Early diagnosis saves lives, but today they are still often recognized late. Ten thousand new cases every year in Italy, hi-tech interventions preserve voice and chewing
Those that affect the head and neck district are different forms of cancer of interest nose, lips, tongue, inside of the mouth, salivary glands, larynx and pharynx which are often diagnosed late, at an advanced stage, when the therapies must be more invasive and the chances of healing are less. Precisely because of the area of the body where these tumors develop, they are often easily visible, yet various investigations have shown that they are little known and the symptoms are underestimated. A study by the Rush University Medical Center in Chicago, recently presented at the annual meeting of the American Head and Neck Society, then highlighted that living in areas with high levels of air pollution can be a risk factor for some types of cancer head and neck, especially for cancer of the oral cavity, larynx and pharynx.
The American study on smog
“This is not the first research on the subject – he explains Stephen Bondi, director of the otorhinolaryngology unit of the IRCCS Istituto Tumori di Candiolo, near Turin -. Since 2013 air pollution in general and the atmospheric particulate (ie the so-called fine particles) are classified among certain carcinogens for humans by the highest authority on the subject, the International Agency for Research on Cancer (Iarc) of Lyon, the agency of the World Health Organization. And a 2018 German study, conducted in Saxony on two million people exposed to increasing levels of pollution, hypothesized a 53% increase in relative risk for the development of mouth and throat cancers. In the new study, the researchers cross-referenced data from the Illinois cancer registry from 2014 to 2018 with the postal codes of residence of patients with head and neck cancer. To determine the level of pollution in individual areas, the researchers used maps from the US Environmental Protection Agency. The results showed a 2.5-fold increased risk of head and neck cancer, especially of the oral and pharyngeal cavities, in people over the age of 65, residing in areas with high levels of diesel particulate matter largely released by traffic. “This study reinforces the hypothesis of the existence of a direct correlation between the increase in pollution values and head and neck cancer, and this association must be considered with extreme attention,” underlines Bondi.
Discovering the presence of these neoplasms is theoretically simple, because they are often identifiable already with aThorough otorhinolaryngological examination, but it is important that people do not overlook possible symptoms. Without getting too alarmed, because these are often signals common to simple inflammatory pathologies, it is good do not ignore mouth ulcers, difficulty swallowing, sore throat or earache, burning or sores in the mouth, persistent hoarseness, swelling in the neck, painful and uncomfortable swallowing, stuffy nose in one nostril or nosebleeds that last for more than three weeks. Better to talk to a doctor, because if the neoplasm is discovered in time, almost nine out of ten patients could recover, but still today more than half of the patients arrive at the diagnosis late, in a locally advanced or already metastatic phase.
Certain causes: smoking, alcohol and Papillomavirus
Environmental pollution (especially atmospheric pollution) includes various carcinogenic substances from human activities (vehicle traffic, industries, domestic heating) or from natural sources (ionizing radiation, ultraviolet rays) and it is estimated that in Italy it is responsible for about 5 cases of cancer out of 100. However, 75% of head and neck cancers are due to the consumption of tobacco and alcoholic beverages. “Those who drink more than four drinks a day and smoke about two packs of cigarettes have a 35-fold increased risk – says the expert -. The disease is more frequent in the North and tends to affect men more, with an incidence two to three times higher than in women and increases with age (especially after 65 years) even if the numbers among women and the under 40s are growing». In Italy, 10,000 new cases are recorded every year and we must not forget that among those responsible for these neoplasms (especially of the oropharynx, oral cavity and larynx) there is also human papillomavirus infection: this is why it is important to take advantage of the opportunity of the HPV vaccination offered free of charge to all Italian 12-year-olds. Then there are others risk factors related to poor oral hygiene (for example sharp teeth or poorly positioned prostheses) or occupational exposure to asbestos dust or wood dust. Poor nutrition (diet low in vitamins A and B, i.e. fresh fruit and vegetables) and the Epstein-Barr virus (a type of herpes virus that is transmitted through saliva and associated with nasopharyngeal cancer).
There are many therapies available today: depending on various factors (the site in which the tumor is located, its extension, aggressiveness, the general health conditions of the patient, the expected aesthetic and functional results) it is possible to resort to surgery (preservative if possible), chemotherapy, radiotherapy, targeted drugs, immunotherapy which can be used alone, in sequence or in combination with each other. However, specialized multidisciplinary teams are needed, able to offer patients the experience and all the indispensable skills to treat these neoplasms, and centers in which the various specialists for these tumors make decisions by comparing them with each other. “Like all cancers, even head and neck cancers are more likely to be successfully cured (and treated in a less invasive way) the sooner they are discovered and the sooner the therapies are started – concludes Bondi -. They are highly disabling diseases with a high emotional impact because they can compromise not only important functions such as chewing, swallowing and voice, but also the self-image with negative consequences in people’s quality of life. Thanks to new surgical techniques and innovative technologies it is possible to intervene with great precision without compromising the nearby nervous structures, thus preserving the functions potentially involved”.
November 24, 2022 (change November 24, 2022 | 14:21)
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