Symptom Assessment for Head Neoplasms

Tumors of the head and neck are a spectrum of malignant neoplasms. Many, and perhaps most, are benign in origin. The differential diagnosis of malignant head and neck neoplasms requires careful clinical observation.

Results from a recent paper provides evidence to guide clinicians and patients in selecting and choosing the most appropriate therapy for specific head and neck malignancies.

This retrospective analysis of patients with brain metastases showed no correlation between tumor size, number or the tumor fraction of necrosis and prognosis. More studies are needed to assess the prognostic value of tumor number and the fraction of necrosis in individual patient cases.

The three most frequent tumors of the central nervous system originate from brain stem cells (glial tumors and gliomas, astrocytomas, oligodendrogliomas and oligoastrocytomas), whereas malignant astrocytoma and parenchymal tumors originate from neuronal progenitor cells.

A total of 521,000 people per year will see an orthopedic surgeon with a primary head and neck tumor at some point. In the United States, there were 278,000 persons with primary head, neck, and cranial cavity tumors seen at some time in 2018 (2.1 tumors per 1,000 persons in the overall U.S. population).

Head and neck lesions can often be observed on imaging studies performed for other indications. Data from a recent study warrant further investigation if they are suggestive of a lesion. For lesions suspected to be malignant or premalignant in nature, more invasive investigation and histological analysis should be ordered to obtain a definitive diagnosis.

In contrast to cervical spine and brain cancers, there is no increased risk for developing head neoplasms. The risk is lowest among men and women with more than 60 years of age with the highest risk being in those older than 90 years. There was no increase in risk of developing head neoplasms in either current or former smokers. This is in contrast to cervical stenosis and brain gliomas.

It is evident from this study that many of the head and neck cancers which were diagnosed were related to occupational exposures. These data imply that head and neck neoplasms may have a multifactorial etiology and prevention policies could result in reduced rates of these malignant tumors in the future.

The present studies illustrate how information provided by a patient to his/her clinician can lead to an improvement in symptom assessment and also change treatment decisions.

Patients with symptom assessment in the clinical trial setting have more than twice the probability of being included in a clinical trial. A protocol for symptom assessment in clinical trials to be required for all clinical trial sites to assess this symptom in CLL patients.

Although serious head neoplasms are rare, their morbidity is highly significant. However, patients suffering from head neoplasms often have long-lasting morbidity, including persistent neurological and neuro-ophthalmic deficits from the primary brain tumor, headache and/or cranial nerve dysfunction related to local recurrence, and progressive visual/hearing impairment and/or cognitive dysfunction from the metastatic disease.