Ear ache and a lump in her throat turned into an unexpected cancer journey for Cosette Calder. The 42 year old Christchurch woman was diagnosed with throat cancer two years ago – a common, yet mostly unmentioned, cancer that falls into a number of other cancers that can occur in the head and neck area.
One of these cancers is diagnosed in Canterbury/West Coast/Nelson Marlborough regions up to six times every week. Treatment of head and neck cancers often have a greater effect on a patient's quality of life, more so than the treatment of cancers found in any other part of the body.
It's a cancer that can go easily undetected – the symptoms often being very mild, and quite common. For Cosette, she was coughing a lot, and sometimes had the taste of blood in her mouth. She experienced pain when yawning. A sensitive throat made swallowing food uncomfortable. A visit to her general practitioner resulted in a referral to the Ear Nose and Throat department at Christchurch Hospital. Here she was told she was most likely experiencing the early stages of throat cancer. Further tests confirmed this.
"I was shocked and upset. However I was thankful that I had an early diagnosis, as this gave me the best chance at being cured and leading a healthy normal life after treatment," Cosette says.
Head and neck cancers often go undetected, because many people don't recognise the early warning signs and symptoms, says a Christchurch Hospital Head and Neck Surgeon, Dr Robert Allison. Since these cancers occur in a range of sites, they can cause a range of different symptoms, such as an ulcer on the tongue, a one-sided sore throat, a husky or hoarse voice, a painless lump in the neck, swallowing problems or changes to your skin in your face and neck area. Any of these symptoms that persist for more than three weeks should be checked by a doctor.
Dr Allison says treatment is complex and can involve major surgery, radiotherapy and chemotherapy. "In Christchurch we see between four and six new head and neck cancer patients per week and some types are becoming more common, particularly cancer of the throat (oropharynx) and the thyroid gland." Treatment can have a significant effect on a patient's ability to eat, swallow, or talk. Surgery can have a major effect on a patient's appearance, he adds.
Every year, July 27 is the international day of recognition for head and neck cancers, this is being recognised locally with a drop by information stall in the main foyer of Christchurch Hospital, run in conjunction with the Cancer Society. The purpose is primarily to raise awareness and educate people about the prevalence of this disease and donations can be made to the Canterbury Head and Neck Cancer support group from 9am to 12 noon.
"Many patients we treat have advanced cancer, which means treatment is more complex with a lower chance of treatment success. Even if the cancer is successfully treated, it can still have a major effect on a patient's quality of life," Dr Allison adds.
"If general practice teams and members of the public were more aware of the early signs and symptoms of head and neck cancer, then we would see patients with less advanced symptoms and consequently a better rate of treatment success."
So what causes head and neck cancers? There can be many different causes, in the past, smoking and drinking were the main contributors. While they are still key causes, cancers of the throat are increasing due to the Human Papilloma Virus. (H.P.V). Medical professionals are hopeful the recent introduction of universal immunisation with Gardasil, will mean that cancers of the throat due to H.P.V will become less common in future years.
For Cosette, her treatment journey was long and hard. First up was a minor surgery to do a biopsy on the tumor that had been discovered in her throat. The next procedure was to insert a feeding tube called a PEG into her stomach - difficulty eating is common. For two months during and after treatment, this is how Cosette feed herself.
For six weeks, Colette underwent intensive chemoradiation – which combined chemotherapy (once a week) and radiation (five times a week). Before this began she had a plastic mask made of her face and shoulders, which she would wear during radiation treatment. This mask would be placed over her head and attached to the table she lay on to keep her in the right position during the treatment. "This was the single hardest part of facing the treatment."
Two years on, Cosette says she is happy to be clear of cancer, and is now actively involved with the Cancer Society Head and Neck Cancer Group and with an online Facebook support group. "I feel happy and healthy again, but it was a gruelling experience. I have my life back and I and enjoy seeing my seven year old son passing his milestones. I am grateful for my second chance."
If you are undergoing treatment for a head and neck cancer or you are a survivor, you may be interested in joining the head and neck support group. Contact Pene Clifford, Cancer Society on 03 379 5835.
"The support group offers information, access to health professionals, and the support of others to help people through the challenges of treatment and beyond," Pene says.
Last year, the Canterbury DHB worked with Cancer Society, Canterbury - West Coast Division to develop a range of Head and Neck Cancer pamphlets for the public.
To find out more see www.canterbury-west-coast.cancernz.org.nz
Or call the Cancer Information Helpline on 0800 226 237.
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