your advice for patients who may feel like they’re hurting your feelings by seeking a specialist or a second opinion? Any advice for self-advocacy? 

Dr. Chandra:

Oh, gosh. I mean, I always tell our patients I strongly encourage it if they bring up especially. You know, I never want to patient of mine or their family members to look back and have any regrets. And so, from the get-go, I think that they should seek opinions. They should feel comfortable with the management that I or someone else is recommending to them.  

And, if a person asks me if it’s okay if they seek an opinion, I’m actually very encouraging of it because it doesn’t hurt my feelings. In fact, I think, again, it empowers the patient, which at the end of the day I think is most important and allows, hopefully, for them to have no regrets. And, I always tell patients more heads are better than one. So, if a colleague has another idea that perhaps I didn’t think of or vice versa, having that discussion and ultimately, that may allow for better patient care, which I think is all of our goals, which is actually our ultimate goal, I should say.