Good nutrition is crucial for any patient undergoing cancer therapy, but many head and neck cancer patients struggle to get the nutrients they need as they prepare for treatment. A large proportion of patients with head and neck cancers present to their doctors with significant weight loss. Sometimes, the weight loss is unexplained. But more often, there is a clear reason for it.
Head and neck cancers commonly refer to malignant tumors originating in the tongue and throat region. Traditionally, those cancers were caused by long-term tobacco use and high alcohol consumption. But in the past three decades, more and more of these cancers have a new cause.
Bisphosphonate use has been increasing in recent years. This is a class of medications that is used to solidify bone mass and prevent fractures. They fight osteoporosis, but also prevent many cancers from spreading into skeletal bones (bone metastases). Many patients with metastatic cancers (breast, prostate, renal cell, multiple myeloma, etc.) will require these medications to counteract the devastating consequences of bone metastases.
Bisphosphonates were described as early as the 19th century, and were approved by the FDA in the 1990s for human use. Fosamax was the first FDA approved bisphosphonate in the USA. The medications come in an oral (pill) form and an IV version. Other commonly prescribed bisphosphonates include:
An uncommon but significant potential side effect o...
A palpable neck lump in any patient should raise some concern. In the case of a pediatric patient, the concern may be less, since reactive and infectious nodes in the neck can be fairly common in children. When a child has a bad episode of pharyngitis, tonsillitis (sore throat), or even a bad cold, the lymph nodes of the neck may react and become enlarged. In that type of scenario, your doctor should prescribe appropriate antibiotics to resolve the enlarged lymph nodes and follow up to make sure that the nodes have regressed.
Very few pediatric neck masses will end up being concerning. Besides infectious neck lymph nodes as stated above, some of the other more common causes of pediatric neck mass are congenital cysts. However, none of the pediatric neck masses should be ignored. A neck lump that persists for more than a few days should be looked at by a pediatrician.
In the adult population, a neck mass or lump can be much more concerning. ...
Cancers of the tongue, tonsil, and throat are being diagnosed at an increasing rate, even in the non-smoking population. Transoral Laser Microsurgery (TLM) and Trans Oral Robotic Surgery (TORS) are some of the newest intervention available for patients with these cancers.
During my first 3 years of medical school in Cleveland, I frankly did not know anything about cancers of the mouth and throat (otherwise called "Head & Neck Cancer"). Really, I did not know you could get cancer in the tongue or tonsil! It wasn't until the final year of medical school that I was exposed to the field of Head & Neck Surgery, that I realize the impact of these cancers on the quality of life of patients.
Those cancers are generally not featured in the media, and I would argue that most of us will live a lifetime without meet...
Oda D, Kim N, Mollen D. Diffuse and Deep Ulceration of Tongue. The Washington State Dental News 2011;8:37.
Harsha W, Kau R, Kim N, Hayden R. Comparison of Anti-Thrombotic Effects of Aspirin, Ketorolac, and Low Molecular Weight Heparin in Rats Set Up for Microvascular Failure. Arch Otolaryngol Head Neck Surg 2011;137:170-174.
Makowski R, Kim N. Rib and Costal Cartilage Necrosis Following Pec Major Flap Harvest. Submitted for review in Head & Neck in December 2011.
Kau R, Kim N, Patel N, Hinni M. Repair of Esophageal Perforation Due to Anterior Cervical Spine Instrumentation. Laryngoscope 2010;120(4):739-742.
Wise S, Harsha W, Kim N, Hayden R. Free Flap Survival Despite Early Loss of the Vascular Pedicle. Head Neck, n/a. doi: 10.1002/hed.21354 (e-pub ahead of publication).
Yoo M, Kim N, Houser S. Natural Draining Osteum of an Agger Nasi Cell. Ear Nose Throat J 2004;83:399-403.
Kim N, Lavertu P. Evaluation of a Thyroid Nodule. Otolaryngol Clin N Am 2003;36:17-33.
Management of Tongue Cancers. N. Kim. Oral Cancer Foundation. Seattle, WA. September 2011.
Contemporary Reconstruction of Laryngopharyngeal Defects. N. Kim. 25th Annual Madigan Head & Neck Surgery Seminar. Tacoma, WA. August 2011. Cat I CME.
Side Effects of Modern Chemoradiation in Head & Neck Cancer. N. Kim. 25th Annual Madigan Head & Neck Surgery Seminar. Tacoma, WA. August 2011. Cat I CME.
Management of Osteoradionecrosis. N. Kim. Pacific Northwest Head, Neck, and Thyroid Cancer Symposium. Seattle, WA. April 2011. Cat I CME.
Complications of Chemo and Radiation Therapy. N. Kim. Northwest Academy of Otolaryngology and Washington State Medical Association Winter 2011 Conference. Seattle, WA. January 2011. Cat I CME.
Reconstruction of Orbitomaxillary Defects. N. Kim. Swedish Neurosciences Institute ENT Exploratorium. Seattle, WA. October 2010. Cat II CME.
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