WATCH RECORDING: Head & Neck Cancers Community Forum

Head & Neck Cancer Awareness ribbon

Head & Neck Cancer Event for social mediaOn April 15, the DCI Office of Health Equity (OHE) hosted a community forum "Conversations with Our Community: What you need to know about prevention, diagnosis, and treatment of oral, head, and neck cancers."

First, Duke Cancer Institute surgical oncologist Michael Stang, MD, addressed thyroid cancer prevention, screening, and treatment. Stang is an associate professor in the Department of Surgery, section of Endocrine Surgery, division of Surgical Oncology, in the Duke University School of Medicine. He is Chief Quality Officer at Duke Raleigh Hospital.
Next, DCI head & neck surgeon Trinitia Cannon, MD, addressed oral/head/neck cancers associated with HPV. Trinitia Cannon, MD, is an associate professor in the Department of Head & Neck Surgery and Communication Sciences in the Duke University School of Medicine and the director of Head & Neck Surgical Oncology at Duke Raleigh Hospital.
Angelo Moore, PhD, RN, who leads the OHE, introduced and moderated this conversation with the community. Both Stang and Cannon both took questions at the close of the program.

Thyroid Cancer

Thyroid Cancer often presents as a lump or nodule in the thyroid. Thyroid nodules and/or cancer may or may not cause symptoms. For many patients, a finding of a cancerous thyroid nodule is found incidentally — when patients are being examined for something else.

Thyroid hormone levels are often completely normal.
"One of the common questions I get from patients is, 'Why do I have this problem if my thyroid hormone levels are normal?' " said Stang. "But the fact is that the thyroid can work just fine despite having a nodule or many nodules even with cancer present."
Very rarely is there difficulty with breathing, swallowing or voice hoarseness unless a more advanced cancer is present, which is more concerning, Stang went on to explain.
There are no known preventative measures in thyroid cancer. There have been numerous studies at Duke (and elsewhere) into flame retardants and other chemicals used in furniture and in pajamas and their possible connection with thyroid cancer.
The best "prevention," Stang said, is proactive screening and understanding which populations are most at-risk .
The incidence rate of thyroid cancer appears to be higher, he said, in the Asian or the Caucasian/White populations than in Hispanic and Black communities.

"We've shown in some of our studies at Duke into racial disparities that African Americans, when presenting with thyroid cancer, will often present at a later stage, or with slightly larger tumors, which would suggest that maybe the overall incidence isn't different but that it's being picked up later," said Stang. "Beyond being female and being in your 30s to 60s, there's also a difference in geographic distribution ... (for example) The northeastern United States has been known for some time as a hotspot for thyroid cancer... This raises the question of (possible) environmental factors that we don't understand."

LEARN MORE about thyroid cancer, including hotspots for thyroid cancer in North Carolina, which part of the U.S. has the highest rates of thyroid cancer, treatment advances, and prognosis, in the video above and through Duke Health.

Oral/Head/Neck Cancers Associated with HPV

Most patients with oropharyngeal cancer present with a long-lasting sore throat, earaches, hoarseness, swollen lymph nodes, pain when swallowing, and unexplained weight loss. Many also present with an enlarged neck mass. Others have no symptoms.

Oropharyngeal cancers are back-of-the tonsil, back-of-the-throat cancers, which are mostly caused by HPV (Human Papilloma Virus), though smoking and alcohol use can also cause oropharyngeal cancer.

There are many types of HPV and those that cause cancer are the high-risk type, including cancers of the cervix, vulva, penis and anus. HPV causes nearly all cervical cancers. It causes 40% of vaginal and vulvar cancers, 40% to 50% of penile cancers and 80% to 90% of anal cancers. It causes 90% of genital warts.

The most well-known type of HPV-associated cancer is cervical cancer (the type for which there's a screening test — the PAP smear).

However, the incidence of oropharangeal cancers is actually higher than cervical cancer, said Cannon.

HPV is transmitted to the mouth through oral sex — infecting the lining (mucosa) of the mouth and throat of the oropharynx.

"Most people who are exposed to HPV don't even know they have anything and the immune system will get rid of the infection," said Cannon. "It's very common in the U.S. Over 20 million Americans have some type of genital or oral HPV infection. About 10% of men and about 4% or women have HPV in their mouths. We don't know why some people are able to get rid of their HPV infection before it causes cancer and why others can't... The time from the first oral HPV infection to cancer takes many years."

LEARN MORE about HPV-associated cancers, including if and when to screen, latency, how to know if HPV has caused one's cancer, and HPV vaccine recommendations for teens and young adults (males and females aged 9 to 26), in the video above or through Duke Health webpages on Oral Cancers  :: Laryngeal (voice box) and Pharyngeal (throat) Cancer :: Tracheal Cancer.


Learn More About the Duke Cancer Institute Office of Health Equity

ACCESS the DCI Office of Health Equity website

Vision: To excel as the leader in reducing cancer disparities through authentic community engagement and partnerships, the delivery of seamless cancer care, and the provision of outstanding and innovative research and resources to achieve optimal health in a changing and diverse environment.

Mission: To reduce cancer disparities and promote health equity within Duke Cancer Institute's catchment area through strategic initiatives that integrate the following core areas:

  • Community Outreach & Engagement
  • Community-Facing Patient Navigation Services
  • Health Disparities Education
  • Clinical Trials Education & Workplace Diversity

Email us or call 919.684.0409 with any questions about our "Conversations with Our Community" events, patient navigation services and any other questions you might have.