Timothy McCulloch, MD
Division of Oral and Maxillofacial Surgery
University of Iowa Hospitals and Clinics

First Published: May 2000
Last Revised: July 2004
Peer Review Status: Internally Peer Reviewed

What is the most common form of these types of cancers?

The most common form of head and neck cancer would be a mucus membrane lesion such as an oral cavity or larynx cancer. The most common histology would be squamous cell cancer. Other very common head and neck cancers would be thyroid cancers or salivary cancers.

How can I differentiate between a mole and a cancerous growth?

The simple ways to tell a mole from a cancerous skin lesion would first be change over time. Cancerous lesions in almost all cases grow with time or change character with time. A dermatologist, a generalist or an otolaryngologist should examine any concerning or new lesion.

Can you tell me if this type of cancer is avoidable by not smoking or drinking?

With regard to the use of tobacco and alcohol, these are both known risk factors for head and neck mucous membrane cancers and avoidance will decrease the potential risk of developing these tumors. There is not a cause-and-effect relationship so unfortunately even non-smokers and non-drinkers may develop head and neck malignancies.

Where are cancerous tumors usually found with throat cancer?

Regarding throat cancers: the most common site should be the voice box, also termed the larynx. These would characteristically present with voice change, swallowing difficulties, or occasionally as a neck mass, which can be painless and soft, commonly representing an enlarged lymph node associated with a throat cancer. Other locations of throat cancer include the tongue base and esophageal inlet, which can present with painful swallowing, ear pain or enlarged lymph node in the neck.

Is it possible for a cancer to go away and then return on its own?

Spontaneous disappearance of the cancers can very rarely occur due to immune responses. However, a pattern of subsequent recurrence would be rare. More likely would be a second primary tumor in a similar location or a lymph node metastatic from the initial primary tumor.

Is there any medication/supplement that can help avoid recurrence of a base-of-tongue cancer?

No known medication or supplement has been proven to help prevent or avoid recurrence. However, maintaining a healthy diet and avoidance of such things as cigarettes can decrease the risk of recurrence.

What is the difference between a regular lymph node and an enlarged node due to malignancy?

Lymph node enlargement is common due to non-malignant causes such as viral or bacterial infections. Spontaneous resolution after the infection would then be expected. Cancerous lymph nodes tend to present without symptoms of infection and are frequently non tender and painless. However, any enlarged lymph node that remains present for greater than two weeks would be best served by a physician's examination.

Is chemo ever an option for oral cancer?

With regard to chemotherapy in oral cancers, as a single mode of treatment, it is not a good option with curative intent in isolation. However, it is not uncommonly used in combination with radiation therapy with a reasonable to good chance of local tumor cure.

Does meningitis suggest the possibility of malignancy

Meningitis as a presenting symptom of malignancy would be extremely rare. Most forms of meningitis are infectious in origin and require an appropriate evaluation by a generalist or a neurologist during which a perimeningeal malignancy would be appropriately addressed.

Is a common cold or the flu likely to reduce one's immune system sufficiently to allow the recurrence of a head/neck cancer?

Immune function is an important part of cancer surveillance. However, a flu or common cold would not significantly decrease the immune function to the point of causing a cancer recurrence without other factors involved.

Who is the best type of specialist to see if you have a suspicion of oral cancer? By the way...What are symptoms?

Regarding oral cancers, the best specialist to evaluate this would most likely be a head and neck cancer surgeon. Most head and neck cancer surgeons will be otolaryngologists, occasionally, a general surgical oncologist. The most common symptoms for oral cancer would be a visible lesion in the oral cavity often times painful, frequently tender, frequently firm to palpations, sometimes white in color, sometimes red in color and occasionally will bleed spontaneously or with trauma.

Are frequent and intense migraines reason to worry?

With regard to migraine headaches, certainly frequently and intense migraine headaches are a significant lifestyle inconvenience and should be evaluated most effectively through a neurologist or headache specialist. They would be only rarely associated with any malignant diseases.

Do cigar smoking and pipe smoking also increase risk?

Cigar and pipe smoking are associated with an increased risk primarily of oral cavity cancers

What faith do you put in to antioxidant vitamins and the like?

With regard to antioxidants, there is some evidence that antioxidants are of value in cancer prevention. The best advice would be to maintain a normal and healthy diet that included a full complement of vitamin-containing fruits and vegetables.

How common are soft tissue cancers?

Soft tissue cancers are grouped most commonly as sarcomas. In the head and neck sarcomas in general are rare. Other common head and neck cancers occur in soft tissues of the neck, which are primarily glandular such as thyroid gland and salivary gland. These types of tumors are extremely common.

When do you suspect there will be a "magic bullet" cure for malignancies?

With regard to cure for malignancies in general, the concept of a magic bullet or simple direct curative treatment will most likely be unavailable for the foreseeable future as to some degree the development of malignancies is a process of aging and is likely to remain a common event which may be delayed as people live longer lives, but unlikely prevented.

Are there any promising new treatments for head/neck cancer cure?

With regard to promising new treatments, essentially all current treatments are modifications of longstanding known and successful treatment methods such as surgery, radiation therapy and chemotherapy. However, newer combinations of treatment are under investigation, many of which improve patient quality of life if not increasing survival. Investigational studies are beginning to look into forms of immune therapy and gene therapy

I have had a mole since birth that recently got scraped off in an accident, and now bleeds a lot and easily. Should this be looked at?

A dermatologist should evaluate any skin lesion that bleeds easily with irritation.