Speaking Up

A young woman rubs her neck as she talks to a nurse
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It was during a business meeting in January 2013 that Robert Hutson, of Oviedo, noticed a lump in his throat. While it wasn't painful, it wouldn't go away.

A healthy, active nonsmoker, Robert didn't think much about it until a neighbor insisted he see a doctor. He made an appointment with Henry Ho, MD, otolaryngologist, at AdventHealth.

Robert learned he had throat cancer that had spread to his tonsils and his tongue.

A Timely Treatment Development
Although Robert would need surgery, Dr. Ho was able to offer him a less invasive alternative to a conventional procedure: transoral robotic surgery.

Traditional surgery requires an open incision in the neck that may result in speech or swallowing difficulties, he says. Robotic surgery, done through the mouth, is minimally invasive. Its been shown to improve long-term swallowing function while speeding up the recovery time.

Robert underwent surgery that March and didn't require radiation, chemotherapy or speech therapy after a portion of his tongue was removed. Then in November, during a regular follow-up visit, Dr. Ho noticed an abnormality near the surgery site.

Dr. Ho set up a CT scan right away because he was concerned, Robert says. Sure enough, the cancer had returned.

Again, Robert underwent robotic surgery, and because the cancer had reappeared so quickly, he also underwent radiation and chemotherapy. Dr. Ho doesn't foresee him needing additional treatment.

Robert learned his cancer was caused by HPV, the human papillomavirus. Most women know strains of HPV can cause cervical cancer, but there are also strains that can lead to cancer of the middle throat.

Roberts case highlights the growing trend of HPV caused head and neck cancers. (More commonly, the cancers have been associated with tobacco use.) Dr. Ho says the number of men in their 50s, like Robert, with HPV-related cancers in their throat and tonsils, is increasing. It's estimated by 2020, HPV will cause more oral than cervical cancer in the US.

The good news, says Dr. Ho, is that 90 percent of HPV throat cancers are curable.

Robert now makes an effort to educate his community about preventing HPV. I had no idea men could develop cancer from HPV, so I tell my friends they should talk with their sons as well as their daughters about HPV, says Robert. This is preventable.

Most head and neck cancers begin in the squamous cells that line the surfaces inside the head and neck. Typical symptoms include a lump or sore (for example, in the mouth) that does not heal, a sore throat that does not go away, difficulty swallowing and hoarseness or other changes in the voice.


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