Head & Neck Cancer FAQs

How common is head and neck cancer?
According to the National Cancer Institute, cancers of the head and neck account for 6 percent of all cancers in the United States. The category includes cancers of the buccal cavity (mouth), head and neck, larynx, pharynx, thyroid, salivary glands and nose/nasal passages. While white men and women currently have the highest incidence rates of head and neck cancer, mortality is still highest in African Americans.

The National Cancer Institute notes that the incidence of thyroid cancer has increased in all races and in both males and females in the past two decades. Thyroid cancer incidence is almost three times higher in females than in males. However, despite the increase in incidence, mortality rates have remained very low. The doubling in the incidence of thyroid cancer since the early 1970s may be due to better imaging and biopsy techniques rather than to an actual increase in cases.

What are the risk factors for head and neck cancer?
A risk factor is anything that increases a person's chance of getting a disease such as cancer. Different cancers have different risk factors. For example, exposure to sunlight is a risk factor for skin cancer and a high-fat, low-fiber diet is a risk factor for colorectal cancer. Scientists have found several risk factors that make a person more likely to develop head and neck cancer:

Tobacco - Tobacco use has long been recognized as the predominant risk factor for development of cancers in the head and neck, especially the larynx and hypopharynx. Smoking has consistently been reported to confer a dose-dependent increase in the risk of developing cancers in this area - the more one smokes, the greater the risk.

Alcohol consumption - Alcohol consumption has also been implicated in head and neck cancer, particularly in combination with tobacco use. Alcohol consumption increases one's chance for laryngeal cancer approximately two to five times that of non-drinkers, and in combination with tobacco use has been shown to have almost a multiplying effect on the risk rather than merely additive. Some reports have suggested up to a 100-fold increased risk.

Oral irritants - Ill-fitting dentures or sharp areas on teeth that rub the tongue or cheek have been implicated in causing head and neck cancer.

Nutritional deficiencies and immune suppression - Nutritional deficiencies and immune suppression have also been associated with cancers of the head and neck. Nutritional deficiencies often go hand-and-hand with alcohol use and may be equally responsible for alcohol's increased risk. Malnutrition as well as dietary deficiencies in some vitamins such as riboflavin, vitamin B derivatives, vitamin A, and retinoids may also play a role.

Gastroesophageal reflux - Gastroesophageal reflux, which is a disorder that is produced from acid in the stomach being expelled back up the food pipe (or esophagus), often manifests as "heartburn". It has been shown that this acid reflux can irritate the lining of the esophagus and has been associated with cancer of the esophagus.

Viruses - Some viruses have also been implicated in the formation of cancers in the head and neck. Specifically, the human papilloma virus (HPV) which commonly causes routine warts of the skin may infect the larynx. Laryngeal papillomas are extremely rare but their presence may confer an increased risk in the long run of developing laryngeal cancer. The Epstein-Barr Virus (EBV) has been implicated in some nasopharyngeal cancer.

Other factors - Other risk factors include occupational exposures such as wood dust, paint fumes, metal-working, gasoline, plastics production, radiation and textiles.

Although these risk factors are well documented, some patients will develop cancer in the head and neck without having any identifiable risk factor. This is particularly true for glandular tumors of the head and neck such as thyroid and salivary gland. Therefore, patients should not ignore Signs and Symptoms of Head and Neck Cancer that are suggestive of a problem even when they are not considered at risk.

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What are the goals of head and neck cancer treatment?
The goals of head and neck cancer treatment are to eradicate cancer and help you achieve an excellent outcome and quality of life following your treatment. Virginia Mason specialists are dedicated to helping patients live well beyond a diagnosis of cancer. All Virginia Mason cancer survivors are encouraged to meet with specialists within the Survivorship Clinic to talk about quality of life and what's next after their treatment for cancer. It is important to remember that more than 11 million Americans today are cancer survivors.

Will my head and neck cancer come back?
This is one of the most common questions asked by cancer survivors. In some cases, cancer can recur or a new cancer can form years or even decades after treatment. One of the goals of the Survivorship Clinic at Virginia Mason is to help patients come to terms with their fears about cancer recurrence so that they can lead productive, fulfilling lives. Another goal is to ensure that survivors realize the importance of, and are scheduled for, periodic check-ups after their last treatment for cancer.

How many doctors will be involved in my care?
Several specialists will be involved in your care including head and neck surgeons, plastic and reconstructive surgeons, medical oncologists (doctors who treat cancer with chemotherapy), radiation oncologists (doctors who treat cancer with radiation), nurses, radiologists, pathologists, speech pathologists, nutritionists, dietitians, physical therapists, social workers and others who have specialized training in head and neck cancer.

