Head and Neck Cancer and PET/CT

Head and neck cancer is a general description used for a number of different types malignant tumors. These occur in the mouth, throat, thyroid gland, sinuses and nasal spaces, the larynx, salivary glands, and the cervical lymph nodes. Tumors of the brain are usually not considered to be a part of this general category of tumors. Head and neck cancers that spread usually do so through the lymph nodes in the neck, although they also can spread to other parts of the body.

The American Cancer Society estimates that 57,700 Americans will be diagnosed with head and neck cancer in the United States in 2003. Although this represents only about 5 percent of all cancers diagnosed, it is particularly devastating because of the functional problems that may result from treatment. Estimates indicate that there are more than 500,000 survivors of oral and head and neck cancer living in the United States today.

The earlier the diagnosis, the less invasive the treatment that may required...this is where PET can help.

Diagnosis

Early cancers of the head and neck may be found by a number of symptoms, including the following:

• A sore on the lip or in the mouth that does not heal
• A lump on the lip or in the mouth or throat
• Unusual bleeding, pain, or numbness in the mouth
• A sore throat or a feeling that something is caught in the throat
• A change in the voice

While these symptoms may often be caused by other, less serious problems, it is important to see a doctor about any symptoms like these. Physicians screen for head and neck cancers through physical examination (the doctor probes gently around the neck and mouth areas). If an abnormal area is found, your doctor must order a biopsy to determine whether the abnormal area is cancer. A PET scan may be needed to determine how far the cancer has spread.

Treatment and Follow-Up

Treatment for head and neck cancer may involve surgery, radiation, and chemotherapy, depending on the stage of the cancer when it is first found. Aggressive cancer treatment may affect normal cells as well as cancer cells, giving patients a variety of symptoms in the follow-up period.

This is also where PET can help. PET is the most useful test that you can have when doctors are staging or re-staging your cancer because it is more accurate than CT or any other test. PET can show if the new symptoms are a result of changes from the radiation therapy or due to new growth of tumor.

Imaging with PET is also critical to looking for the return of the cancer. In many patients with head and neck cancers, a mass may remain after treatment. The mass itself may be on CT scan, but CT cannot determine if the tumor has been successfully treated or if residual cancer remains that must be treated. PET can be used to image tumor response to therapy and to detect recurrence in successfully treated lesions. After surgery and other treatments, PET is extremely important to monitor to see if the cancer cells have returned and if treatment should be re-started.

How Does PET/CT make a Difference?

• PET can diagnoses malignant nodes from normal and normal reactive nodes.
• PET can stage the extent of disease, even lymph node involvement.
• PET can monitor for recurrence and detection of residual disease following the initial therapy. Altered anatomy does not present a difficulty for PET in disease detection.

More Information

Find the support you need! Several organizations provide information and support to patients and their families, including the following:

American Cancer Society
American Public Health Association
Association of Community Cancer Centers
Cancer Care
Common Cause: Citizen Action Network
General Healthcare Advocacy: The Florence Project
Imaging for Hope
National Cancer Institute
National Coalition for Cancer Survivorship
Patients First