Faculty Group Practice Newsletter

April has been designated Oral, Head, and Neck Cancer Awareness Month, bringing attention to the symptoms and risk factors of these diseases – and the fact that diagnoses are on the rise. More than 54,000 new cases are expected in 2023.

“These cancers are most common in patients that have a history of smoking and drinking, but the human papillomavirus is increasing in prevalence, and that also causes a lot of oropharyngeal cancer,” says Orly Coblens, MD, FACS, Associate Professor in the Department of Otolaryngology.

According to the Head and Neck Cancer Alliance, head and neck cancers typically begin in the squamous cells that line the moist, mucosal surfaces inside the head and neck, like inside the mouth, nose, and throat.

Cancers of the head and neck are further categorized by the area of the head or neck in which they begin, such as the oral cavity, pharynx, larynx, paranasal sinuses and nasal cavity, or salivary glands. Cancers that begin in the salivary glands are relatively uncommon.

Males who have a history of tobacco and alcohol use account for the majority of all mucosal cancers. However, there is a growing number of 50-to-70-year-old patients who do not have this history, and whose cancer in the tonsils or base of the tongue is mediated by the HPV.

“A painless neck mass is one of the big signs in a male between the ages of 50 to 70. It’s usually a good indicator that there is some kind of malignancy,” Dr. Coblens says. Other signs and symptoms for individuals to look for include a neck mass, voice change, ear pain, difficulty swallowing, or a feeling that something is stuck in the back of the throat.

UTMB’s Head and Neck Surgery team consists of Dr. Coblens, Dr. Sepehr Shabani, Dr. Viran Ranasinghe, and Dr. Vicente Resto. They take a multidisciplinary approach to managing these cases, from the time of diagnosis throughout the patient’s treatment.

This may involve a surgical resection to remove the jaw, a portion of the tongue, or the voice box, then reconstruction to help the patient maintain the greatest quality of life possible. The surgeons employ robotic surgery for tonsil cancer, with these patients typically being males in the 50-to-70 age range who do not have a history of alcohol or tobacco use.

Throughout the course of a patient’s treatment, Dr. Coblens and her team work closely with colleagues across several disciplines, including speech pathologists, radiation oncologists, medical oncologists, and physical therapists, as well as pathologists and radiologists.

“We run a weekly tumor board on Mondays, where we have all of those services together and we discuss patients from presentation to termination of treatment paradigm to follow up,” she says.

As patients diagnosed with these conditions can be assured by the quality of care they receive at UTMB, there is also a strong emphasis on prevention.

UTMB is partnering with the Head and Neck Cancer Alliance to hold free community screenings this month. ENT will host an event April 19 from 8 a.m. to 5 p.m. at League City Campus, 2280 Gulf Freeway South, second floor. For more information or to make an appointment,  contact Roxann Ortiz; walk-ins are welcome also. The Division of Oral and Maxillofacial Surgery is also hosting a screening April 21 at 2817 Postoffice St. in Galveston. 

Additionally, the Department of Otolaryngology runs a smoking cessation program. The program entails a visit with Reagan Davis, PA-C, at the UTMB Ear Nose & Throat/Surgical Oncology clinic located in the UTMB League City Campus, on the second floor.

Any tobacco user who is willing and motivated to quit can participate. Although, most medical literature cites that these programs are more effective for smokers compared to smokeless tobacco users. Patients who have comorbid health conditions that are at an increased risk of developing cancers and/or patients that have been recommended to quit tobacco before proceeding with surgical interventions are the ideal candidates.

Most standard insurance plans approve up to eight tobacco counseling visits per year. Visits consist of identifying triggers for tobacco use and developing an individualized treatment plan for the ultimate goal of complete cessation, including pharmacotherapy and other non-invasive options. The referral for the clinic is “consult/referral smoking cessation” in Epic.

Members of the Head and Neck Surgery team see patients at their clinics at the League City Hospital Campus and at Brittany Bay in League City. Additionally, Dr. Resto sees patients in Galveston. They perform surgeries in Galveston and League City, with most major surgeries taking place at the Galveston campus.