Guidelines Explain Head and Neck Cancers to Patients

Dentistry Today


The National Comprehensive Cancer Network (NCCN) has published the first of three guidelines for patients with head and neck cancers, focused on oral cavity (mouth and lip) cancers. The guidebook offers treatment explanations based on the recommendations from the NCCN Clinical Practice Guidelines in Oncology used by clinicians, put into plain language with an accompanying glossary and background. 

“These guidelines will help to decrease the anxieties associated with a cancer diagnosis,” said Mary Ann Caputo, executive director of Support for People with Oral and Head and Neck Cancer, which sponsored the guidelines. “You will learn and empower yourself with the necessary knowledge of the disease and its treatment. These tools will enable one to go forward with a strong conviction of moving on and living a full life.” 

“When I was first diagnosed, I was surprised, overwhelmed, and scared. I was completely focused on the treatment for my cancer, and so initially I was less aware of all the information shared with me during my medical appointments about my particular diagnosis,” said Jason Mendelsohn, board member of the Head and Neck Cancer Alliance, another sponsor.

“These guidelines are a great resource that patients, their caregivers, and families can read when they’re ready and able to focus on everything they need to know. We believe they will be a great resource for head and neck cancer patients everywhere,” Mendelsohn.

Mendelsohn’s experience is common, said Ellie Maghami, MD, chief and professor of the Division of Otolaryngology/Head and Neck Surgery at the City of Hope National Medical Center and member of the NCCN Guidelines Panel for Head and Neck Cancers, adding that while smoking and other tobacco use is by far the most common cause of mouth cancer, it can happen to anybody. 

“It’s not just an old person’s disease or just a smoker’s disease. For instance, incidences of tongue cancer, which is a type of oral cancer, are on the rise in non-smoking young people,” said Maghami, who also explained that the human papillomavirus or HPV, despite its common link to throat cancer, is actually responsible for fewer than 5% of tongue cancer occurrences.

The guidelines explain that there are several different types of cancers that can originate in all different parts of the mouth. They are generally treated first by surgery, including immediate reconstruction as needed and followed by rehabilitation of speech and swallow functions. Treatment at a high-volume cancer center with highly experienced specialists who frequently treat these rarer types of cancers can be beneficial.

Also, the guidelines recommend enrollment in clinical trials whenever possible and advocate for asking questions and seeking second opinions. Plus, the guidelines note that early detection can make a huge difference. According to Maghami, these cancers often are caught early thanks to the mouth’s high visibility. 

“It’s relatively easy to do a self-exam for oral cavity cancers. If you see something in your mouth that looks abnormal of feels strange for more than a few days, talk to a doctor about it,” said Maghami.

This free online resource also is available in print through for a nominal fee. Publication was made possible thanks to funding through the NCCN Foundation. The next two books in the Head and Neck series will cover oropharynx and nasopharynx cancers. The NCCN notes, though, that the guidelines do not replace the expertise and clinical judgment of the clinician. 

“Patients need reliable, accurate, up-to-date information presented in an easy to understand fashion,” said Maghami. “And that’s exactly what NCCN provides.”

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