Tags: Cancer | Roger Ebert | head and neck cancer | Richard Borrowdale | M.D.

Roger Ebert’s Cancer Rare and Difficult to Treat

By Charlotte Libov   |   Friday, 05 Apr 2013 10:54 AM

Film critic Roger Ebert’s long battle with head and neck cancer demonstrates the complexity of treating this relatively rare disease, a top cancer specialist tells Newsmax Health.
“Cancers that occur in the head and neck can be very complicated to treat,” says Richard Borrowdale, M.D., division director of Head and Neck Oncologic Surgery at Loyola University Medical Center. 
Ebert died on Thursday at age 70 after a decade-long struggle against the disease.
Head and neck cancers are defined as those that arise in the nasal cavity, sinuses, lips, mouth, salivary glands, throat, or larynx (voice box). They are relatively rare, accounting for 3 to 5 percent of all cancers in the U.S. This year, an estimated 53,640 people (39,300 men and 14,340 women) will develop head and neck cancers. It is estimated that 11,520 deaths will occur this year from the disease. 
Most begin in the flat squamous cells that make up the thin surface layer (called the epithelium) of the structures in the head and neck, and, if not caught early, can move into the deeper tissues.
According to Dr. Borrowdale, symptoms of head and neck cancer include the following:
  • A mass in the mouth
  • A sore on the tongue that doesn’t heal
  • A lump in the neck that doesn’t go away with antibiotics
  • Hoarseness
  • Changes in voice
  • Problems swallowing
“Head and neck cancer is usually caused by smoking or drinking, but we are seeing more and more oral facial cancers caused by the human papillomavirus, or HPV, the same type of virus better known for causing cervical cancer,” Dr. Borrowdale told Newsmax Health. Ebert did not smoke.
“Head and neck cancer is usually treated with surgery or radiation, but in the type that is caused by HPV, a combination of radiation and chemotherapy can be very effective. The tumor almost seems to melt away,” he said.
Survival rates for head and neck cancer vary greatly, depending on where the cancer is, Dr. Borrowdale said. “If you look at survival rates for all types, in the past it might have been 50 percent and now it’s closer to 65 to 70 percent,” he said.
Because of the complicated nature of treatment, people with head and neck cancers “are better off being treated at an academic medical center, where we see 10 cases a week,” he added.
Ebert was not shy about sharing the details of his medical crisis, revealing to fans how he lost his voice and his ability to eat, and showing how surgeries and weight loss had dramatically altered his appearance. But he continued to work almost until his death.
Two days before he died, Ebert announced on his blog that he was slowing down his pace, having been diagnosed with a recurrence of cancer in his hip, which he had fractured a few years earlier. According to Dr. Borrowdale, it is not unusual for head and neck cancer to reappear after several years, after chemotherapy has kept it at bay. The spread of the malignancy would have signaled “that the cancer was no longer curable,” he said.

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