Why Younger, Healthier Non-Smokers Now Getting Head, Neck Cancer

Head and Neck Cancer
Print icon

Dr. Andrew L. Salner
Medical Director
Hartford HealthCare Cancer Institute

The “face” of head and neck cancer has changed over the past 5 years, as the cause of these cancers is shifting.

An estimated 51,000 new cases of oral cavity and pharynx cancers will occur in the United States this year, twice as common in men as in women, and the eighth-most common cancer diagnosed in men, according to the American Cancer Society.  Other types in this group include cancers of the larynx, sinuses, salivary glands, lip, ear structures and nasal cavity.

In the past, heavy use of both alcohol and tobacco contributed as the major cause of these cancers. In the last decade, Human Papilloma Virus (HPV) has become a major cause, notably in the oropharynx (tonsil and base of tongue).  Survival is improved in this group of people with HPV-related cancer, perhaps related to the more treatment-sensitive underlying biology of the disease.

This is important because younger, healthier non-smokers are now experiencing head and neck cancer, and a great percentage are living longer and therefore potentially at risk for developing late effects of therapy.

As one of the largest and most comprehensive providers of head and neck cancer care in New England, Hartford HealthCare Cancer Institute physicians and staff are committed to helping monitor patients after treatment and provide interventions as appropriate.

Therapy for these patients frequently involves either surgical removal of the cancer and involved lymph nodes in the neck or a combination of radiation therapy and chemotherapy — or some combination of all three therapies.  Given the function-rich location of these cancers, any therapy can have a short- or long-term impact on speech, swallowing, taste, smell, appetite, ability to eat and drink, appearance, breathing, mouth moisture, neck mobility, dental and jawbone health, affect and a host of other functions.

All of our therapies have evolved to help reduce adverse effects. Advanced surgery techniques and reconstruction methods help to enhance functional recovery. Intensity modulated radiation therapy (IMRT) helps to reduce radiation dose to uninvolved tissues such as salivary glands when feasible. Chemotherapy choices now include targeted molecular and immunotherapy options which may help to reduce side effects.

We encourage our patients to have a “survivorship visit” after active treatment is completed to discuss their treatment summary and survivorship care plan, a document provided to them at this visit. This includes a discussion of recommended surveillance for their cancer, wellness strategies, other cancer screenings they should embrace and possible late effects of treatment.

Some of these late effects may occur in the first five years after treatment, while some could occur even later.  The benefit of the survivorship visit is to educate the patient about these possible effects as well as to share the information with the patient’s primary care provider, who receives a copy of the survivorship care plan, so that they might help in this monitoring, even after the patient no longer sees their cancer care team.

Although late effects are not common, their identification may help to provide relief and improved quality of life for the patient.  For example, by identifying an issue such as pharyngeal dysfunction or exposed bone in the mandible, the patient and their PCP can contact our care team to gain help from speech therapy, oral surgery or other members to help address the issue.

We are collaborating with researchers at Memorial Sloan Kettering Cancer Center to develop a survivorship care plan and monitoring process that will help to support patients and families during the months and years of survivorship.  With major grants from the National Cancer Institute and the American Cancer Society, these efforts will likely help head and neck cancer patients throughout the U.S. and abroad.

Dr. Andrew Salner is a radiation oncologist and Medical Director of the Hartford HealthCare Cancer Institute at Hartford Hospital

What's New

Three people jogging on road, winter background.

Don’t Let Winter Freeze Your Exercise Routine: Here’s How

As the cold weather and snow begins to arrive in New England it’s time to start thinking of ways to keep exercising throughout the winter months.  As Dayle Stark, DPT (doctorate of physical therapy) from Hartford HealthCare Rehabilitation Network explains, there are many ways to remain active no matter what...

Gifts for the Kitchen

A Dietitian’s Good-for-You Holiday Gift Guide

As the days count down, are you still looking for meaningful gifts for those few left on your holiday shopping list? I try to consider gifts that can make 2020 more healthy and productive.  Maybe a couple of these ideas will pique your interest enough to check out further. For...

Hartford HealthCare Names First Connecticut Courage Award Winners

At the age of 15, University of New Haven football team senior running back Chris Liggio lost both his parents in a murder-suicide. Taylor Herd, a senior guard on the Quinnipiac University women’s basketball team, suffered two ACL tears in the same knee in high school, and her father has...

Healthy Diet

Cancer Survivors: Find The Power of a Healthy Diet

By Diane Avino Dietitian Gray Cancer Center Hartford HealthCare Cancer Institute at Hartford Hospital Eating well is important during all stages of life, but it’s particularly important for cancer survivorship. Adequate nutrition is a crucial part of staying well through cancer treatments as well as promoting your long-term health. Eating...


As Cancer Treatment Evolves, a Focus on Reducing Side Effects

By Dr. Omar Eton Melanoma DMT Lead Hartford HealthCare Cancer Institute Over the past two decades, there has been great progress in understanding the relationship between cancer and the defenses a patient can muster against it. This led to a Nobel Prize for James P. Allison and Tasuku Honjo in...

Stomach Cancer

Stomach Cancer: Signs You Shouldn’t Ignore

By Dr. Bret Schipper Chief of Surgical Oncology The Hospital of Central Connecticut and MidState Medical Center Stomach, or gastric, cancer in the United States is somewhat rare, but it’s important to know the signs and symptoms. According to the American Cancer Society, about 27,500 cases of stomach cancer will...

How the mind reacts to tragedy.

How the Mind Responds to Endless Bad National News

Two shootings in two days at military bases in Hawaii and Florida barely made the evening news, and these tragedies didn’t result in much water cooler talk, either. Is this the new normal? Not necessarily, according to Dr. Anthony Ng, medical director of the Hartford HealthCare Behavioral Health Network’s East...