To hear the words—you have cancer—can leave anyone with feelings of disbelief and fear, and unknowing of where to turn for information, help and support. Being diagnosed with an oral cancer or a cancer of the head and neck is especially challenging. Thoughts of having a cancer and then treatment that could involve chemotherapy, radiation therapy, or surgery to an area of the body that involves talking, eating, and drinking can be overwhelming. This year, the American Cancer Society estimates that over 53,000 Americans will hear these words and be diagnosed with head, neck or oral cancer.
Oral, and Head and Neck Cancer Symptoms & Risk Factors
The National Cancer Institute (NCI) defines cancers of head and neck as cancers that occur in the oral, and head and neck region of the body. These cancers can occur in the nasal cavity, sinuses, lips, gums, roof of the mouth, tongue, mandible, salivary glands, throat, tonsils, larynx, and affected lymph nodes in this region. Head and neck cancers account for 3 percent of all cancers diagnosed each year. The NCI reports that risk factors for developing cancers of the head and neck include using of tobacco products (smokeless tobacco and smoking cigarettes, cigars, or pipes), heavy intake of alcoholic beverages, and exposure to the oral human papillomavirus (HPV).
Symptoms of oral, and head neck cancer can include:
- white or red patches in the mouth or lips
- oral sores that do not heal
- bleeding of the mouth or gums
- loose teeth
- difficulty or pain with chewing or swallowing
- a lump in the neck
- an earache that does not go away
- numbness of the lip, chin or jaw
However, as many of my patients have relayed to me over the years—they didn’t have any symptoms, they never smoked, and if they did drink alcohol it wasn’t much—their cancer was discovered by their dentist or doctor at a routine dental check-up or doctor’s visit. As for most types of cancers, finding cancer at an earlier stage (e.g. when it is smaller, and contained in one area and has not spread) is key for more successful treatment—or as your doctor may say, “better outcomes and improved survival”. So knowing the possible symptoms of head and neck cancers is vital for early and timely diagnosis. So if you or someone you know has a concerning bump in the mouth, oral pain, changes in chewing or swallowing, or lump in your neck—get it checked out!
Eating Challenges after Cancer Diagnosis
Nutritionally, being diagnosed and going through head and neck cancer treatment can make eating hard to do, actually really difficult! Once diagnosed, oncologists and surgeons warn of lasting side effects of cancer treatment. A dry mouth, an intensely sore mouth, difficulty and pain with chewing and swallowing, and risk of dental decay—the treatment side effect list is endless and daunting, even scary. Patients are referred to meet with me before their treatment begins to receive information and help with eating to start their therapy as nutritionally as strong as possible. For the majority of my patients, it means having a feeding tube (a gastrostomy or percutaneous endoscopic gastrostomy – PEG) placed in their stomachs to help keep them nourished while undergoing and recovering from treatment. Feeding tubes commonly stay in place for a period of four to six months. I am available to meet with patients regularly to help them through their weeks of treatment and then during their road to recovery.
Where to Find Support, Nutrition Information and Encouragement
The following is my “go-to-list” when patients and caregivers ask me for resources for help and support.
Registered Dietitians (RDs) are nutrition and dietetic professionals that can provide patients and their caregivers with individualized help for nutrition well-being through the continuum of cancer care. After meeting with your surgeon or oncologist ask for a referral to the RD at your cancer center or hospital, or an RD your local community. Ask to see if a certified specialist in oncology nutrition (CSO), an RD with specialized training, knowledge and experience in cancer nutrition, is available in your area.
Support for People with Oral and Head and Neck Cancer (SPONHC) is a self-help, non-profit organization that is involved in the development of programs of support. SPONHC’s mission “is to raise awareness and meet the needs of oral and head and neck cancer patients.” Their phone number is 1-800-877-0928. SPONHC is a great place to find personal stories written by people diagnosed with head and neck cancer, awareness materials, helpful resources, local chapters, national support organizations, and a listing of supportive care products (such as mouth moisturizers, and oral and skin care products).
SPONHC offers two publications for sale on their website to help with nutrition, psychosocial and practical concerns. The books are:
- Eat Well – Stay Nourished: Recipe and Resource Guide, is a wonderful source of nutrition information and recipes for those coping with eating challenges.
- Meeting the Challenges of Oral and Head and Neck Cancer: A Guide for Survivors and Caregivers, helpful and comprehensive resource filled with practical information for patients and their families.
American Cancer Society: Be sure to check out the Oral Cavity and Oropharyngeal Cancer home page for detailed information about these cancer.
National Cancer Institute: – 1(800) 4CANCER – Be sure to check out the Head and Neck Cancer home page for a comprehensive review of head and neck cancers. Eating Hints is also a free publication available from the NCI. To order or print a copy of this publication go to http://www.cancer.gov/cancertopics/coping/eatinghints.pdf.
Head and Neck Cancer Awareness Month
During this month of awareness for head and neck cancer, the purpose of this blog is to provide readers with an overview of these cancers and where to turn for support, information, and encouragement. This month we will also provide oral care suggestions and eating hints for getting ready for cancer treatment and managing possible side effects of treatment that can impact nutrition well-being, and discuss nutrition and physical activity recommendations for life after treatment—cancer survivorship. As a registered dietitian that has worked with people with head and neck cancer and their caregivers for over thirty years I can personally attest to their courage, determination, and grace as they faced, undergone, and recovered from cancer treatment.