Open Up: The Truth About Oral Cancer

Author: Rohan Walvekar, MD, Co-Director of ENT Services at UMC

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Oral cancer will be responsible for over 10,000 deaths and will affect over 50,000 people in the United States in 2018.

These numbers may surprise you, because, in general, oral cancers are not thought of as commonly occurring; however, Louisiana is one of the states with highest incidence of oral and pharyngeal cancers in the United States.

What is the rate of these cancers in Louisiana?

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April honors Oral Cancer Awareness, and is a good time to learn about the signs, symptoms and treatment of oral cancer, as well as the importance of early detection.

What are oral cancers and why should we care about these cancers?

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Oral cancers are cancers that affect parts of our mouth such as the gums, tongue or palate. They are most commonly caused by tobacco use and alcohol consumption. There is a new threat called Human Papilloma Virus (HPV-16) that can also cause certain types of oral and oropharyngeal cancers.

These cancers are important because they have a devastating effect on a person’s ability to communicate with the world around them by affecting speech and swallowing, breathing and appearance; treatment, which is most commonly involves surgical removal, may also have an serious impact on these functions that are so vital to us.

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Surgical management is the ideal treatment for oral cancers but comes with the possibility of a disfiguring operation (e.g. removal of jaw bone or tongue affecting appearance or speech) and loss of function.

Early detection of oral cancer plays a vital role improving quality of life and function by limiting extent of surgery and consequently side effects of treatment.

In addition, it’s important to note that early-stage tumors (i.e. tumors detected at an earlier stage of the disease) have better chances of cure (5-year disease-free survival: 60-80 percent) as compared to cancers diagnosed when they are too large or advanced (5-year disease-free survival rates: 30-40 percent).

Unlike other types of cancers that may miss detection until they are too advanced; oral cancers can be diagnosed earlier with inspection and a biopsy – both of which can be easily done during an oral cavity examination by an expert in the clinic or at a cancer-screening event.

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Patients who notice a sore, ulcer or growth in the mouth that has not responded to treatment or a lump in the neck (oral cancers can spread to lymph nodes in the neck) that does not go away either after treatment or spontaneously in 2-3 weeks, should get check by an oral cavity expert such as an ENT surgeon or Head & Neck Cancer Surgeon.

The slogan that the Head Neck Cancer Alliance (OHANCAW) promotes –“All you have to do is open your mouth” is a testament to how a simple cancer screening can save lives and improve outcomes for oral cancer patients who are diagnosed early.

Get screened – promote screening – save lives!

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Click here to learn more about our Cancer Services and future screenings.

To make an appointment with an ENT, visit our website here. 

About Dr. Walvekar

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Rohan R. Walvekar, MD, earned his doctoral degree from the University of Mumbai. After graduating in 1998, he completed a residency in Otolaryngology and Head Neck Surgery at the TN Medical College & BYL Nair Charitable Hospital, Mumbai, India, with triple honors. Subsequently, he completed two head neck surgery fellowships, and trained at at the Tata Memorial Hospital, Mumbai, which is India’s most prestigious cancer institute, catering to over 5000 new head neck cancer registrations a year. After completing an Advanced Head Neck Oncologic Surgery fellowship at the University of Pittsburgh, he became an Assistant Professor in Head Neck Surgery within the Department of Otolaryngology Head Neck Surgery at the University of Pittsburgh/VA Medical Center, prior to joining the LSU Health Sciences Center in July 2008. His clinical interests are head neck surgery and salivary endoscopy. His research interests include evaluating prognostic markers and clinical outcomes of head and neck cancer therapy and treatment of salivary gland disorders.

Colon Cancer: When & Why You Should Start Screening

Author: Guy Orangio, MD,  FACS, FASCRS, UMC Colorectal Cancer Surgeon

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Colorectal cancer is the fourth most commonly occurring cancer and the second leading cause of cancer deaths in the United States, with over 56,000 people expected to die from this disease each year. However, this cancer is preventable and curable when detected and treated early.

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March is Colorectal Cancer Awareness Month, a perfect time to learn more about  this disease and when and why to get screened. Because there are often no symptoms when it is first developing, colorectal cancer can only be caught early through regular screening.