What will happen if I decide not to undergo treatment?
The decision to undergo head and neck cancer treatment resides completely with you and your family. Many cancers, when caught early, are highly treatable, allowing patients to live years and even decades beyond their initial diagnosis. Patients with advanced cancer may be eligible for enrollment in a clinical trial (study) that offers investigational new treatment not available to most patients. A decision about whether or not to have treatment should be made after discussions with your family, your doctor, and after carefully weighing all the options available to you.

Will my age determine the treatment I receive?
More likely, the stage and type of your cancer as well as your overall general health will determine the treatment you receive.

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How can a speech pathologist help me?
Sometimes people experience changes in their ability to talk after surgery or other treatment involving the mouth or throat. In these situations, working with the speech pathologist on exercises and strategies to improve the ability to talk and communicate is very logical. However, many people are a little confused when they are having swallowing problems and their doctor refers them to a speech pathologist. Speech pathologists are experts in swallowing disorders that involve the mouth or throat. You use the same anatomical mechanism for talking that you do for swallowing, and it is this mechanism that the speech pathologist knows very well. Speech pathologists are specially trained in therapeutic exercises and techniques to rehabilitate swallowing.

The speech pathologist working in the Virginia Mason Otolaryngology Department in Seattle can be reached at (206) 223-6374.

Should my family members be tested for head and neck cancer?
Some cancers - breast, prostate, pancreatic and colon - can have a hereditary component that may make it advisable for family members to be tested. Virginia Mason offers a hereditary cancer risk consultation to help patients and their family members who are thinking about having genetic testing performed.

What do I need to do after I've had all of my treatment?
After your treatment, you will be scheduled for follow-up visits with your surgeon. During these visits you will have a physical exam and imaging tests performed. Your follow-up visits will last 5 years or longer.

Virginia Mason specialists dedicate efforts to helping patients live well beyond a diagnosis of cancer. All Virginia Mason cancer survivors are encouraged to meet with specialists within the Survivorship Clinic to talk about quality of life and what's next after their cancer treatment.

For more information about head and neck cancer please click on a link below.

How do I get to the different clinics at Virginia Mason?

Maps and directions to all of the Virginia Mason clinics are located in our online clinic directory.

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What kind of parking is available at Virginia Mason Seattle Main Clinic?

Parking at the Seattle Main Clinic
For appointments in the Buck Pavilion, please park in the Buck Garage. If your appointment is in the Lindeman Pavilion, park in the Lindeman Parking Garage, located under the building. Additional parking is available under the Benaroya Research Institute and the Terry and University Parking Lot.

Wheelchairs are available at the Ninth and Spring Street entrance.

I have questions about financial matters, who do I call?

If you have questions about your bill, call (206) 223-6601 or 1-800-356-0017, ext. 36601.

If you have questions about financial counseling, payment arrangements and Medicaid, please call (206) 223-6715 or 1-800-356-0017, ext. 36715. For questions about referral authorizations, Medicare, and other insurance questions, call (206) 625-7373, ext. 60591 or 1-800-356-0017, ext. 60591.

If you have questions about insurance coverage for chemotherapy medications, please call your insurance company directly.

If you have questions about insurance coverage on your prescriptions, please call your insurance company directly.

Is Virginia Mason’s Cancer Institute accredited?

Virginia Mason’s Cancer Services are accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the American College of Surgeons (ACoS) Commission on Cancer awarded our program a three-year accreditation in 2006. These are the two most important accrediting agencies for cancer services.

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Where can I get something to eat at the Downtown Campus?

Four Seasons Cafe: Located on the 4th floor of the hospital.

Vending Machines: Vending machines are available 24-hours-a-day on the fourth floor of the hospital near the entrance to the cafeteria.

I’d like to talk about something personal – is there a social worker or a chaplain available?

Social Work
The Virginia Mason Oncology Social Work Program helps patients cope with the impact of cancer on their lives and the lives of their families at no cost. Social, emotional, financial and discharge planning issues can be discussed. Resource and information referrals also are available.

Call (206) 223-6954 for more information or to set up an appointment.

Our non-denominational chaplains are available to provide counseling, compassionate listening, crisis intervention, grief and bereavement resources, and patient advocacy. Contact the Department of Spiritual Care by calling (206) 583-6463, ext. 36463. Chaplains are available 24 hours a day. Referrals may be left on voicemail, or for immediate assistance, call the operator to request the chaplain on call.

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