There are approximately 9,000 head and neck cancer diagnoses in Italy every year. The problem is that the first signs can resemble very common ailments. And just as the season of colds and sore throats begins, oncologists remind us which symptoms not to underestimate and when to contact the doctor.
A sore throat, a hoarse voice, a blocked nostril, a small lesion in the mouth. They are so common that they almost never attract attention. Then, with autumn, they become part of the daily landscape: colds, respiratory viruses, inflammation. In most cases there is nothing to worry about. But there is a variable that can change the meaning of a symptom: how long it lasts. This is the principle of three week ruleat the center of the Make Sense Campaign, the European campaign dedicated to the prevention of head and neck tumors. The indication is simple: if a symptom compatible with these tumors persists for at least three weeks, it is advisable to talk to your doctor and, when necessary, contact a specialist. It does not mean that after 21 days a sore throat becomes suspicious of cancer. It means that a persistent ailment should not automatically be dismissed as a seasonal problem. Among the signs indicated by specialists are persistent hoarseness, sore throat, difficulty or pain in swallowing, mouth sores that do not heal, red or white spots in the mouth, a lump in the neck, persistent blockage of only one nostril, and nose bleeds. They are non-specific manifestations, which can have many other explanations. Precisely for this reason it is their persistence, rather than their simple appearance, that deserves attention.
Head and neck cancers: smoking, alcohol and HPV change the risk profile
With the expression head and neck tumors it indicates a group of neoplasms that can affect the oral cavity, tongue, pharynx, larynx, nasal cavities, paranasal sinuses and salivary glands. They are therefore not a single disease and do not all have the same risk factors. Smoking and alcohol remain among the main factors associated with many of these neoplasms. The risk increases especially when the two exposures are present together. But in recent decades the role of human papillomavirus, HPVassociated in particular with a portion of tumors of the oropharynx, including some tumors of the tonsils and base of the tongue. Prevention therefore also involves the reduction of modifiable risk factors, starting from tobacco smokemoderation of alcohol consumption and prevention of HPV infection through vaccination. But for these cancers there is no single population screening program comparable to those available for breast or colorectal. Because of this recognizing a persistent symptom can become particularly important. Early diagnosis can in fact change the path of the disease. When head and neck cancer is detected at an early stage, the chances of treatment and preservation of the functions involved may be greater. And it is precisely because these are organs that are used to speak, breathe, eat and swallow that timeliness does not only concern survival, but also the quality of life.
The early diagnosis campaign: over 180 centers in Italy
From the 21st to 26th September the Make Sense Campaign brings days dedicated to awareness and early diagnosis to Italy, with over 180 centers adherents. The initiative is promoted by the European Head and Neck Society and, in Italy, by the Italian Association of Head and Neck Oncology (AIOCC). Access methods vary from center to center and the list of participating facilities is available on the organisers’ websites. The aim is not to transform every sore throat into a suspected oncological one. It’s exactly the opposite: avoid both alarmism and underestimation. A symptom that appears and disappears quickly often belongs to the normal history of seasonal infections. A symptom that persists without explanation, however, deserves to be evaluated. There three week rule it is, after all, a common sense rule applied to health: it doesn’t say what we have, but suggests when to stop waiting for it to go away on its own and go to our doctor to ask for advice.