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Most colon cancers start as non-cancerous growths called polyps. If we are able to find these polyps while they are still non-cancerous, we remove them and the cancer may be prevented. Major surgery can usually be avoided.

STAGES

Screening programs begin by classification of risk based on personal, family and medical history. People who are at increased risk may need earlier and more frequent screening depending upon the recommendation of their healthcare provider.

The American Society of Colon and Rectal Surgeons (ASCRS), which is dedicated to advancing the treatment of patients with diseases affecting the colon, rectum and anus, supports the following colorectal cancer screening guidelines:

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Recommendations Screening People at Average Risk

  • Men and women at average risk should have screening for colorectal cancer and adenomatous polyps beginning at age 50 years.
  • A colonoscopy (a test that allows the physician to look directly at the lining of the entire colon and rectum) every 10 years or a barium enema (x-ray of the colon) every 5 to 10 years are acceptable alternatives. •

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Recommendations for Screening People at Increased Risk

  • People at increased risk of colorectal cancer or adenomatous polyps include those with first-degree relative (parent, sibling or child) with colon cancer or adenomatous polyps diagnosed before 60 years
  • People with two first-degree relatives who were diagnosed at any age, should have screening colonoscopy starting at age 40 years — or ten years younger than the earliest diagnosis in their family — and then repeat every five years.
  • People with a first-degree relative with colon cancer or adenomatous polyp diagnosed at age greater than 60 years or two second degree relatives with colorectal cancer should be advised to be screened as average risk persons beginning at age 40 years
  • People with one second-degree relative (grandparent, aunt or uncle) or a third-degree relative (great-grandparent or cousin) with colorectal cancer should be screened as average risk persons

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Prevention Tips

In addition to timely and regular screening for colorectal cancer, people may be able to lower their risk of getting the disease by:

  • Avoiding foods that are high in fat.
  • Eating plenty of vegetables, fruits and other high-fiber foods.
  • Exercising regularly and maintaining a normal body weight.
  • Not smoking and drinking alcohol only in moderation.

 

For information on the Comprehensive Colorectal Cancer Program at UMC, click here.

 

About Dr. Orangio

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Guy Orangio, MD, is a board-certified colorectal surgeon at UMC and an Association Professor of Clinical Surgery at LSU Health New Orleans.

 

Mammo Is Ammo: How Early Screening Saved My Life

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Author: Tamira Armwood, Breast Cancer Survivor, University Medical Center New Orleans

I clung to the words like I do to my rosary when I pray: tightly. What was supposed to be a routine mammogram screening at age 40 turned into a quick discovery of a mass on my right breast. Immediate emotions of fear and worry consumed me. But then a moment of relief came: After the biopsy, we determined the mass was benign.

That was July 2014, but the start of my journey against cancer did not begin until six months later.

Fast-forward to January at my follow-up appointment. My radiologist performed another biopsy, but this time, the results were not so favorable. “Stage 2 Breast Cancer,” she said, which means the cancer inside of me was growing, but still contained in the breast and nearby lymph nodes.

Because of the cancer’s aggression, a treatment plan was immediately created.

I can’t remember any thoughts that weren’t concerned with my own disbelief.

I couldn’t have cancer. I have no family history of it! Did she really just say those words? How am I going to tell my daughters? What if I don’t make it?

I prayed for strength, courage, wisdom, hope and support, and the amount of each of these needs I received from my husband and daughters was nearly two-fold. Like me, they had no certainty of what was going to happen. Unlike me, fear was not their focus but, rather, the fight.

When my treatment plan was established, my breast surgeon informed me I would need a lumpectomy performed to remove the lump from my breast. In addition, I would have to experience 18 weeks of chemotherapy treatment plus 33 days of radiation. The information, tests and costs were overwhelming, but then I meditated on Jeremiah 29:11, which says, “For I know the plans I have for you. Plans to give you hope and a good future.”

What this told me was that I was not near my end.

In my diagnosis, there was hope. After my treatment, there would be a good future.

