[전문의에게서 듣는다] Kyungho Oh Professor, Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Ansan Hospital
Oh Gyeong-ho, professor of otolaryngology-head and neck surgery at Korea University Ansan Hospital, said, “Recently, the number of head and neck cancers related to human papillomavirus (HPV) is increasing, so it is necessary to prepare countermeasures.” Courtesy of Korea University Ansan Hospital
Head and neck cancer is a general term for cancers that occur between the head and collarbone, that is, inside and outside the head, face, and neck, excluding the brain and eyes. Oral cancer, oropharyngeal cancer, larynx cancer, lower pharynx cancer, sinus cancer, nasal cancer, salivary gland cancer, thyroid cancer, etc.
The head and neck area is the passage through which all nerves from the head, except for the spinal nerves, pass, and the passage through which the blood vessels from the heart pass toward the head. Although important nerves and blood vessels pass through intricately, the space of the neck excluding the spine and trachea is very narrow, so head and neck cancer requires very sophisticated surgery.
I met Oh Kyung-ho, a professor at the Department of Otorhinolaryngology-Head and Neck Surgery at Korea University Ansan Hospital. Professor Oh said, “Recently, oropharyngeal cancer (cancer of the tonsils, tongue root, and uvula) related to HPV (Human Papillomavirus), which causes cervical cancer, is increasing, so it is necessary to prepare countermeasures.”
-The medical department called ‘head and neck surgery’ is unfamiliar to the general public.
“Head and neck surgery is a specialized department that treats diseases that occur in a wide range of areas (excluding the nose and ears) from the bottom of the brain to the top of the chest in the field of otolaryngology, both internally and surgically. It applies to all diseases that occur in the neck, such as the mouth, salivary glands, pharynx, larynx, bronchi, cervical esophagus, and thyroid gland.
Head and neck cancer is closely related to smoking. Carcinogens generated when smoking start in the mouth and enter the lungs through the pharynx and larynx, increasing the risk of cancer in all exposed areas. If you get cancer while smoking, the course (prognosis) is very poor, and alcohol is also a major risk factor for cancer.
Head and neck cancers associated with human papillomavirus (HPV) are also on the rise. HPV is a virus that causes cervical cancer, etc., and is pointed out as the main cause of oropharyngeal cancer, a type of head and neck cancer.
Head and neck cancer associated with HPV is rapidly increasing in the United States and Europe. In the case of oropharyngeal cancer, men are more than four times more likely to get HPV vaccine than women, so men also get the HPV vaccine.
In order to prevent head and neck cancer, it is good to quit drinking and smoking, and if you smoke or drink frequently, you need to visit an otolaryngology-head and neck surgeon for regular checkups. HPV vaccination may also be considered to prevent HPV-associated oropharyngeal cancer.”
– Speaking of head and neck cancer symptoms.
“Because the range of the head and neck is very wide, such as the oral cavity and pharynx, the initial symptoms are also diverse. To notice symptoms early, you need to carefully observe changes in your body and have regular checkups related to head and neck cancer.
Oral cancer can cause lumps on the lips, gums, or tongue, long-lasting pain, or discomfort when chewing or swallowing food. Tongue cancer (舌癌) is the most common oral cancer, and it should be suspected if ulcers occur on the tongue and the pain is severe. Also, if you feel a lump around your ear or under your chin, it could be salivary gland cancer.
When exposed to nasopharyngeal cancer, something like a lump in the neck may be touched, or when the cancer progresses, nasal congestion and bleeding may occur. Laryngeal cancer is relatively easy to notice the symptoms, but it can be suspected when the hoarse voice gets worse for several weeks to several months. If hoarseness persists for more than two weeks after the appearance, and if you feel a foreign body in your throat or have difficulty swallowing food, you must visit a hospital.”
– Head and neck cancer treatment is difficult.
“Head and neck cancer is a cancer that develops in the organs that breathe, eat, and speak. Even if the surgery goes well, the patient may not be able to eat properly, or the facial deformity or defect may make it difficult to carry out daily activities.
For head and neck cancer, as with other cancers, extensive excision of the tumor is the principle. In the case of head and neck cancer, we should not be satisfied with removing cancer and increasing the survival rate, but also focus on preserving eating, voice, and language skills, which are important functions of the oral cavity, tongue, and larynx.”
-How does Korea University Ansan Hospital treat head and neck cancer?
“We have been operating a multidisciplinary treatment system specialized in head and neck cancer treatment for over 20 years. Unlike other cancer surgeries, head and neck cancer has been working organically for a long time because efforts must be made to preserve the function of the head and neck.
Before surgery, medical staff from related departments such as otolaryngology, head and neck surgery, radiation oncology, oncology, radiology, pathology, and nuclear medicine gather to discuss the treatment plan. In addition to surgery, various treatment options such as radiation therapy and chemotherapy are combined to establish an optimized treatment strategy and discuss rehabilitation.
Head and neck cancer surgery focuses on trying to remove the tumor while preserving voice and swallowing functions as much as possible. To this end, robotic surgery, which is easy to secure a field of view and can perform sophisticated surgery in a narrow space, is also considered. By inserting a robot arm and a 3D high-definition camera to the deepest part of the oral cavity, which is out of reach, only the affected area can be removed without scarring, and the operation time can be reduced and recovery can be achieved in one to two weeks.”
Daeik Kwon medical journalist dkwon@hankookilbo.com