If there is anything this disease has taught me, it is how to embrace the little things in life.

On this journey, I experienced a great degree of setback: hair loss, excessive weight gain, nail discoloration, lymphedema and periods of extreme fatigue. What I gained, however, was far greater. After my diagnosis, I smiled more. I shared more information with family and, even, strangers. I got excited more. I displayed courage more.

In the most unexpected way, I have become more grateful for the little blessings this experience has given me. It has brought my family closer together, mended broken relationships and been a common cause for which we can all show passion and compassion.

If you are someone who has recently been diagnosed with cancer, my advice to you is this:

Know there is hope. Stay the course. Stand in Faith. And never quit.

I didn’t have a family history of breast cancer, but genetic breast cancers only account for about 15%-20% of all breast cancers. That’s why it’s so important to get screened.

Because of this mantra, I preserved through the fight.

Because of my annual mammogram, I became a breast cancer survivor.

Thank you so much for allowing me to share my story with you.

Tamira Armwood

 

For more information about mammograms at UMC, visit http://www.umcno.org/mammograms.

 

 

 

Facing Cancer: Head On

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Author: Rohan R. Walvekar, MD, Mervin L. Trail Endowed Chair in Head & Neck Oncology and Director of Salivary Endoscopy Service at University Medical Center New Orleans

When most people hear the word “cancer,” it’s likely that breast, prostate and lung cancers first come to mind.

However, few people realize that head and neck cancer accounts for four percent of all cancers in the United States.

Affecting twice as many men as they do women, head and neck cancers are projected to affect nearly 65,000 people in the world this year alone, killing roughly 14,000 of those afflicted.

Oral and head/neck cancers are unique because they directly affect the organs that allow us to communicate. Often living in the oral cavity of people’s mouths, these forms of cancer can also be found in the tonsils, voice box, throat, tongue or neck – specifically in a person’s lymph nodes. They leave lasting effects on appearance, speech, the sense of smell, eating, swallowing and even breathing.

Tobacco and alcohol are the most common risk factors for these forms of cancer.

Early screening is important before it’s too late.

University Medical Center New Orleans is offering free head and neck screenings on September 22 from 11 a.m. to 2 p.m. in the UMC Conference Center Room J.

If you are unfamiliar with head and neck cancer or want to learn more about the screening process, here’s what you should know:

About Screening

  • UMC is offering free oral cancer screening to the public on September 22.
  • Screening for head and neck cancer takes 1 minute or less.
  • An experienced physician will examine you using a non-painful and effective method for detecting oral cancers. He or she will examine your oral cavity and neck to evaluate and diagnose abnormal lesions of the mouth, neck, thyroid and salivary glands.
  • Oral screenings are NOT dental screenings.
  • If you are experiencing problems with your voice box or throat, a UMC physician will happily discuss these concerns in-person at the screening and then set up an appropriate follow-up appointment with our hospital’s ENT Clinic.

Why It’s Important

  • If detected early, cancer prognosis in stages 1 and 2 is significantly better than that of later cancer stages (stages 3-4).
  • Treatment can be administered with limited consequences to function.
    • Smaller and more functional operations (surgery or radiation) are possible; recovery times are much faster.
    • For late stage tumors, multiple treatment modalities have to be included (surgery + radiation + chemotherapy). Prognosis can be poor and recovery time often takes longer.
    • In later stages, there is a higher recurrence rate, longer rehabilitation and, often, permanent impact on function. This is when the need for a permanent tracheotomy, a feeding tube or disfiguring surgery comes into play.

How to Know if You Should Get Checked

If you are experiencing any of the following symptoms, it is best that you get screened:

  • Ulcer or growth or discoloration in the mouth that may not have gone away with treatment
  • Neck lump or mass (suggestive of spread to the lymph nodes in the neck)
  • Pain in the ear (with no prior ear disease)
  • Difficulty swallowing or changes in voice

How to Register for your Free Screening

Walk-ins are welcome, but we encourage you to pre-register using the form here on our website.

For more information on head and neck cancer types, symptoms, diagnosis and treatment, please visit the Head and Neck Cancer Alliance online.